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Food-specific IgE levels rise after positive food challenge but drop to baseline

ORLANDO, Fla. — Food-specific IgE levels appear to elevate at 1-year following a food challenge but return baseline by year 3, according to data presented here during the American Academy of Allergy, Asthma & Immunology 2012 Annual Meeting.

Yiqun Hui, MD, PhD, from the division of allergy and clinical immunology at The Mt. Sinai School of Medicine in New York, and colleagues conducted the study to determine the impact of a positive (failed) oral food challenge (OFC) on serum IgE levels.

“With a child fails an OFC, there is always a question about the encounter of the allergy during the OFC and whether that will have any impact on later recovery from food allergy,” Hui told Infectious Diseases in Children. “At this moment, we do not have that kind of data.”

The researchers found that food specific IgE levels were transiently elevated in the year following a positive OFC, but fell toward baseline afterwards.

Hui and colleagues conducted a retrospective chart review of children undergoing outpatient OFC during 2008-2010. Patients were included in the study if their serum IgE levels were measured (using ImmunoCAP, kIUA/L) to the challenged food within 1 year prior and at least one time in the 36 months following OFC.

Data from individual patients with multiple sIgE determinations were tested independently by time following the OFC and grouped as 0 to 12 months, 12 to 24 months and 24 to 36 months.

According to the study results, of the 142 children with positive OFCs, 70 had qualifying tests performed. Four of those had three post-OFC sIgE; 30 had two post-OFC sIgE; and 36 had one test.

Data pooled from all challenges showed that sIgE levels were elevated in the first year following OFC (median post-OFC vs baseline: 5.86 [1.34] vs. 2.91 [0.91]; P<.01, n=51), approached pre-challenge level in the second year (4.92 [1.00] vs. 2.49 [1.07]; P=.21, n=45), and continued to decline in the third year (1.31 [0.58] vs. 1.33 [0.85]; P<.36, n=11).

“What we can see here is that after a positive OFC, there is a trend for sIgE to increase within the first 12 months. But after that, the trend is no longer there. We can say is that the impact of a positive OFC to sIgE levels is a trending thing and does not seem to have impact the future IgE levels.” Hui said. “However, we do not have a really a good control, and a prospective study with controls is required to validate and quantify the impact of this observation.” — by Cassandra A. Richards

For more information:

• Hui Y. #114. Effect of a reaction during oral food challenges (OFC) on food-specific IgE levels (sIgE). Presented at: The AAAAI 2012 Annual Meeting; March 2-6, 2012; Orlando, Fla.

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