Specific IgG 4 antibodies to cow's milk proteins in pediatric patients with eosinophilic esophagitis

Schuyler, Alexander J.; Wilson, Jeffrey M.; Tripathi, Anju; Commins, Scott P.; Ogbogu, Princess U.; Kruzsewski, Patrice G.; Barnes, Barrett H.; McGowan, Emily C.; Workman, Lisa J.; Lidholm, Jonas; Rifas‐Shiman, Sheryl L.; Oken, Emily; Gold, Diane R.; Platts-Mills, Thomas A.E.; Erwin, Elizabeth A.

doi:10.1016/j.jaci.2018.02.049

Cited by 78 publications

(69 citation statements)

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“…56 Since then, several studies have confirmed the presence of food-specific IgG4 in the serum. 57,58 In our recent work, the calculated quantitative ratios of IgG4 ab: IgE ab specific to Bos d 4 and Bos d 5 were greater than 1000:1. 58 The implication is that this level of IgG4 can both inhibit IgE assays in vitro and prevent immediate symptoms in vivo.…”

Section: What Role Do Igg and Particularly Igg4 Antibodies Play In Comentioning

confidence: 84%

“…57,58 In our recent work, the calculated quantitative ratios of IgG4 ab: IgE ab specific to Bos d 4 and Bos d 5 were greater than 1000:1. 58 The implication is that this level of IgG4 can both inhibit IgE assays in vitro and prevent immediate symptoms in vivo. We have also asked a different question: "What is the normal level of IgG4 to common antigens in the population?"…”

Section: What Role Do Igg and Particularly Igg4 Antibodies Play In Comentioning

confidence: 84%

“…Using the Viva birth cohort in Boston, we have reported IgG4 levels at age 7 and age 13. 58,59 At age 7, the pattern of IgG4 and IgE ab to milk and peanut allergens was already dramatically different (Fig 1). At ages 12 to 13, high IgG4 levels to cow's milk proteins are relatively common; by contrast, comparably high levels of IgG4 to peanut proteins are rare.…”

Section: What Role Do Igg and Particularly Igg4 Antibodies Play In Comentioning

confidence: 98%

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α-Gal and other recent findings that have informed our understanding of anaphylaxis

Wilson

Platts-Mills

2020

Annals of Allergy, Asthma & Immunology

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A B S T R A C TObjective: To summarize the current understanding of anaphylaxis, with an emphasis on major findings that have been reported within the last 10 years. Data Sources: Queries relating to anaphylaxis, immunoglobulin E (IgE), and mast cells were conducted with PubMed and Google Scholar, searching for primary articles and review papers. Study Selections: We focused on articles written in English and which were reported in major allergy and immunology journals. Results: Anaphylaxis represents an extreme manifestation of a form of allergic immunity that appears to have evolved to protect against "toxic" threats that present at skin and mucosal barriers. The factors that have contributed to a rise in anaphylaxis are increasingly appreciated to relate to changes in hygiene and microbial ecology that have occurred with industrialization. Induction of allergen-specific IgG4 is often part of the allergic response and is associated with protection against anaphylaxis. The recognition of the a-Gal syndrome suggests that carbohydrates can be epitopes that are relevant to anaphylaxis and that IgEmediated reactions do not always occur "immediately." Conclusion: Our understanding of anaphylaxis has advanced significantly over the past 10 years. It is anticipated that ongoing research will build on this foundation to further advance our knowledge of anaphylaxis and also translate into clinically meaningful therapies.Ó 2019 Published by Elsevier Inc. on behalf of American College of Allergy, Asthma & Immunology. InstructionsCredit can now be obtained, free for a limited time, by reading the review article and completing all activity components. Please note the instructions listed below:Review the target audience, learning objectives and all disclosures.Complete the pre-test.Read the article and reflect on all content as to how it may be applicable to your practice.Complete the post-test/evaluation and claim credit earned. At this time, physicians will have earned up to 1.0 AMA PRA Category 1 Credit TM . Minimum passing score on the post-test is 70%. Overall Purpose Participants will be able to demonstrate increased knowledge of the clinical treatment of allergy/asthma/immunology and how new information can be applied to their own practices.Disclosures: TPM has a patent on an IgE assay to a-Gal and has received assay support from Phadia/Thermo-Fisher; JW has received research support from Phadia/Thermo-Fisher.

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Section: What Role Do Igg and Particularly Igg4 Antibodies Play In Comentioning

confidence: 84%

Section: What Role Do Igg and Particularly Igg4 Antibodies Play In Comentioning

confidence: 84%

Section: What Role Do Igg and Particularly Igg4 Antibodies Play In Comentioning

confidence: 98%

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α-Gal and other recent findings that have informed our understanding of anaphylaxis

Wilson

Platts-Mills

2020

Annals of Allergy, Asthma & Immunology

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“…It is unknown whether OIT-associated EoE is due to the unmasking of preexisting, lower-grade esophageal eosinophilia or the initiation of new esophageal disease. Interesting observations have shown that IgG4 levels are increased in EoE (146)(147)(148)(149). IgG4 is thought to be a neutralizing antibody because it binds weakly to activating Fcγ receptors.…”

Section: Oral Immunotherapy and The Mechanism Of Desensitizationmentioning

confidence: 99%

Mechanisms of gastrointestinal allergic disorders

Azouz¹,

Rothenberg²

2019

Journal of Clinical Investigation

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Gastrointestinal (GI) allergic disease is an umbrella term used to describe a variety of adverse, food antigen-driven, immunemediated diseases. Although these diseases vary mechanistically, common elements include a breakdown of immunologic tolerance, a biased type 2 immune response, and an impaired mucosal barrier. These pathways are influenced by diverse factors such as diet, infections, exposure to antibiotics and chemicals, GI microbiome composition, and genetic and epigenetic elements. Early childhood has emerged as a critical period when these factors have a dramatic impact on shaping the immune system and therefore triggering or protecting against the onset of GI allergic diseases. In this Review, we will discuss the latest findings on the molecular and cellular mechanisms that govern GI allergic diseases and how these findings have set the stage for emerging preventative and treatment strategies.

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“…The important role of milk as an eliciting food in patients with EoE might be related to the strong anti-milk IgG 4 response, as well as the strong type 2-and regulatory T cell-dependent immunity that are characteristic of EoE. [29][30][31]…”

Section: Eoementioning

confidence: 99%

Advances in eosinophilic diseases in 2018

Klion

Rothenberg

2019

Journal of Allergy and Clinical Immunology

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Interest in eosinophil biology and eosinophilic diseases is increasing, as reflected in a doubling of the number of annual articles focused on this topic published in the Journal of Allergy and Clinical Immunology over the past decade. Although the majority of these publications relate to eosinophilic asthma, a growing proportion of them focus on breakthroughs in the diagnosis, treatment, and pathogenesis of other eosinophilic disorders, most notably eosinophilic esophagitis. This review highlights advances in our understanding of eosinophilia and eosinophilic disorders (excluding asthma) published in the

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Specific IgG 4 antibodies to cow's milk proteins in pediatric patients with eosinophilic esophagitis

Abstract: sIgG to CM proteins are common and high titer in children with EoE. Although it is not clear that this response is pathogenic, sIgG levels imply that these antibodies are an important feature of the local immune response that gives rise to EoE.

Cited by 78 publications

References 56 publications

α-Gal and other recent findings that have informed our understanding of anaphylaxis

α-Gal and other recent findings that have informed our understanding of anaphylaxis

Mechanisms of gastrointestinal allergic disorders

Advances in eosinophilic diseases in 2018

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