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Garib V, Trifonova D, Freidl R, Linhart B, Schlederer T, Douladiris N, Pampura A, Dolotova D, Lepeshkova T, Gotua M, Varlamov E, Beltyukov E, Naumova V, Taka S, Kiyamova A, Katsamaki S, Karaulov A, Valenta R. Milk Allergen Micro-Array (MAMA) for Refined Detection of Cow's-Milk-Specific IgE Sensitization. Nutrients 2023; 15:nu15102401. [PMID: 37242284 DOI: 10.3390/nu15102401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/04/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Immunoglobulin-E(IgE)-mediated hypersensitivity to cow's milk allergens is a frequent cause of severe and life-threatening anaphylactic reactions. Besides case histories and controlled food challenges, the detection of the IgE antibodies specific to cow's milk allergens is important for the diagnosis of cow-milk-specific IgE sensitization. Cow´s milk allergen molecules provide useful information for the refined detection of cow-milk-specific IgE sensitization. METHODS A micro-array based on ImmunoCAP ISAC technology was developed and designated milk allergen micro-array (MAMA), containing a complete panel of purified natural and recombinant cow's milk allergens (caseins, α-lactalbumin, β-lactoglobulin, bovine serum albumin-BSA and lactoferrin), recombinant BSA fragments, and α-casein-, α-lactalbumin- and β-lactoglobulin-derived synthetic peptides. Sera from 80 children with confirmed symptoms related to cow's milk intake (without anaphylaxis: n = 39; anaphylaxis with a Sampson grade of 1-3: n = 21; and anaphylaxis with a Sampson grade of 4-5: n = 20) were studied. The alterations in the specific IgE levels were analyzed in a subgroup of eleven patients, i.e., five who did not and six who did acquire natural tolerance. RESULTS The use of MAMA allowed a component-resolved diagnosis of IgE sensitization in each of the children suffering from cow's-milk-related anaphylaxis according to Sampson grades 1-5 requiring only 20-30 microliters of serum. IgE sensitization to caseins and casein-derived peptides was found in each of the children with Sampson grades of 4-5. Among the grade 1-3 patients, nine patients showed negative reactivity to caseins but showed IgE reactivity to alpha-lactalbumin (n = 7) or beta-lactoglobulin (n = 2). For certain children, an IgE sensitization to cryptic peptide epitopes without detectable allergen-specific IgE was found. Twenty-four children with cow-milk-specific anaphylaxis showed additional IgE sensitizations to BSA, but they were all sensitized to either caseins, alpha-lactalbumin, or beta-lactoglobulin. A total of 17 of the 39 children without anaphylaxis lacked specific IgE reactivity to any of the tested components. The children developing tolerance showed a reduction in allergen and/or peptide-specific IgE levels, whereas those remaining sensitive did not. CONCLUSIONS The use of MAMA allows for the detection, using only a few microliters of serum, of IgE sensitization to multiple cow's milk allergens and allergen-derived peptides in cow-milk-allergic children with cow-milk-related anaphylaxis.
