Oral Challenge with Pasteurized Egg White from <i>Gallus domesticus</i>

Abstract

Background: Since raw egg may cause digestive toxic infections, we assessed whether pasteurized raw egg white is as reliable as fresh raw egg white in the diagnosis of egg allergy. Methods: Thirty-two egg-allergic children were challenged with both pasteurized and fresh raw egg white. Open challenges were carried out with increasing doses of pasteurized raw egg white and fresh raw egg white administered every 60 min. Results: Eleven children (34.4%) had positive challenges with pasteurized raw egg white. Twenty-one children (65.62%) who tolerated pasteurized raw egg white also had a negative challenge with fresh raw egg white. If the challenge with pasteurized raw egg white resulted positive, the study was stopped. The protein profile and IgE-binding capacity of both pasteurized and fresh egg white were almost identical as observed by SDS-PAGE and IgE immunoblotting. In the IgE immunoblotting-inhibition and ImmunoCAP-inhibition assays, both extracts behaved in a similar way. Conclusions: We did not find any relevant allergenic differences between fresh and pasteurized egg white. This study supports the use of pasteurized egg white in the diagnosis of allergy to fresh raw egg proteins.

Dehydrated egg white: An allergen source for improving efficacy and safety in the diagnosis and treatment for egg allergy

“…Our results are consistent with those of Jurado‐Palomo et al. who found no allergenic differences in vitro or in vivo between raw and pasteurized egg white. The present study also showed that the second heat treatment after pasteurization to obtain DEW – drying with air at 80°C for 1 min – does not affect the allergenicity of the proteins.…”

Egg OIT in clinical practice (SEICAP II): Maintenance patterns and desensitization state after normalizing the diet

“…PEW (Guillen, Valencia, Spain), whose allergenicity has been proven equivalent to raw EW , was the material used for the OIT (Supporting Information Table in the repository), which was performed in three phases. (a) The initial dose escalation phase performed in the hospital, starting with 1 mL of a 1/1000 water solution of PEW; if the patient did not develop allergic symptoms, a double dose was administered every 30 minutes until reaching undiluted PEW; if the patient did not develop DARs, they were discharged 2 hours later and the desensitization protocol was continued the next day.…”

Relative reactivity to egg white and yolk or change upon heating as markers for baked egg tolerance

“…Care must however be taken relating to potential risk of infection that could be avoided using pasteurized fractions or extracts, provided they are not cross contaminated and correctly standardized. No impact of pasteurization on egg allergenicity, as generally assumed, was confirmed on E and EW for most but not all tested children. This might be related to protein unfolding and/or aggregation, which occur during pasteurization .…”

“…Oral challenges, one performed with raw/pasteurized EW or E and the other with hard‐boiled EW or baked egg, establish the phenotype. The use of pasteurized products to avoid potential risk of infection is supported by studies reporting that they maintained their IgE‐binding capacity or allergenicity . Baked egg‐reactive subjects have larger skin prick test (SPT) wheals and greater EW‐, OVA‐ and OVM‐specific IgE levels than baked egg‐tolerant subjects but with a great deal of overlap .…”