Molecular allergen sensitization profile and casein threshold determination predicting the persistence of cow's milk protein allergy in Tunisia (North Africa)
BackgroundCow's milk protein allergy (CMPA) represents a major health concern in Tunisia, with diagnostic challenges influencing disease prognosis. Molecular allergen testing has emerged as a valuable tool to enhance diagnostic accuracy and predict disease persistence.ObjectiveThis study aims t...
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Frontiers Media S.A.
2025-04-01
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| Series: | Frontiers in Allergy |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/falgy.2025.1564564/full |
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| author | Yasmina Ouerdani Yasmina Ouerdani Imen Zamali Imen Zamali Imen Zamali Yousr Galai Yousr Galai Ahlem Ben Hmid Ahlem Ben Hmid Ahlem Ben Hmid Yosra Nasri Ines Ben Sghaier Hayet Kebaier Hechmi Louzir Jihene Bouguila Jihene Bouguila Nissaf Ben Alaya Bouafif Nissaf Ben Alaya Bouafif Mélika Ben Ahmed Mélika Ben Ahmed Mélika Ben Ahmed Samar Samoud Samar Samoud Samar Samoud |
| author_facet | Yasmina Ouerdani Yasmina Ouerdani Imen Zamali Imen Zamali Imen Zamali Yousr Galai Yousr Galai Ahlem Ben Hmid Ahlem Ben Hmid Ahlem Ben Hmid Yosra Nasri Ines Ben Sghaier Hayet Kebaier Hechmi Louzir Jihene Bouguila Jihene Bouguila Nissaf Ben Alaya Bouafif Nissaf Ben Alaya Bouafif Mélika Ben Ahmed Mélika Ben Ahmed Mélika Ben Ahmed Samar Samoud Samar Samoud Samar Samoud |
| author_sort | Yasmina Ouerdani |
| collection | DOAJ |
| description | BackgroundCow's milk protein allergy (CMPA) represents a major health concern in Tunisia, with diagnostic challenges influencing disease prognosis. Molecular allergen testing has emerged as a valuable tool to enhance diagnostic accuracy and predict disease persistence.ObjectiveThis study aims to characterize the clinical and epidemiological features of CMPA in a Tunisian population, with a particular focus on the role of molecular allergens in assessing disease chronicity.MethodsA retrospective analysis was conducted on 262 cases of IgE-mediated CMPA diagnosed at the Pasteur Institute of Tunis between 2020 and 2023. Sensitization to molecular allergens was assessed using ImmunoCAP (Phadia 100).ResultsCMPA symptoms predominantly manifested in infancy (94%, 246/262), with a male predominance (sex ratio: 1.6). Acute reactions were the most frequent presentation (69.9%, 79/113), and polysensitization was common (81%, 212/262), particularly to β-lactoglobulin. Spontaneous resolution occurred in approximately 33% of cases (29/87), with a mean age of 3 years and 8 months. Persistent CMPA was significantly associated with elevated IgE levels to whole milk, β-lactoglobulin, and casein (p < 0.05). ROC curve analysis identified predictive thresholds for disease persistence, including 4.2 kU/L for whole milk-specific IgE and 0.37 kU/L for casein-specific IgE (p = 0.006).ConclusionMolecular allergen testing improves CMPA diagnosis and offers critical prognostic insights. The identification of IgE thresholds may facilitate early risk stratification and guide personalized management strategies. |
| format | Article |
| id | doaj-art-6b3cb2318d034ac08150e823c4fdb20a |
| institution | OA Journals |
| issn | 2673-6101 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Allergy |
| spelling | doaj-art-6b3cb2318d034ac08150e823c4fdb20a2025-08-20T02:17:29ZengFrontiers Media S.A.Frontiers in Allergy2673-61012025-04-01610.3389/falgy.2025.15645641564564Molecular allergen sensitization profile and casein threshold determination predicting the persistence of cow's milk protein allergy in Tunisia (North Africa)Yasmina Ouerdani0Yasmina Ouerdani1Imen Zamali2Imen Zamali3Imen Zamali4Yousr Galai5Yousr Galai6Ahlem Ben Hmid7Ahlem Ben Hmid8Ahlem Ben Hmid9Yosra Nasri10Ines Ben Sghaier11Hayet Kebaier12Hechmi Louzir13Jihene Bouguila14Jihene Bouguila15Nissaf Ben Alaya Bouafif16Nissaf Ben Alaya Bouafif17Mélika Ben Ahmed18Mélika Ben Ahmed19Mélika Ben Ahmed20Samar Samoud21Samar Samoud22Samar Samoud23Laboratory of Clinical Immunology, Institut Pasteur de Tunis, Tunis, TunisiaFaculty of Medicine of Sousse, University of Sousse, Sousse, TunisiaLaboratory of Clinical Immunology, Institut Pasteur de Tunis, Tunis, TunisiaFaculty of Medicine de Tunis, University of Tunis El Manar, Tunis, TunisiaLaboratory of Transmission, Control and Immunobiology of Infection, Institut Pasteur de Tunis, Tunis, TunisiaLaboratory of Clinical Immunology, Institut Pasteur de Tunis, Tunis, TunisiaFaculty of Pharmacy of Monastir, University of Monastir, Monastir, TunisiaLaboratory of Clinical Immunology, Institut Pasteur de Tunis, Tunis, TunisiaFaculty of Medicine de Tunis, University of Tunis El Manar, Tunis, TunisiaLaboratory of Transmission, Control and Immunobiology of Infection, Institut