Is the Quantification of Antigen-Specific Basophil Activation a Useful Tool for Monitoring Oral Tolerance Induction in Children With Egg Allergy?

Abstract

Objectives: To assess modifications in baseline specific IgE-and anti-IgE-and antigen-specific-mediated basophil activation in egg-allergic children. The values were compared before and after the children completed specific oral tolerance induction (SOTI) with egg. Patients and Methods: We studied 28 egg-allergic children who completed SOTI with egg. The basophil activation test and specific IgE determinations with egg white, ovalbumin, and ovomucoid were performed in all 28 children. Results: A decrease in antigen-specific activation with egg white, ovalbumin, and ovomucoid was observed only at the 2 lowest concentrations used (5 and 0.05 ng/mL). Baseline activation was higher in patients with multiple food allergies and in those who developed anaphylaxis during SOTI; this activation decreased in both groups after completion of SOTI. A significant decrease was also observed in specific IgE values for egg white, ovalbumin, and ovomucoid after tolerance induction. Conclusions: Food tolerance induction is a specific process for each food that can be mediated by immunologic changes such as a decrease in specific IgE values and in specific and spontaneous basophil activation.

Immunological Outcomes of Allergen-Specific Immunotherapy in Food Allergy

“…Most studies used the CD63 activation marker for measuring basophil activation. A significant reduction in allergen-induced CD63 expression was observed in the majority of AIT studies including peanut (36,53,98,(101)(102)(103)(104), CM (94, 100), and egg (95,96,105,106) AIT.…”

“…There are numerous studies investigating BAT as a measurement of efficacy of AIT during peanut, CM, egg, peach, and apple OIT, SLIT, and EPIT (Supplementary Table 1), which generally show a reduction in the basophil activation. However, in only seven studies the BAT was one of the main outcome parameters (36,(93)(94)(95)(96)(97)(98)(99). Furthermore, correlation with the clinical outcome was only assessed in five studies (63,94,(98)(99)(100)(101).…”

“…A single center study with 28 egg allergic children (5-10 years) showed that OIT with egg white was effective. Twenty-seven out of 28 children became tolerant to egg and showed a significant decrease in CD63 expression to egg white, ovalbumin and ovomucoid (95). Another study with a combination of SLIT/OIT included 30 CM allergic children (6-12 years).…”

“…Thirteen studies also assessed the basophil marker CD203c, including studies on peanut (36,57,98,99,101,103,104,109), egg (105,106), and CM (95,100,108). Only four studies showed a significant decrease in CD203c expression upon allergen stimulation during or after the AIT protocol (36,99,105,106).…”

Basophil Activation as Marker of Clinically Relevant Allergy and Therapy Outcome

“…Also, a decrease in antigen-specific CD63 basophil expression (egg white, ovomucoid, ovalbumin) was associated with the development of tolerance to egg by specific oral tolerance induction after 15 days and 1 month, respectively, of the buildup phase (41,42).…”