Epitopes described in "Presence of functional, autoreactive human milk-specific IgE in infants with cow's milk allergy."

Article Authors:K M Järvinen; L Geller; R Bencharitiwong; H A Sampson
Article Title:Presence of functional, autoreactive human milk-specific IgE in infants with cow's milk allergy.
Reference Detail
Reference ID:1022755
Abstract:BACKGROUND: Occasionally, exclusively breastfed infants with cow's milk allergy (CMA) remain symptomatic despite strict maternal milk avoidance. OBJECTIVE: To determine whether or not persistence of symptoms could be due to sensitization against endogenous human milk proteins with a high degree of similarity to bovine allergens. METHODS: Ten peptides representing known bovine milk IgE-binding epitopes [-lactalbumin (ALA), - and -casein] and the corresponding, highly homologous human milk peptides were labelled with sera from 15 breastfed infants with CMA, aged 3 weeks to 12 months, and peptide (epitope)-specific IgE antibodies were assessed. Nine of the 15 breastfed infants became asymptomatic during strict maternal avoidance of milk and other major food allergens; six infants remained symptomatic until weaned. Ten older children, aged 5-15 years, with CMA were also assessed. The functional capacity of specific IgE antibodies was assessed by measuring -hexosaminidase release from rat basophilic leukaemia cells passively sensitized and stimulated with human and bovine ALA. RESULTS: A minimum of one human milk peptide was recognized by IgE antibodies from 9 of 15 (60%) milk-allergic infants, and the majority of older children with CMA. Genuine sensitization to human milk peptides in the absence of IgE to bovine milk was occasionally seen. There was a trend towards specific IgE being detected to more human milk peptides in those infants who did not respond to the maternal milk elimination diet than in those who did (P = 0.099). Functional IgE antibody to human ALA was only detected in infants not responding to the maternal diet. CONCLUSIONS AND CLINICAL RELEVANCE: Endogenous human milk epitopes are recognized by specific IgE from the majority of infants and children with CMA. Such autoreactive, human milk-specific IgE antibodies appear to have functional properties in vitro. Their role in provoking allergic symptoms in infants exclusively breastfed by mothers strictly avoiding dietary milk remains unclear.
Affiliations:Division of Pediatric Allergy & Immunology, The Mount Sinai School of Medicine, New York, NY 10029-6574, USA. kirsi.jarvinen-seppo@mssm.edu.
Reference Type:Literature
PubMed ID:22092935
Journal:Clin Exp Allergy
Journal Volume:42
Article Pages:238-47
Journal ISSN:0954-7894
Article Chemical List:Milk Proteins;Peptides;Immunoglobulin E
Article MeSH List:Animals; Antibody Specificity(genetics; immunology); Breast Feeding; Cattle; Cell Line, Tumor; Child; Child, Preschool; Female; Humans; Immunoglobulin E(blood; genetics; immunology); Infant; Infant, Newborn; Male; Milk Hypersensitivity(blood; genetics; immunology); Milk Proteins(genetics; immunology); Peptides(genetics; immunology); Rats; Sequence Homology, Amino Acid
Curation Last Updated:2015-06-07 20:11:52