Changes in antigen-specific T-cell number and function during oral desensitization in cow's milk allergy enabled with omalizumab
D Bedoret, A K Singh, V Shaw, E G Hoyte, R Hamilton, R H DeKruyff, L C Schneider, K C Nadeau, D T Umetsu, D Bedoret, A K Singh, V Shaw, E G Hoyte, R Hamilton, R H DeKruyff, L C Schneider, K C Nadeau, D T Umetsu
Abstract
Food allergy is a major public health problem, for which there is no effective treatment. We examined the immunological changes that occurred in a group of children with significant cow's milk allergy undergoing a novel and rapid high-dose oral desensitization protocol enabled by treatment with omalizumab (anti-immunoglobulin (Ig)E monoclonal antibodies). Within a week of treatment, the CD4(+) T-cell response to milk was nearly eliminated, suggesting anergy in, or deletion of, milk-specific CD4(+) T cells. Over the following 3 months while the subjects remained on high doses of daily oral milk, the CD4(+) T-cell response returned, characterized by a shift from interleukin-4 to interferon-γ production. Desensitization was also associated with reduction in milk-specific IgE and a 15-fold increase in milk-specific IgG4. These studies suggest that high-dose oral allergen desensitization may be associated with deletion of allergen-specific T cells, without the apparent development of allergen-specific Foxp3(+) regulatory T cells.
Trial registration: ClinicalTrials.gov NCT00968110.
Conflict of interest statement
Conflict of interest: the authors declare that no conflict of interest exists.
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References
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Source: PubMed