Bedoret, DenisSingh, A KShaw, VHoyte, E GHamilton, RDeKruyff, Rosemarie H.Schneider, LyndaNadeau, K CUmetsu, Dale2013-04-222012Bedoret, D, A K Singh, V Shaw, E G Hoyte, R Hamilton, R H DeKruyff, L C Schneider, K C Nadeau, and D T Umetsu. 2012. Changes in antigen-specific T cell number and function during oral desensitization in cow’s milk allergy enabled with omalizumab. Mucosal Immunology 5(3): 267-276.1933-0219http://nrs.harvard.edu/urn-3:HUL.InstRepos:10579379Food allergy is a major public health problem for which there is no effective treatment. We examined the immunological changes that occurred in a group of children with significant cow’s milk allergy undergoing a novel and rapid high dose oral desensitization protocol enabled by treatment with omalizumab (anti-IgE mAb). Within a week of treatment, the CD4+ T cell response to milk was nearly eliminated, suggesting anergy in, or deletion of, milk-specific CD4+ T cells. Over the following three months while the subjects remained on high doses of daily oral milk, the CD4+ T cell response returned, characterized by a shift from IL-4 to IFN-γ production. Desensitization was also associated with reduction in milk-specific IgE and a 15-fold increase in milk-specific IgG4. These studies suggest that high dose oral allergen desensitization may be associated with deletion of allergen-specific T cells, without the apparent development of allergen-specific Foxp3+ regulatory T cells.en-USJournal Article2013-04-2210.1038/mi.2012.5