Ovomucoid is Not Superior to Egg White Testing in Predicting Tolerance to Baked Egg

Overview

Journal J Allergy Clin Immunol Pract

Specialty Allergy & Immunology

Date 2013 Sep 10

PMID 24013255

Citations 25

Authors

Lisa M Bartnikas

William J Sheehan

Katherine S Larabee

Carter Petty

Lynda C Schneider

Wanda Phipatanakul

Affiliations

Soon will be listed here.

Abstract

Background: Children with egg allergy may tolerate baked egg products. Ovomucoid specific IgE (sIgE) antibody levels have been suggested to predict outcomes of baked egg challenges.

Objective: We determined the relationship of ovomucoid and egg white sIgE levels and egg white skin prick test (SPT) wheal size with baked egg challenge outcome.

Methods: Retrospective review of 1186 patients who underwent ovomucoid sIgE blood testing. Subset analysis was of 169 patients who underwent baked egg food challenges.

Results: Egg white sIgE, ovomucoid sIgE, and egg white SPT were different among those eating regular egg, eating baked egg only, or avoiding all egg (P < .001 for all). One hundred forty-two of 169 patients (84.0%) passed baked egg challenges. We were able to establish >90% predictive values for passing baked egg challenge for egg white sIgE, ovomucoid sIgE, and egg white SPT.No patient with egg white SPT wheal <3 mm failed a baked egg challenge. Receiver operating characteristic curve analysis of egg white sIgE, ovomucoid sIgE, and egg white SPT showed areas under the curve of 0.721, 0.645, and 0.624, respectively. No significant difference was observed among these immunologic parameters in their abilities to predict baked egg challenge outcome (P [ .301).

Conclusion: Most children with egg allergy in this study passed baked egg challenges. Ovomucoid sIgE, although a useful clinical predictor of baked egg tolerance, was not superior to egg white SPT or sIgE in predicting outcome of baked egg challenge.

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References

Caubet J, Kondo Y, Urisu A, Nowak-Wegrzyn A . Molecular diagnosis of egg allergy. Curr Opin Allergy Clin Immunol. 2011; 11(3):210-5. DOI: 10.1097/ACI.0b013e3283464d1b. View

Kato Y, Watanabe H, Matsuda T . Ovomucoid rendered insoluble by heating with wheat gluten but not with milk casein. Biosci Biotechnol Biochem. 2000; 64(1):198-201. DOI: 10.1271/bbb.64.198. View

Eggesbo M, Botten G, Halvorsen R, Magnus P . The prevalence of allergy to egg: a population-based study in young children. Allergy. 2001; 56(5):403-11. DOI: 10.1034/j.1398-9995.2001.056005403.x. View

Lieberman J, Huang F, Sampson H, Nowak-Wegrzyn A . Outcomes of 100 consecutive open, baked-egg oral food challenges in the allergy office. J Allergy Clin Immunol. 2012; 129(6):1682-4.e2. DOI: 10.1016/j.jaci.2012.04.007. View

Des Roches A, Nguyen M, Paradis L, Primeau M, Singer S . Tolerance to cooked egg in an egg allergic population. Allergy. 2006; 61(7):900-1. DOI: 10.1111/j.1398-9995.2006.01134.x. View

Liacouras C, Furuta G, Hirano I, Atkins D, Attwood S, Bonis P . Eosinophilic esophagitis: updated consensus recommendations for children and adults. J Allergy Clin Immunol. 2011; 128(1):3-20.e6. DOI: 10.1016/j.jaci.2011.02.040. View

Sampson H, Ho D . Relationship between food-specific IgE concentrations and the risk of positive food challenges in children and adolescents. J Allergy Clin Immunol. 1997; 100(4):444-51. DOI: 10.1016/s0091-6749(97)70133-7. View

Sicherer S, Sampson H . 9. Food allergy. J Allergy Clin Immunol. 2006; 117(2 Suppl Mini-Primer):S470-5. DOI: 10.1016/j.jaci.2005.05.048. View

Nowak-Wegrzyn A, Fiocchi A . Rare, medium, or well done? The effect of heating and food matrix on food protein allergenicity. Curr Opin Allergy Clin Immunol. 2009; 9(3):234-7. DOI: 10.1097/ACI.0b013e32832b88e7. View

10.

Sampson H, McCaskill C . Food hypersensitivity and atopic dermatitis: evaluation of 113 patients. J Pediatr. 1985; 107(5):669-75. DOI: 10.1016/s0022-3476(85)80390-5. View

11.

DeLong E, Delong D, Clarke-Pearson D . Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics. 1988; 44(3):837-45. View

12.

Leonard S, Sampson H, Sicherer S, Noone S, Moshier E, Godbold J . Dietary baked egg accelerates resolution of egg allergy in children. J Allergy Clin Immunol. 2012; 130(2):473-80.e1. PMC: 3428057. DOI: 10.1016/j.jaci.2012.06.006. View

13.

Alessandri C, Zennaro D, Scala E, Ferrara R, Bernardi M, Santoro M . Ovomucoid (Gal d 1) specific IgE detected by microarray system predict tolerability to boiled hen's egg and an increased risk to progress to multiple environmental allergen sensitisation. Clin Exp Allergy. 2011; 42(3):441-50. DOI: 10.1111/j.1365-2222.2011.03915.x. View

14.

Boyce J, Assaad A, Burks A, Jones S, Sampson H, Wood R . Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol. 2010; 126(6 Suppl):S1-58. PMC: 4241964. DOI: 10.1016/j.jaci.2010.10.007. View

15.

Lemon-Mule H, Sampson H, Sicherer S, Shreffler W, Noone S, Nowak-Wegrzyn A . Immunologic changes in children with egg allergy ingesting extensively heated egg. J Allergy Clin Immunol. 2008; 122(5):977-983.e1. DOI: 10.1016/j.jaci.2008.09.007. View

16.

Eigenmann P, Sicherer S, Borkowski T, Cohen B, Sampson H . Prevalence of IgE-mediated food allergy among children with atopic dermatitis. Pediatrics. 1998; 101(3):E8. DOI: 10.1542/peds.101.3.e8. View

17.

Clark A, Islam S, King Y, Deighton J, Szun S, Anagnostou K . A longitudinal study of resolution of allergy to well-cooked and uncooked egg. Clin Exp Allergy. 2011; 41(5):706-12. DOI: 10.1111/j.1365-2222.2011.03697.x. View

18.

Bernstein I, Li J, Bernstein D, Hamilton R, Spector S, Tan R . Allergy diagnostic testing: an updated practice parameter. Ann Allergy Asthma Immunol. 2008; 100(3 Suppl 3):S1-148. DOI: 10.1016/s1081-1206(10)60305-5. View

19.

Caubet J, Bencharitiwong R, Moshier E, Godbold J, Sampson H, Nowak-Wegrzyn A . Significance of ovomucoid- and ovalbumin-specific IgE/IgG(4) ratios in egg allergy. J Allergy Clin Immunol. 2012; 129(3):739-47. DOI: 10.1016/j.jaci.2011.11.053. View

20.

Ando H, Moverare R, Kondo Y, Tsuge I, Tanaka A, Borres M . Utility of ovomucoid-specific IgE concentrations in predicting symptomatic egg allergy. J Allergy Clin Immunol. 2008; 122(3):583-8. DOI: 10.1016/j.jaci.2008.06.016. View