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

Research output: Contribution to journalArticle

67 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)267-276
Number of pages10
JournalMucosal Immunology
Volume5
Issue number3
DOIs
StatePublished - May 1 2012

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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    Bedoret, D., Singh, A. K., Shaw, V., Hoyte, E. G., Hamilton, R., DeKruyff, R. H., Schneider, L. C., Nadeau, K. C., & Umetsu, D. T. (2012). Changes in antigen-specific T-cell number and function during oral desensitization in cow's milk allergy enabled with omalizumab. Mucosal Immunology, 5(3), 267-276. https://doi.org/10.1038/mi.2012.5