PMID- 38420126
OWN - NLM
STAT- MEDLINE
DCOM- 20240301
LR  - 20240326
IS  - 1664-3224 (Electronic)
IS  - 1664-3224 (Linking)
VI  - 15
DP  - 2024
TI  - Food-specific IgG4-guided diet elimination improves allergy symptoms in children.
PG  - 1281741
LID - 10.3389/fimmu.2024.1281741 [doi]
LID - 1281741
AB  - Allergic diseases in children are major public health concerns due to their 
      widespread and rising prevalence. Food-specific immunoglobulin G4(FS-IgG4) has 
      been detected in patients with allergic diseases, but its clinical significance 
      is still debated. In the present study, 407 children with allergic diseases were 
      recruited and categorized into three groups according to the different systems 
      involved: the respiratory system group, the skin system group, and a multiple 
      system group, with the collection of clinical symptoms and serum antibodies, 
      including total immunoglobulin E (IgE), house dust mite (HDM) IgE, food-specific 
      IgE (FS-IgE), and FS-IgG4. Part of these patients were followed up with the 
      intervention of FS-IgG4-guided diet elimination with or without add-on probiotics 
      supplement. The analysis at baseline revealed distinct serum levels of different 
      antibodies. The positive rate of FS-IgG4 in all groups was more than 80%, and the 
      proportion of total IgE and FS-IgG4 both positive in the multi-system group was 
      the highest (p=0.039). Egg and milk were the foods with the highest positive rate 
      of FS-IgG4 in all groups. After diet elimination for more than 3 months, serum 
      FS-IgG4 in children significantly decreased (P<0.05) along with the improvement 
      of clinical symptoms, regardless of the add-on of probiotics. However, the 
      intervention did not impact the serum levels of total IgE, FS-IgE, and HDM IgE. 
      There was no further decrease of serum FS-IgG4 level in children followed up for 
      more than 1 year, which may be related to noncompliance with diet elimination. 
      Multivariate regression analysis revealed that the decline of serum FS-IgG4 was 
      an independent predictable factor for the improvement of clinical symptoms 
      (adjusted OR:1.412,95%CI 1.017-1.96, p=0.039). The add-on of probiotics showed 
      less efficiency in reducing the FS-IgG4 level in more patients with relief of 
      clinical symptoms. Our results confirmed the correlation between FS-IgG4 and 
      allergic diseases, and the decreased FS-IgG4 could be a useful predictor for the 
      improvement of allergic symptoms. FS-IgG4-guided diet elimination is an efficient 
      treatment for allergic diseases. Our study adds solid data to the clinical 
      significance of FS-IgG4 in allergic diseases.
CI  - Copyright (c) 2024 Yang, Yu, Yao, Diao, Li, Wang, Li, Ge, Hu and Wang.
FAU - Yang, Boyun
AU  - Yang B
AD  - Department of Allergy, Second Affiliated Hospital of Zhejiang University School 
      of Medicine, Hangzhou, Zhejiang, China.
FAU - Yu, Hanxiao
AU  - Yu H
AD  - Clinical Research Center, Second Affiliated Hospital of Zhejiang University 
      School of Medicine, Hangzhou, Zhejiang, China.
FAU - Yao, Wo
AU  - Yao W
AD  - Department of Allergy, Second Affiliated Hospital of Zhejiang University School 
      of Medicine, Hangzhou, Zhejiang, China.
FAU - Diao, Ran
AU  - Diao R
AD  - Department of Allergy, Second Affiliated Hospital of Zhejiang University School 
      of Medicine, Hangzhou, Zhejiang, China.
FAU - Li, Bohui
AU  - Li B
AD  - Department of Allergy, Second Affiliated Hospital of Zhejiang University School 
      of Medicine, Hangzhou, Zhejiang, China.
FAU - Wang, Yongfang
AU  - Wang Y
AD  - Department of Allergy, Second Affiliated Hospital of Zhejiang University School 
      of Medicine, Hangzhou, Zhejiang, China.
FAU - Li, Ting
AU  - Li T
AD  - Department of Allergy, Second Affiliated Hospital of Zhejiang University School 
      of Medicine, Hangzhou, Zhejiang, China.
FAU - Ge, Liuya
AU  - Ge L
AD  - Outpatient Care Department, Second Affiliated Hospital of Zhejiang University 
      School of Medicine, Hangzhou, Zhejiang, China.
FAU - Hu, Yingying
AU  - Hu Y
AD  - Outpatient Care Department, Second Affiliated Hospital of Zhejiang University 
      School of Medicine, Hangzhou, Zhejiang, China.
FAU - Wang, Huiying
AU  - Wang H
AD  - Department of Allergy, Second Affiliated Hospital of Zhejiang University School 
      of Medicine, Hangzhou, Zhejiang, China.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20240214
PL  - Switzerland
TA  - Front Immunol
JT  - Frontiers in immunology
JID - 101560960
RN  - 0 (Immunoglobulin G)
RN  - 0 (Allergens)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Child
MH  - Animals
MH  - Humans
MH  - *Immunoglobulin G
MH  - *Hypersensitivity
MH  - Allergens
MH  - Immunoglobulin E
MH  - Diet
MH  - Pyroglyphidae
MH  - Dermatophagoides pteronyssinus
MH  - Milk
PMC - PMC10899459
OTO - NOTNLM
OT  - IgE
OT  - allergy
OT  - children
OT  - diet elimination
OT  - food-specific IgG4
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2024/02/29 06:43
MHDA- 2024/03/01 06:44
PMCR- 2024/01/01
CRDT- 2024/02/29 04:08
PHST- 2023/08/23 00:00 [received]
PHST- 2024/01/25 00:00 [accepted]
PHST- 2024/03/01 06:44 [medline]
PHST- 2024/02/29 06:43 [pubmed]
PHST- 2024/02/29 04:08 [entrez]
PHST- 2024/01/01 00:00 [pmc-release]
AID - 10.3389/fimmu.2024.1281741 [doi]
PST - epublish
SO  - Front Immunol. 2024 Feb 14;15:1281741. doi: 10.3389/fimmu.2024.1281741. 
      eCollection 2024.