Background: The role of specific IgG 4 antibodies in natural tolerance acquisition remains a matter of debate; the specific IgE/IgG 4 ratio might add value to the measurement of absolute amounts of IgE for assessing the ongoing status of egg reactivity. Objective: We sought to determine the significance of IgG 4 antibodies to ovalbumin (OVA) and ovomucoid (OVM) in egg-allergic children. Methods: One hundred seven egg-allergic children (mean age 6.9 years; range 1.6-18.6 years) were challenged to baked egg. The outcomes of the challenges were related to the level of specific IgE and IgG 4 to OVM and OVA, component IgE/IgG 4 ratios, and mediator release in a functional assay based on the rat basophil leukemia cell line. Results: Baked egg-reactive children had significantly higher OVA and OVM ratios of IgE/IgG 4 and mediator release in the rat basophil leukemia-based assay than did tolerant children (P <.05 for both). The OVA- and OVM-specific IgE/IgG 4 ratios and mediator release were correlated. In the receiver operating characteristic analysis, the areas under the curve for a logistic regression model including specific IgE and IgG 4 to OVA and OVM were significantly greater compared with the areas under the curve for egg white-specific IgE and OVM-specific IgE. Conclusions: The balance between IgE and IgG 4 to OVA and OVM has functional consequences. A model that includes the interactions between IgE and IgG 4 to OVA and OVM accurately predicts reactivity to baked egg and warrants further investigation.

Original languageEnglish
Pages (from-to)739-747
Number of pages9
JournalJournal of Allergy and Clinical Immunology
Issue number3
StatePublished - Mar 2012


  • Egg
  • IgE
  • IgE/IgG ratio
  • IgG
  • children
  • egg allergy
  • egg white
  • food allergy
  • hypersensitivity
  • ovalbumin
  • ovomucoid


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