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Clin Exp Allergy. 2016 Feb;46(2):308-16. doi: 10.1111/cea.12608.

Elevated IL-5 and IL-13 responses to egg proteins predate the introduction of egg in solid foods in infants with eczema.

Author information

1
School of Paediatrics and Child Health, The University of Western Australia, Perth, WA, Australia.
2
Telethon KIDS Institute, The University of Western Australia, Perth, WA, Australia.
3
Women's & Children's Health Research Institute, Adelaide, SA, Australia.
4
Healthy Mothers, Babies and Children, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.
5
School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, SA, Australia.
6
Children, Youth and Women's Health Service, Adelaide, SA, Australia.
7
Department of Clinical Sciences, Pediatrics, Umeå University, Umea, Sweden.
8
Department of Immunology, Princess Margaret Hospital, Perth, WA, Australia.

Abstract

BACKGROUND:

Egg allergy is a leading cause of food allergy in young infants; however, little is known about early allergen-specific T-cell responses which predate the presentation of egg allergy, and if these are altered by early egg exposure.

OBJECTIVE:

To investigate the early T-cell responses to multiple egg proteins in relation to patterns of egg exposure and subsequent IgE-mediated egg allergy.

METHODS:

Egg-specific T-cell cytokine responses (IL-5, IL-13, IL-10, IFNγ and TNFα) to ovomucoid (OM), ovalbumin (OVA), conalbumin (CON) and lysozyme (LYS) were measured in infants with eczema at 4 months of age (n = 40), before randomization to receive 'early egg' or a placebo as part of a randomized controlled trial (Australian New Zealand Clinical Trials Registry number 12609000415202) and at 12 months of age (n = 58), when IgE-mediated egg allergy was assessed by skin prick test and food challenge.

RESULTS:

In 4-month-old infants, who had not directly ingested egg, those who subsequently developed egg allergy already had significantly higher Th2 cytokine responses to multiple egg allergens, particularly elevated IL-13 responses to OVA (P = 0.004), OM (P = 0.012) and LYS (P = 0.003) and elevated IL-5 to the same antigens (P = 0.031, 0.04 and 0.003, respectively). IL-13 responses (to OVA and LYS) and IL-5 responses (to LYS) at 4 months significantly predicted egg allergy at 12 months. All responses significantly declined with age in the egg-allergic infants, and this did not appear to be modified by 'early' introduction of egg.

CONCLUSIONS & CLINICAL RELEVANCE:

Elevated egg-specific Th2 cytokine responses were established prior to egg ingestion at 4 months and were not significantly altered by introduction of egg. Th2 responses at 4 months of age predicted egg allergy at 12 months, suggesting that this could be used as a biomarker to select infants for early prevention and management strategies.

KEYWORDS:

allergy prevention; cytokines; eczema; egg allergy; egg protein; infancy

PMID:
26250967
DOI:
10.1111/cea.12608
[Indexed for MEDLINE]

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