Predictive value of IgE/IgG₄ antibody ratio in children with egg allergy

• Main Authors: Okamoto Shindou, Taniuchi Shoichiro, Sudo Kyoko, Hatano Yasuko, Nakano Keiji, Shimo Tomohiko, Kaneko Kazunari
• Format: Article
• Language: English
• Published: BMC 2012-06-01
• Series: Allergy, Asthma & Clinical Immunology
• Subjects: Food allergy; IgG₄; egg white; IgE; Food challenge
• Online Access: http://www.aacijournal.com/content/8/1/9
• ISSN: 1710-1484; 1710-1492

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to investigate the role of specific IgG₄ antibodies to hen’s egg white and determine their utility as a marker for the outcome of oral challenge test in children sensitized to hen’s egg</p> <p>Methods</p> <p>The hen’s egg oral food challenge test was performed in 105 sensitized children without atopic dermatitis, and the titers of egg white-specific immunoglobulin G₄ (IgG₄) and immunoglobulin E (IgE) antibodies were measured. To set the cut-off values of IgG₄, IgE, and the IgE/IgG₄ ratio for predicting positive results in oral challenges, receiver operating characteristic curves were plotted and the area under the curves (AUC) were calculated.</p> <p>Results</p> <p>Sixty-four of 105 oral challenges with whole eggs were assessed as positive. The AUC for IgE, IgG₄, and IgE/IgG₄ for the prediction of positive results were 0.609, 0.724, and 0.847, respectively. Thus, the IgE/IgG₄ ratio generated significantly higher specificity, sensitivity, positive predictive value (%), and negative predictive value (%) than the individual IgE and IgG₄. The negative predictive value of the IgE/IgG₄ ratio was 90% at a value of 1.</p> <p>Conclusions</p> <p>We have demonstrated that the egg white-specific serum IgE/IgG₄ ratio is important for predicting reactivity to egg during food challenges.</p>