Tolerance To Extensively Heated Milk (HM) In Children With Cow's Milk Allergy: A Follow Up

Kim, J.S.; Nowak‐Węgrzyn, Anna; Noone, S.; Bencharitiwong, Ramon; Bloom, K.A.; Sampson, Hugh A.

doi:10.1016/j.jaci.2010.12.118

Cited by 4 publications

(6 citation statements)

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“…In contrast, peanut allergic patients avoid peanuts, likely leading to less Ag exposure, resulting in their having less differentiated IL-5− Th2 cells. Recent sporadic cases of EGID in peanut and milk anaphylactic patients undergoing oral immunotherapy may possibly reflect this enhanced differentiation of IL-5+ Th2 cells upon repeated food Ag exposure (41-44). Similarly, the association of asthma with perennial allergen sensitization (e.g.…”

Section: Discussionmentioning

confidence: 99%

Hierarchical IL-5 Expression Defines a Subpopulation of Highly Differentiated Human Th2 Cells

Upadhyaya

Yin

Hill

et al. 2011

The Journal of Immunology

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Each of the three Th2 cytokine genes, IL-4, IL-5, and IL-13, has different functions. We hypothesized that Th2 heterogeneity could yield Th2 subpopulations with different cytokine expression and effector functions. Using multiple approaches we demonstrate that human Th2 cells are composed of two major subpopulations: a minority IL-5+ (IL-5+, IL-4+, IL-13+) and majority IL-5− Th2 (IL-5−, IL-4+, IL-13+) population. IL-5+ Th2 cells comprised only 20% of all Th2 cells.Serial rounds of in vitro differentiation initially yielded IL-5− Th2, but required multiple rounds of differentiation to generate IL-5+ Th2 cells. IL-5+ Th2 cells expressed less CD27 and greater PD-1 than IL-5− Th2 cells, consistent with their being more highly differentiated, Ag exposed memory cells. IL-5+ Th2 cells expressed greater IL-4, IL-13, and GATA-3, relative to IL-5− Th2 cells. GATA-3 and H3K4me3 binding to the IL5 promoter was greater in IL-5+ relative to IL-5− Th2 cells, whereas there was no difference in their binding to the IL4 and IL13 promoters. Conversely, H3K27me3 binding to the IL5 promoter was greater in IL-5− Th2 cells.These findings demonstrate Th2 lineage heterogeneity, in which the IL5 gene is regulated in a hierarchical manner relative to other Th2 genes. IL-5+ Th2 cells are phenotypically distinct and have epigenetic changes consistent with greater IL5 promoter accessibility. Recurrent antigenic exposure preferentially drives the differentiation of IL-5+ Th2 cells. These results demonstrate that IL-5+ and IL-5− Th2 cells respectively represent more and less highly differentiated Th2 cell subpopulations. Such Th2 subpopulations may differentially contribute to Th2 driven pathology.

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Section: Discussionmentioning

confidence: 99%

Hierarchical IL-5 Expression Defines a Subpopulation of Highly Differentiated Human Th2 Cells

Upadhyaya

Yin

Hill

et al. 2011

The Journal of Immunology

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“…After three months, children consuming baked milk products had significantly smaller SPT and higher casein—IgG4 compared with baseline. On repeat challenges with uncooked cow’s milk, the group of children who tolerated heated cow’s milk outgrew their milk allergy quicker than the group who did not tolerate heated cow’s milk in their diet [7]. …”

Section: Studies Assessing Tolerance To Baked Proteins In Individumentioning

confidence: 99%

“…Kim [7] reported the results of the long-term follow-up of the group initially described by Nowak-Wegrzyn. The initial baked milk challenge was tolerated by 65 of 88 children.…”

Section: Studies Assessing Tolerance To Baked Proteins In Individumentioning

confidence: 99%

“…Complete and absolute avoidance of a food allergen may not be necessary in a child’s diet if they show tolerance to that food in an alternative format. Many children with cow’s milk or egg allergies tolerate foods containing baked milk [7] or egg protein [8], and the hypothesis that this might be associated with a move towards tolerance of the protein has moved dietary management strategies away from strict avoidance to allowing the inclusion of the baked protein in the diet if it is tolerated [9,10,11]. …”

Section: Introductionmentioning

confidence: 99%

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Heated Allergens and Induction of Tolerance in Food Allergic Children

et al. 2013

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Food allergies are one of the first manifestations of allergic disease and have been shown to significantly impact on general health perception, parental emotional distress and family activities. It is estimated that in the Western world, almost one in ten children have an IgE-mediated allergy. Cow’s milk and egg allergy are common childhood allergies. Until recently, children with food allergy were advised to avoid all dietary exposure to the allergen to which they were sensitive, in the thought that consumption would exacerbate their allergy. However, recent publications indicate that up to 70% of children with egg allergy can tolerate egg baked in a cake or muffin without apparent reaction. Likewise, up to 75% of children can tolerate baked goods containing cow’s milk, and these children demonstrate IgE and IgG4 profiles indicative of tolerance development. This article will review the current literature regarding the use of heated food allergens as immunotherapy for children with cow’s milk and egg allergy.

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“…Those who tolerated the heated allergen and incorporated it into their diet developed immunologic changes consistent with desensitization. In addition, preliminary findings suggest that the individuals ingesting the baked products may experience accelerated tolerance [24]. With this background, there is an ongoing large-scale trial to determine the safety and efficacy of baked goods as a form of IT for milk and egg allergy.…”

Section: Oral Immunotherapymentioning

confidence: 99%

Vaccines and Immunomodulatory Therapies for Food Allergy

Lieberman

Nowak‐Węgrzyn

2011

Curr Allergy Asthma Rep

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The apparent increase in food allergy prevalence has led to a surge in the amount of clinical and basic science research dedicated to the field. At the current time, allergen avoidance remains the cornerstone of treatment; however, recent clinical trials investigating various forms of immunotherapy have opened doors to the possible future application of an active treatment strategy in everyday practice. In addition, improvements in molecular biology have allowed researchers to purify, clone, and modify allergens, thus laying the groundwork for research on vaccines using modified proteins of decreased allergenicity. Finally, various allergen-nonspecific immunomodulatory therapies are also being investigated as a means to alter the immune response to food allergens. With these emerging therapeutic strategies, it is hoped that practitioners will have options in caring for their food-allergic patients in the near future.

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Tolerance To Extensively Heated Milk (HM) In Children With Cow's Milk Allergy: A Follow Up

Cited by 4 publications

References 0 publications

Hierarchical IL-5 Expression Defines a Subpopulation of Highly Differentiated Human Th2 Cells

Hierarchical IL-5 Expression Defines a Subpopulation of Highly Differentiated Human Th2 Cells

Heated Allergens and Induction of Tolerance in Food Allergic Children

Vaccines and Immunomodulatory Therapies for Food Allergy

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