Fuente: "milk OR dairy products" World Allergy Organ J. 2026 Apr 10;19(4):101367. doi: 10.1016/j.waojou.2026.101367. eCollection 2026 Apr.ABSTRACTBACKGROUND: During the first 5 years of life, atopic individuals may develop cutaneous or respiratory symptoms with foodborne or airborne allergens. The route and dose of exposure are associated with sensitization. However, limited studies compare food and airborne allergies in these children.OBJECTIVE: To characterize and compare the developmental patterns of symptoms, specific IgE (sIgE)/specific IgG4 (sIgG4), and B cell subsets in response to food or airborne allergens under 5 years old.METHODS: Children aged from birth to 5 years old with food allergy and/or respiratory allergy symptoms were recruited from Jan 2019 to Dec 2021. Clinical parameters were systematically documented, and the sIgE responses to 29 common allergens were quantified via ImmunoCAP. A subset of participants (n = 45, with 9 cases in each age group) underwent assessments of sIgE/sIgG4 to egg, milk, and house dust mite (HDM) components. Peripheral B cell subsets were phenotypically characterized using multiparametric flow cytometry (n = 20).RESULTS: As the children ages, positivity rate to inhalant allergens (D. farina and D. pteronyssinus) rapidly increased to 57.04% and 58.23% respectively, while positivity for food allergens of eggs and milk dropped to 27.44% and 32.7%. Notably, allergen component-specific IgG4 levels against egg and milk allergens were significantly higher compared to those against HDM. However, all sIgG4 exhibited mild (0.3 < ρ < 0.52) or no correlation (ρ < 0.3) with corresponding components sIgE. Although most B cell subsets had no significant difference between the food and HDM sensitization, the tSNE analysis identified that the frequency of C6 (CD19+CD38+ IgG4+IgE++) effector B cells significantly increased in the 4-5 year HDM group, while memory B cell-like cells (C11, CD19+CD27+CD38+IgG4+) highly expressed in food allergies.CONCLUSIONS: Our study demonstrates the frequency, route, and dosage of exposure may contribute to distinct variations in the repertoire of allergen-specific IgE/IgG antibodies and B cell subsets, highlighting the importance of exposure modalities in shaping early immune responses.PMID:42006627 | PMC:PMC13091336 | DOI:10.1016/j.waojou.2026.101367