原標題：牛奶口服免疫治療期間唾液IgG4增加
　　①背景：牛奶過敏(CMA)是兒童嚴重過敏反應(yīng)和過敏反應(yīng)的常見原因。口服免疫治療(OIT)在脫敏過程中發(fā)生免疫變化，顯示出良好的效果。我們在麥吉爾大學(xué)健康中心研究所的研究小組已經(jīng)證明，在牛奶OIT增量和維持階段，血清IgG4水平有所上升。我們評估了唾液IgG4在牛奶免疫治療過程中作為一種潛在的非侵入性脫敏生物標志物的變化。
　?、诜椒ǎ何覀儗Τ晒ν瓿缮夒A段的受試者在基線(治療開始前)和升級階段(200ml劑量)結(jié)束時進行了中期分析。在基線和200毫升劑量時評估唾液中牛奶蛋白組份(α-如白蛋白，β-乳球蛋白,酪蛋白)的特異性IgG4。③結(jié)果：所有三種牛奶蛋白的唾液IgG4水平從開始到200ml劑量的過程中總體呈上升趨勢。α-乳白蛋白,β-乳球蛋白,和酪蛋白唾液IgG4平均濃度基線分別是0 ng / mL (SEM 0 ng / mL), 0.5 ng / mL (SEM 0.3 ng / mL),和177.4 ng / mL (SEM 126.1 ng / mL)。相比，在劑量為200毫升的提升階段，三種蛋白的唾液IgG4平均濃度分別為:424.1 ng / mL (SEM 265.2 ng / mL), 1142 ng / mL (SEM 858.5 ng / mL),和3367 ng / mL (SEM 2443 ng / mL)。 ④結(jié)論：在IgE介導(dǎo)的兒童牛奶過敏中，牛奶OIT的成功升級階段與唾液中牛奶蛋白特異性IgG4的增加有關(guān)。這表明，它可以作為兒童口服免疫治療的一種潛在的非侵入性脫敏標記物。更大樣本的進一步評估正在進行中。
延伸閱讀
JACI                                                       
Salivary IgG4 Increases during Milk Oral Immunotherapy
DOI: https://doi.org/10.1016/j.jaci.2016.12.820
Abstract:
Rationale
Cow’s milk allergy (CMA) is a frequent cause of severe allergic reactions and anaphylaxis in children. Oral immunotherapy (OIT) has shown promising results with immunological changes occurring during desensitization. Our team at the Research Institute of McGill University Health Centre has demonstrated an increase in serum IgG4 during the escalation and maintenance phases of milk OIT. We assessed the changes in salivary IgG4 during milk OIT, as a potential non-invasive biomarker of desensitization.
Methods
We performed an interim analysis at baseline (prior to the start of treatment) and at the end of escalation phase (200ml dose) of the milk OIT protocol in subjects who successfully completed the escalation phase. Milk protein component (α-lactalbumin, β-lactoglobulin, casein) -specific salivary IgG4 were evaluated at baseline and 200ml.
Results
There was an overall increase in salivary IgG4 from baseline to 200ml for all three milk proteins. The mean salivary IgG4 concentration at baseline was 0 ng/mL (SEM 0 ng/mL), 0.5 ng/mL (SEM 0.3ng/mL), and 177.4 ng/mL (SEM 126.1ng/mL) for α-lactalbumin, β-lactoglobulin, and casein respectively; compared to the mean salivary IgG4 concentration at the 200ml dose of escalation phase: 424.1 ng/mL (SEM 265.2ng/mL), 1142 ng/mL (SEM 858.5ng/mL), and 3367 ng/mL (SEM 2443ng/mL) for α-lactalbumin, β-lactoglobulin, and casein respectively.
Conclusions
Successful escalation phase of milk OIT in IgE-mediated CMA in children is associated with an increase in salivary milk protein-specific IgG4. This suggests it could be used as a potential non-invasive biomarker of desensitization in OIT in children. Further assessment with a larger sample size is underway.
All Authors:
Bahar Torabi  Oliver Schneide Duncan Lejtenyi
Moshe Ben-Shoshan  Bruce D. Maze
　　創(chuàng)建過敏性疾病的科研、科普知識交流平臺，為過敏患者提供專業(yè)診斷、治療、預(yù)防的共享平臺。