J ALLERGY CLIN IMMUNOL
VOLUME 139, NUMBER 2
443 In vitro Hypoallergenicity of Peanut Protein-
Blueberry Polyphenol Aggregate Particles
Nathalie Plundrich1, Rishipal Bansode2, Leonard Williams2, and Mary
Ann Lila1; 1North Carolina State University, Plants for Human Health
Institute, Kannapolis, NC, 2North Carolina Agricultural and Technical
State University, Center for Excellence in Post-Harvest Technologies,
Kannapolis, NC.
RATIONALE: The effector phase of the peanut (PN) allergic reaction
involves crosslinking of PN allergen epitopes with PN-specific IgE located
on mast cell and basophil surfaces causing them to degranulate and to
release inflammatory compounds. Plant-derived polyphenolic compounds
are able to bind to proteins. In this study, stable aggregate particles
comprised of PN proteins and blueberry pomace polyphenols were
investigated for their allergen response potential by binding to IgE in vitro.
METHODS: Peanut protein-blueberry pomace polyphenol aggregate
particles were created by complexing lowbush blueberry (Vaccinium an-
gustifolium) pomace polyphenols with roasted PN flour. Particles contain-
ing 5 to 40% polyphenols were created. For the detection of PN-specific
IgE binding by PN proteins, immunoblotting was performed with pooled
plasma from seven PN-allergic individuals. RBL-2H3 mast cells were
exposed to aggregate particles or PN flour and evaluated for markers of
degranulation (b-hexosaminidase and histamine).
RESULTS: IgE binding capacity to PN proteins in aggregate particles was
significantly decreased (p<0.05) in the 15, 30 and 40% polyphenol samples
by 21, 30 and 31% compared to uncomplexed PN proteins, respectively.
Anti-DNP-IgE-sensitized RBL-2H3 cells challenged with DNP-BSA and
Ionomycin in the presence of aggregate particles were evaluated for
their release of b-hexosaminidase and histamine. Aggregate particles with
lower %polyphenol concentrations appeared to mitigate Ionomycin
induced-degranulation.
CONCLUSIONS: Results suggest the modification of PN proteins with
blueberry pomace polyphenols led to the formation of aggregate particles
with reduced allergenic potential. Future trials are warranted to investigate
the immunomodulatory mechanisms of the aggregate particles.
444 Building a Pediatric Food Allergy Natural History
Registry
Jesse Blumenstock, MS (c)1, Serena Chan, PhD2, Ruixuan Zhou3, Mar-
jorie Yarbrough, MPH1, Madeline Walkner4, Paul J. Bryce, PhD5,6,
Anne Marie Singh, MD7,8, and Ruchi S. Gupta, MD, MPH1,9; 1North-
western University, Chicago, IL, 2Univeristy of Illinois, Champaign, IL,
3
University of Illinois, Champaign, IL, 4Ann and Robert H Lurie Chil-
dren’s Hospital - Chicago, Chicago, IL, 5Northwestern Feinberg School
of Medicine, Chicago, IL, 6Division of Allergy-Immunology, Department
of Medicine, Northwestern University Feinberg School of Medicine,
Chicago, IL, 7Division of Allergy & Immunology, Department of Pediat-
rics, Northwestern University Feinberg School of Medicine, Chicago, IL,
8
Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL,
9
Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL.
RATIONALE: Despite affecting up to 6 million children nationwide, the
natural history of food allergy is not well understood. Food allergy affects
individuals through both clinical manifestations and its impact on family
and community. To obtain a comprehensive understanding of the natural
course of food allergy and its effects, we have developed a prospective
pediatric food allergy registry.
METHODS: We have begun recruiting families with one or more children
with food allergy into a prospective registry. We are analyzing children’s
medical records and surveying caregivers about reaction history and how
food allergy affects their child and their family. This data will be analyzed
to determine reaction patterns, predictors of tolerance and severity, and
psychosocial effects.
RESULTS: Currently, 182 families are enrolled from two clinics. Follow-
up surveys cover quality of life, GI symptoms, parental social support,
anxiety and child-peer relations, self-efficacy, accidental ingestion, therapy
Abstracts AB139
choice, food allergy knowledge, school/daycare experience, and manage-
ment of comorbid conditions.
Preliminary results of completed subjects (N5158) indicate respondents
are mostly male (65.2%), white (76.6%), with an average age of 6.4 years
(SD53.7). The majority of respondents (34.2%, N554) are currently
allergic to five or more foods. Peanut (67.1%, N5106), tree nuts (65.2%,
N5103), and egg (32.3%, N551) are the most prevalent allergens.
CONCLUSIONS: As additional data is collected, we will analyze parent-
reported survey responses in conjunction with lab and food challenge data
to determine predictors of tolerance, severity, and psychosocial effects of
food allergy on the lives of children and their families.
445 Tolerance of Partially Hydrolyzed Whey Formula in
Cow's Milk Allergic Patients
Maureen S. Egan, MD1, Tricia D. Lee, MD2, Jade Andrade2, Galina
Grishina, MS2, Michelle Mishoe2, Gustavo Gimenez, MSc2, Hugh A.
Sampson, MD, FAAAAI3, and Supinda Bunyavanich3,4; 1Section of Al-
lergy & Immunology, Department of Pediatrics. Children’s Hospital of
SUNDAY
Colorado., Denver, CO, 2Division of Allergy & Immunology, Department
of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY,
3
Department of Pediatrics, Icahn School of Medicine at Mount Sinai,
New York, NY, 4Department of Genetics and Genomic Sciences, Icahn
School of Medicine at Mount Sinai, New York, NY.
RATIONALE: The identification of children with cow’s milk allergy
(CMA) who can tolerate partially hydrolyzed whey formula (pHWF) could
enable their use of pHWF, which is better tasting and less expensive than
hypoallergenic formulas. We sought to identify the current prevalence and
immune profiles of children with CMA who tolerate pHWF.
METHODS: Children with cow’s milk sensitization (by skin prick test
(SPT) or specific IgE (sIgE)) and recent reaction to cow’s milk underwent
oral food challenge (OFC) to pHWF, SPT, sIgE and laboratory testing,
including a Luminex-based peptide assay (LPA) to fully characterize their
CMA. LPA is a high-throughput assay that examines IgE binding to
sequential allergenic epitopes in milk.
RESULTS: The first 10 patients, mean age 61.8 months (range 11 months
to 10.8 years), all failed OFC to pHWF. Recruitment was terminated based
on statistical calculations supporting marginal benefit to additional
recruitment. Among the participants, milk sIgE ranged from 1.16 kUA/L
to >100 kUA/L. Reaction to pHWF was independent of sensitization pro-
file (casein-predominant, whey predominant, vs. casein and whey cosensi-
tization). Immunoblots and LPA supported that the patients reacted to
residual casein in pHWF. LPA demonstrated differential binding of 10
casein protein epitopes based on SPT and casein sIgE.
CONCLUSIONS: The prevalence of pHWF tolerance was 0% in a US-
based cohort of CMA children, with immune profiling supporting that
residual casein in pHWF was responsible. This low rate of tolerance is in
contrast to previously reported rates from small European studies.
Consistent with current guidelines, pHWF should be avoided in children
with CMA.