Milk-specific IgE and IgG4 responses are lower in Amish than Hutterite children
Monday, March 5, 2018
South Hall A2 (Convention Center)
Lisa J. Workman, Maya Retterer, Jeffrey M. Wilson, MD, PhD, Mark Holbreich, MD FAAAAI, Erika von Mutius, MD MSc, Michelle M Stein, PhD, Carole Ober, PhD, Thomas A.E. Platts-Mills, MD PhD FAAAAI
RATIONALE: Despite the emergence of food allergy as a significant health care burden, the mechanisms that lead to sensitization are not well understood. The Amish of Indiana and Hutterites of South Dakota represent two genetically and culturally similar farming populations in the United States that nonetheless have significant differences in the prevalence of aeroallergen sensitization and asthma. Recent work highlights a difference in endotoxin exposure related to traditional versus modern farming as one explanation, though other lifestyle differences, such as consumption of raw versus processed milk, could also be important. Here we compared specific IgE and IgG4 responses to common food in children from these two groups.

METHODS: We assessed specific-IgE to milk, wheat and peanut as well as specific-IgG4 to milk proteins (alpha-lactalbumin, beta-lactoglobulin, bovine serum albumin, caseins), egg, wheat and peanut in sera from 26 Amish and 26 Hutterite children.

RESULTS: The number of sera with detectable IgE to milk (p<0.05) and levels of IgG4 to alpha-lactalbumin >1µg/mL (p<0.01) were lower in Amish than Hutterite children. There was a similar trend for IgG4 responses to beta-lactoglobulin, bovine serum albumin, caseins and egg, but not for wheat or peanut.

CONCLUSIONS: Despite many shared genetic and lifestyle features, milk IgE and IgG4 responses are significantly lower in Amish than Hutterite children. This finding is in keeping with an inverse relationship between levels of endotoxin exposure in early childhood and aeroallergen sensitization. The fact that the difference is evident for milk, but not wheat or peanut, suggests that dietary differences may also be relevant.