CLINICAL AND IMMUNOLOGICAL ASPECTS OF FOOD ALLERGY IN CHILDHOOD

ABSTRACT. 36 children of atopic mothers (group I) and 17 children of healthy mothers (Group II) were selected for a study of the relationship between the onset of atopic symptoms and the occurrence of IgE-, IgG- and IgA-antibodies, with special regard to the development of antibodies to β-lactoglobulin (BLG) and ovomucoid (OM). Atopic symptoms developed in 50 % of the children in group I and in no one of group II. The cord serum IgE concentrations were shown to be predictive of subsequent development of atopic symptoms, and the levels remained higher in group I than in group II. The serum IgA concentrations were low and within normal limits in both groups and bore no relationship to atopic heredity or to later development of atopic symptoms. However, at six months of age the serum IgA levels were lower in the children of atopic mothers (p<0.1). Low titers of IgE antibodies to BLG and OM occurred in several children of Group I but seemed to have clinical significance in only a few children. IgG antibodies to BLG and OM were shown to occur frequently and in equivalent titers in cord sera and maternal sera indicating a transport across the placental barrier. High cord titers were found in children of group I who remained asymptomatic, indicating a possible protective function by these antibodies. The titers to BLG were higher in group I than in group II. Most titers decreased during the first months of life and then a rise occurred.     

A FOLLOW-UP STUDY OF INFANTS WITH ADVERSE REACTIONS TO COW'S MILK I. Serum IgE, Skin Test Reactions and RAST in Relation to Clinical Course

Abstract. 47 infants with cow's milk sensitivity were followed for a period varying between 6 months to 4 years (mean 28 months). The age at onset of symptoms varied between 14 days to 20 months. The clinical course was studied in relation to reaginic allergy by use of serum IgE, skin prick test and RAST. Infants with an immediate onset of symptoms from the gastrointestinal tract and the skin after cow's milk intake were discerned as a distinct entity having a high frequency of atopy in the family, positive skin tests and positive RASTs to milk (71%). Cases with delayed reactions to cow's milk seldom had a positive RAST or skin test. Most infants of both groups showed an increasing tolerance to milk. In RAST positive infants the RAST-titers increased significantly after onset of symptoms. After having reached a peak the titers subclined in several cases. The titers did not reflect the degree of milk sensitivity during the follow-up period. However, infants who developed high titers seemed to develop tolerance more slowly than infants with low titers.     

Clinical and immunological aspects of food allergy in childhood. I. Estimation of IgG, IgA and IgE antibodies to food antigens in children with food allergy and atopic dermatitis

Sixtynine children with case histories of food intolerance and 30 food tolerant children with atopic dermatitis have been investigated regarding serum IgE levels and IgE-, IgG, and IgA-antibodies to some common foods. Children with food intolerance had significantly higher IgE levels and to a larger extent specific IgE antibodies to the tested allergens. IgE antibodies to cow's milk were found in 71% of the children with histories of cow's milk allergy but occurred also in similar titers in 27% of milk tolerant children with other food allergies. IgE antibodies to egg-white occurred in 88% of egg allergies, but low and moderate titers were also found in 17% of children without food intolerance. However, all children with high titers had symptoms of egg allergy. IgE antibodies to the fish allergen were only found in fish allergic children while IgE antibodies to the fish allergen were only found in fish allergic children while IgE antibodies to soy-bean and green peas were found less consistently. The level of serum IgA antibodies to milk was similar in both groups. The IgG antibody titers to all tested food antigens seemed to parallel the IgE antibody titer to the same food. It was not possible to correlate the IgG antibody titers to symptoms.