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Utility of Measuring Cow's Milk Components Specific IgE Levels in Evaluating Clinical Tolerance of Milk Allergy
Sunday, March 6, 2016
South Exhibit Hall H (Convention Center)
Kazuyo Kuzume, Munemitsu Koizumi, Koji Nishimura, Michiko Okamoto, Eiichi Ishii
Rationale: The purpose of this study was to evaluate the utility of cow’s milk components specific IgE levels in predicting clinical tolerance in patients with milk allergy

Methods: Forty-three (43) patients with milk allergy, undertaking oral immunotherapy were examined for cow’s milk and it’s components, casein, alpha-lactalbumin (ALA), beta-lactoglobulin (BLG), and whey specific IgE levels using IMMULITE 2000 3gAllergy (3gAllergy). Also milk, casein, ALA, and BLG specific IgE levels were measured by ImmunoCAP, describing as CAPmilk, CAPcasein, CAPALA, and CAPBLG. The ratios of 9 parameters mentioned above and total IgE levels were calculated. All data were analyzed by ROC curve analysis with setting the state variables according to how much heated milk each patient could tolerate. We defined a patient who could not tolerate 10ml of heated milk as a high risk patient and one who could tolerate over 100ml of heated milk as a low risk patient.

Results: Month of ages and serum total IgE levels were not significantly different between the groups. As analyzing these data, the best five parameters to predict high risk patients were ALA/IgE, whey/IgE, milk/IgE, CAPmilk/IgE, and casein/IgE, and their AUCs were 0.904, 0.892, 0.887, 0.860, and 0.855, respectively. Also, the best five parameters to predict low risk patients were ALA/IgE, BLG, whey/IgE, milk/IgE, and casein, and their AUCs were 0.914, 0.899, 0.897, 0.892, and 0.887, respectively. CAPALA could not predict any tolerances.

Conclusions: The ALA level using 3gAllergy was the best predictor for both high risk and low risk patients, especially when considering ithe nfluence of total IgE levels.