Role of conformational and linear epitopes in the achievement of tolerance in cow's milk allergy

doi:10.1046/j.1365-2222.2001.01218.x

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Wiley InterScience

Clinical & Experimental Allergy

Volume 31 Issue 10, Pages 1599 - 1606

Published Online: 7 Jul 2008

The Official Journal of the British Society for Allergy & Clinical Immunology

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Role of conformational and linear epitopes in the achievement of tolerance in cow's milk allergy

L. Vila , K. Beyer , K.-M. Järvinen , P. Chatchatee , L. Bardina and H. A. Sampson

Division of Paediatric Allergy and Immunology and Jaffe Institute for Food Allergy, The Mount Sinai Medical Center, New York, USA

Correspondence: Kirsten Beyer, Division of Paediatric Allergy & Immunology, Box-No. 1198, The Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY 10029–6574, USA. E-mail: Kirsten.Beyer@mssm.edu

KEYWORDS

cow's milk allergy • tolerance • epitope • conformational • linear • α_s1-casein • β-casein

ABSTRACT

BackgroundCow's milk (CM) is one of the leading causes of food allergy in children. However, approximately 85% of milk-allergic children become clinically tolerant to CM within the first 3 years of life. The mechanisms involved in the achievement of tolerance remain unknown.

Objective

ObjectiveTo study whether IgE antibodies from children with persistent cow's milk allergy (CMA) differ from children who become clinically tolerant in their ability to recognize linear and conformational epitopes of α_s1- and β-casein.

Methods

MethodsThirty-six milk-allergic children were included in the study: 11 of the children became clinically tolerant, and 25 had persistent CMA. Blood was obtained from all patients during the time they showed clinical reactions to milk challenge. Six non-milk-allergic children served as controls. Specific IgE antibodies against linear (denatured) as well as conformational (native) milk proteins were determined by probing dot-blots with patients' sera. In addition, selected decapeptides from α_s1- and β-casein, previously found to be suggestive of persistent CMA, were synthesized on a cellulose-derivatized membrane and probed with individual sera from 10 patients who outgrew CMA and from 10 patients with persistent CMA.

Results

ResultsAnalysis of immunodot-blots showed that, in comparison to tolerant patients, milk-allergic children with persistent symptoms had a significantly higher ratio of specific IgE antibodies to linearized than to native α- and β-casein (P < 0.005 and P < 0.02, respectively). Comparing the selected decapeptides, six of the 10 patients with persistent allergy recognized the peptide corresponding to amino acids 69–78 from α_s1-casein while none of the patients who outgrew CMA had IgE binding to this epitope.

Conclusion

ConclusionPatients with persistent milk allergy possess higher detectable levels of IgE antibodies to linear epitopes from α_s1- and β-casein than children who have achieved tolerance. Specific IgE binding to particular linear epitopes in α_s1-casein may be a predictive factor for persistence of CMA.

Submitted 21 August 2000; revised 20 March; accepted 30 April 2001.

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1365-2222.2001.01218.x About DOI