Pasteur de Tunis, Tunis, TunisiaLaboratory of Clinical Immunology, Institut Pasteur de Tunis, Tunis, TunisiaLaboratory of Clinical Immunology, Institut Pasteur de Tunis, Tunis, TunisiaLaboratory of Clinical Immunology, Institut Pasteur de Tunis, Tunis, TunisiaLaboratory of Transmission, Control and Immunobiology of Infection, Institut Pasteur de Tunis, Tunis, TunisiaFaculty of Medicine of Sousse, University of Sousse, Sousse, TunisiaDepartment of Pediatrics, Hospital Farhat Hached, Sousse, TunisiaFaculty of Medicine de Tunis, University of Tunis El Manar, Tunis, TunisiaNational Observatory of New and Emerging Diseases, Ministry of Health, Tunis, TunisiaLaboratory of Clinical Immunology, Institut Pasteur de Tunis, Tunis, TunisiaFaculty of Medicine de Tunis, University of Tunis El Manar, Tunis, TunisiaLaboratory of Transmission, Control and Immunobiology of Infection, Institut Pasteur de Tunis, Tunis, TunisiaLaboratory of Clinical Immunology, Institut Pasteur de Tunis, Tunis, TunisiaFaculty of Medicine of Sousse, University of Sousse, Sousse, TunisiaLaboratory of Transmission, Control and Immunobiology of Infection, Institut Pasteur de Tunis, Tunis, TunisiaBackgroundCow's milk protein allergy (CMPA) represents a major health concern in Tunisia, with diagnostic challenges influencing disease prognosis. Molecular allergen testing has emerged as a valuable tool to enhance diagnostic accuracy and predict disease persistence.ObjectiveThis study aims to characterize the clinical and epidemiological features of CMPA in a Tunisian population, with a particular focus on the role of molecular allergens in assessing disease chronicity.MethodsA retrospective analysis was conducted on 262 cases of IgE-mediated CMPA diagnosed at the Pasteur Institute of Tunis between 2020 and 2023. Sensitization to molecular allergens was assessed using ImmunoCAP (Phadia 100).ResultsCMPA symptoms predominantly manifested in infancy (94%, 246/262), with a male predominance (sex ratio: 1.6). Acute reactions were the most frequent presentation (69.9%, 79/113), and polysensitization was common (81%, 212/262), particularly to β-lactoglobulin. Spontaneous resolution occurred in approximately 33% of cases (29/87), with a mean age of 3 years and 8 months. Persistent CMPA was significantly associated with elevated IgE levels to whole milk, β-lactoglobulin, and casein (p < 0.05). ROC curve analysis identified predictive thresholds for disease persistence, including 4.2 kU/L for whole milk-specific IgE and 0.37 kU/L for casein-specific IgE (p = 0.006).ConclusionMolecular allergen testing improves CMPA diagnosis and offers critical prognostic insights. The identification of IgE thresholds may facilitate early risk stratification and guide personalized management strategies.https://www.frontiersin.org/articles/10.3389/falgy.2025.1564564/fullcow's milk allergymolecular allergenspecific IgEsensitization profiletolerance |
| spellingShingle | Yasmina Ouerdani Yasmina Ouerdani Imen Zamali Imen Zamali Imen Zamali Yousr Galai Yousr Galai Ahlem Ben Hmid Ahlem Ben Hmid Ahlem Ben Hmid Yosra Nasri Ines Ben Sghaier Hayet Kebaier Hechmi Louzir Jihene Bouguila Jihene Bouguila Nissaf Ben Alaya Bouafif Nissaf Ben Alaya Bouafif Mélika Ben Ahmed Mélika Ben Ahmed Mélika Ben Ahmed Samar Samoud Samar Samoud Samar Samoud Molecular allergen sensitization profile and casein threshold determination predicting the persistence of cow's milk protein allergy in Tunisia (North Africa) Frontiers in Allergy cow's milk allergy molecular allergen specific IgE sensitization profile tolerance |
| title | Molecular allergen sensitization profile and casein threshold determination predicting the persistence of cow's milk protein allergy in Tunisia (North Africa) |
| title_full | Molecular allergen sensitization profile and casein threshold determination predicting the persistence of cow's milk protein allergy in Tunisia (North Africa) |
| title_fullStr | Molecular allergen sensitization profile and casein threshold determination predicting the persistence of cow's milk protein allergy in Tunisia (North Africa) |
| title_full_unstemmed | Molecular allergen sensitization profile and casein threshold determination predicting the persistence of cow's milk protein allergy in Tunisia (North Africa) |
| title_short | Molecular allergen sensitization profile and casein threshold determination predicting the persistence of cow's milk protein allergy in Tunisia (North Africa) |
| title_sort | molecular allergen sensitization profile and casein threshold determination predicting the persistence of cow s milk protein allergy in tunisia north africa |
| topic | cow's milk allergy molecular allergen specific IgE sensitization profile tolerance |
| url | https://www.frontiersin.org/articles/10.3389/falgy.2025.1564564/full |
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