Apolipoprotein B : a new biomarker for anaphylaxis

Petterson, M.E. (Maria Eleonore) (2015) Apolipoprotein B : a new biomarker for anaphylaxis. thesis, Medicine.

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Abstract

Food allergy is common in children, with prevalence rates ranging from 6-8% in children younger than five years and 3.5-4% in the entire population. Furthermore, previous studies have shown both an increasing prevalence of food allergy during the last decade and an increasing number of patients and caregivers seeking diagnosis. To this day there are few known biomarkers predicting the severity of a food-allergic reaction. Previous studies have examined laboratory markers such as specific immunoglobulin E (IgE), platelet activating factor (PAF) and parameters of the basophil activation test (BAT). However, some of these studies show conflicting results. No previous study has examined the role of apolipoprotein B in food allergy. The aim of this study was to examine apolipoprotein B as a possible biomarker for the severity of allergic reactions. Data and serum samples from the food challenge unit database – and serum bank in the University Medical Center Groningen from 2002-2014 were collected. Only patients with a positive -or negative food challenge on the verum-test day and with a history of food allergy to the tested allergic food were included in the analysis. Cases without a matching serum sample in the serum bank or having missing variables were excluded. 837 double-blind, placebo controlled, food challenges (DBPCFC) were included in the final analysis. The level of apolipoprotein B did neither predict the food challenge outcome (p-value = 0,790, adjusted odds ratio = 0,899, 95% CI 0,409-1,976) nor the severity of the DBPCFC reaction (p-value = 0,894, beta= -0,006). Conversely, the severity of the accidental home reaction was predicted by the concentration of apolipoprotein B (p-value 0,011, beta= -0,088, R2= 0,008). This effect was stronger in food challenge negative patients (p-value=0,003, beta=-0,154, R2=0,034) but was not present in patients with a positive food challenge (p-value=0,326, beta=-0,046, R2=0,002). The results of this study suggest that apolipoprotein B is a biomarker for the severity of allergic reactions generally. However this biomarker is not clinically useful since it predicts only a very small part of the risk. Additionally, it seems that patients with a negative food challenge and a convincing history of allergic reaction most likely have had an anaphylaxis, but probably not to food.

Item Type:	Thesis (Thesis)
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:43
Last Modified:	25 Jun 2020 10:43
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/444

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