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Affiliation(s)
- Victoria Garib
- Center for Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, 1090 Vienna, Austria
- International Center of Molecular Allergology, Ministry of Innovation Development, Tashkent 100174, Uzbekistan
| | - Daria Trifonova
- Center for Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, 1090 Vienna, Austria
- Laboratory of Immunopathology, Department of Clinical Immunology and Allergy, Sechenov First Moscow State Medical University, 119991 Moscow, Russia
| | - Raphaela Freidl
- Center for Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, 1090 Vienna, Austria
| | - Birgit Linhart
- Center for Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, 1090 Vienna, Austria
| | - Thomas Schlederer
- Center for Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, 1090 Vienna, Austria
| | - Nikolaos Douladiris
- Allergy Department, 2nd Pediatric Clinic, National & Kapodistrian University of Athens, 11527 Athens, Greece
| | - Alexander Pampura
- Department of Allergology and Clinical Immunology, Research and Clinical Institute for Pediatrics Named after Yuri Veltischev at the Pirogov Russian National Research Medical University of the Russian Ministry of Health, 117997 Moscow, Russia
| | - Daria Dolotova
- Department of Bioinformatics, Department of Pediatric Surgery, Pirogov Russian National Research Medical University of the Russian Ministry of Health, 117997 Moscow, Russia
| | - Tatiana Lepeshkova
- Department of Faculty Therapy, Endocrinology, Allergology and Immunology, Ural State Medical University, 620028 Ekaterinburg, Russia
| | - Maia Gotua
- Center of Allergy and Immunology, 123182 Tbilisi, Georgia
| | - Evgeniy Varlamov
- Department of Allergology and Clinical Immunology, Research and Clinical Institute for Pediatrics Named after Yuri Veltischev at the Pirogov Russian National Research Medical University of the Russian Ministry of Health, 117997 Moscow, Russia
| | - Evgeny Beltyukov
- Department of Faculty Therapy, Endocrinology, Allergology and Immunology, Ural State Medical University, 620028 Ekaterinburg, Russia
| | - Veronika Naumova
- Department of Faculty Therapy, Endocrinology, Allergology and Immunology, Ural State Medical University, 620028 Ekaterinburg, Russia
| | - Styliani Taka
- Allergy Department, 2nd Pediatric Clinic, National & Kapodistrian University of Athens, 11527 Athens, Greece
| | - Alina Kiyamova
- International Center of Molecular Allergology, Ministry of Innovation Development, Tashkent 100174, Uzbekistan
| | - Stefani Katsamaki
- International Center of Molecular Allergology, Ministry of Innovation Development, Tashkent 100174, Uzbekistan
| | - Alexander Karaulov
- Laboratory of Immunopathology, Department of Clinical Immunology and Allergy, Sechenov First Moscow State Medical University, 119991 Moscow, Russia
| | - Rudolf Valenta
- Center for Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, 1090 Vienna, Austria
- Laboratory of Immunopathology, Department of Clinical Immunology and Allergy, Sechenov First Moscow State Medical University, 119991 Moscow, Russia
- NRC Institute of Immunology FMBA of Russia, 115478 Moscow, Russia
- Karl Landsteiner University for Health Sciences, 3500 Krems, Austria
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Freidl R, Garib V, Linhart B, Haberl EM, Mader I, Szépfalusi Z, Schmidthaler K, Douladiris N, Pampura A, Varlamov E, Lepeshkova T, Beltyukov E, Naumova V, Taka S, Nosova D, Guliashko O, Kundi M, Kiyamova A, Katsamaki S, Valenta R. Extensively Hydrolyzed Hypoallergenic Infant Formula with Retained T Cell Reactivity. Nutrients 2022; 15:nu15010111. [PMID: 36615769 PMCID: PMC9824366 DOI: 10.3390/nu15010111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/29/2022] [Accepted: 12/07/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Immunoglobulin E (IgE)-mediated cow's milk allergy (CMA) can be life-threatening and affects up to 3% of children. Hypoallergenic infant formulas based on hydrolyzed cow's milk protein are increasingly considered for therapy and prevention of cow's milk allergy. The aim of this study was to investigate the allergenic activity and ability to induce T cell and cytokine responses of an infant formula based on extensively hydrolyzed cow's milk protein (whey) (eHF, extensively hydrolyzed formula) supplemented with Galactooligosaccharides (GOS) and Limosilactobacillus fermentum CECT5716 (LF) to determine its suitability for treatment and prevention of CMA. METHODS eHF and standard protein formula based on intact cow's milk proteins (iPF) with or without Galactooligosaccharide (GOS) and Limosilactobacillus fermentum CECT5716 (LF) were investigated with allergen-specific antibodies and tested for IgE reactivity and allergenic activity in basophil degranulation assays with sera from cow's milk (CM)-allergic infants/children. Their ability to stimulate T cell proliferation and cytokine secretion in cultured peripheral blood mononuclear cells (PBMC) from CM-allergic infants and children was studied with a FACS-based carboxyfluorescein diacetate succinimidyl ester (CFSE) dilution assay and xMAP Luminex fluorescent bead-based technology, respectively. RESULTS An eHF supplemented with GOS and LF exhibiting almost no IgE reactivity and allergenic activity was identified. This eHF induced significantly lower inflammatory cytokine secretion as compared to an intact protein-based infant formula but retained T cell reactivity. CONCLUSIONS Due to strongly reduced allergenic activity and induction of inflammatory cytokine secretion but retained T cell reactivity, the identified eHF may be used for treatment and prevention of CMA by induction of specific T cell tolerance.
