COW'S MILK SPECIFIC ANTIBODIES, SERUM IMMUNOGLOBULINS COMPLEMENT FRACTIONS, LYMPHOCYTE SUBSETS AND STIMULATION OF LYMPHOCYTES IN COW'S MILK ALLERGY

Abstract

A cow's milk (CM) challenge test was done to 34 children aged from 3 to 51 months suspected to have CM allergy. Nineteen of them had clinical relapse during the CM challenge: 16 (84 %} showed cutaneous, 4 (21 %} gastrointestinal and 6 {32 %) respiratory manifestations. Fourteen showed immediate reaction within an hour of ingestion or skin contact with CM, in five the reaction took place later. Before and during the challenge test we measured serum levels of immnunoglobulins G, A, M and E, complement fractions 3 and 4, of class specific cow's milk antibodies, numbers of lymphocyte subsets and the stimulation of lymphocytes in whole blood by photohemaagglutinin, concanavalin A and betalactoglobulin. Of the 19 patients with positive CM challenge, 11 (61 %) showed increased levels of CM specific IgE antibodies, and of the remaining 8, betalactoglobulin stimulation was positive in 5, in half the helper/suppressor ratio increased during the challenge and 3 had decreased serum level of C3. None of the laboratory methods used could alone discriminate between children who reacted to CM in challenge and who did not. The combination of increased level of CM specific IgE with decreased serum IgG and C3 gave the sensitivity of 83 % and specificity of 55 % to predict clinical reaction.