Cellular and Humoral Immunoreactivity against Hen’s Egg White: Relevance in Allergic Patients

Abstract

Background: Hypersensitivity to chicken eggs is the second most common food allergy, presenting IgE-mediated and non-IgE-mediated hypersensitivity mechanisms. While IgE-mediated hypersensitivity is easily detected, non-IgE-mediated endotypes present challenging obstacles to diagnosis. Aim: To evaluate the potential of the Tube Titration of Precipitins (TTP) and the Leukocyte Adherence Inhibition Test (LAIT) to discriminate cellular and humoral immunoreactivity against hen's egg white (albumen). Study Design: We retrospectively examined the medical charts of two cohorts of patients clinically diagnosed with diverse allergic phenotypes with clinical suspicion of non–IgE-mediated hypersensitivity against hen's egg white, who were investigated with the help of TTP or LAIT. Methodology: The registered results of the semi-quantitative serum TTP against 1 mg/mL albumen extract (TTP cohort) as well as the registered results of the Leukocyte Adherence Inhibition (LAI) percentage promoted by the ex vivo challenges against 1 mg/mL albumen extract (LAIT cohort) were distributed through a cascade distribution chart to outline the variability of the results. The statistical characteristics inside each cohort were calculated. Results: The cascade distribution for TTP with hen's egg extract showed a relatively uniform distribution. There were eight negative results. The mean was estimated at 1:156; the median was 1:64; the standard deviation was estimated at 1:185; the mode was 1:512 (appeared eighteen times). The cascade distribution for LAIT with hen's egg extract showed a relatively uniform distribution. There were twenty and one negative results. The LAI ranged from 0% to 98%. The mean was 44.2%; the median was 48.5%; the standard deviation was 32.2%; the mode was 0% (appeared 21 times).  Conclusion: Our preliminary results support that the TTP and LAIT performed with hen's albumen extract may discriminate diverse humoral and cellular immunoreactivity degrees in patients suffering from diversified allergic phenotypes.