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Affiliation(s)
- Raphaela Freidl
- Center for Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, A-1090 Vienna, Austria
| | - Victoria Garib
- Center for Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, A-1090 Vienna, Austria
- International Center of Molecular Allergology, Ministry of Innovation Development, Tashkent 100174, Uzbekistan
| | - Birgit Linhart
- Center for Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, A-1090 Vienna, Austria
| | | | - Isabelle Mader
- HiPP GmbH & Co. Vertrieb KG, 85276 Pfaffenhofen, Germany
| | - Zsolt Szépfalusi
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Pulmonology, Allergy and Endocrinology, Comprehensive Center of Pediatrics, Medical University Vienna, A-1090 Vienna, Austria
| | - Klara Schmidthaler
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Pulmonology, Allergy and Endocrinology, Comprehensive Center of Pediatrics, Medical University Vienna, A-1090 Vienna, Austria
| | - Nikos Douladiris
- Allergy Department, 2nd Pediatric Clinic, National & Kapodistrian University of Athens, 11527 Athens, Greece
| | - Alexander Pampura
- Department of Allergology and Clinical Immunology, Research and Clinical Institute for Pediatrics Named after Yuri Veltischev at the Pirogov Russian National Research Medical University of the Russian Ministry of Health, 117997 Moscow, Russia
| | - Evgeniy Varlamov
- Department of Allergology and Clinical Immunology, Research and Clinical Institute for Pediatrics Named after Yuri Veltischev at the Pirogov Russian National Research Medical University of the Russian Ministry of Health, 117997 Moscow, Russia
| | - Tatiana Lepeshkova
- Department of Faculty Therapy, Endocrinology, Allergology and Immunology, Ural State Medical University, 620014 Ekaterinburg, Russia
| | - Evgeny Beltyukov
- Department of Faculty Therapy, Endocrinology, Allergology and Immunology, Ural State Medical University, 620014 Ekaterinburg, Russia
| | - Veronika Naumova
- Department of Faculty Therapy, Endocrinology, Allergology and Immunology, Ural State Medical University, 620014 Ekaterinburg, Russia
| | - Styliani Taka
- Allergy Department, 2nd Pediatric Clinic, National & Kapodistrian University of Athens, 11527 Athens, Greece
| | - Dina Nosova
- Allergy Department, UNIMED Laboratories, 119049 Moscow, Russia
| | - Olga Guliashko
- Allergy Department, UNIMED Laboratories, 119049 Moscow, Russia
| | - Michael Kundi
- Department for Environmental Heath, Center for Public Health, Medical University of Vienna, A-1090 Vienna, Austria
| | - Alina Kiyamova
- International Center of Molecular Allergology, Ministry of Innovation Development, Tashkent 100174, Uzbekistan
| | - Stefani Katsamaki
- International Center of Molecular Allergology, Ministry of Innovation Development, Tashkent 100174, Uzbekistan
| | - Rudolf Valenta
- Center for Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, A-1090 Vienna, Austria
- NRC Institute of Immunology FMBA of Russia, 119049 Moscow, Russia
- Laboratory of Immunopathology, Department of Clinical Immunology and Allergy, Sechenov First Moscow State Medical University, 119049 Moscow, Russia
- Karl Landsteiner University for Health Sciences, 3500 Krems, Austria
- Correspondence: ; Tel.: +43-1-40400-50420
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