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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Main Authors: Yasmina Ouerdani, Imen Zamali, Yousr Galai, Ahlem Ben Hmid, Yosra Nasri, Ines Ben Sghaier, Hayet Kebaier, Hechmi Louzir, Jihene Bouguila, Nissaf Ben Alaya Bouafif, Mélika Ben Ahmed, Samar Samoud
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
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.
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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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