Changes in antigen-specific T-cell number and function during oral desensitization in cow's milk allergy enabled with omalizumab MUCOSAL IMMUNOLOGY 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; 5 (3): 267-276


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-? 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.

View details for DOI 10.1038/mi.2012.5

View details for Web of Science ID 000303011300006

View details for PubMedID 22318492