Assessment of Serum Levels of Specific IgE to Cow Milk and Gluten Antigens in Autistic Children

Abstract Background Regimens of dietary restrictions of cow’s milk protein and wheat showed good impact on autistic children without clear explanation. Objective To investigate the possible link between serum levels of specific IgE to cow milk and gluten allergens and the severity of autism in a group of autistic children. Methods This pilot case-control study was conducted at the Department of Pediatrics, Children's Hospital, Faculty of Medicine, Ain Shams University over a period of 6 months, from May 2022 to November 2022. Twenty four autistic children aged 4 to 12 years and twenty four age- and sex-matched healthy children were included after excluding children with any chronic, allergic or autoimmune disease. Diagnosis of autism was settled according to 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Serum levels of specific IgE for 4 cow’s milk proteins and gluten protein were assessed for the patients and healthy children using Enzyme-linked immunosorbent assay (ELISA) technique. Results Mean age of autistic patients was 6.48±2.54 years with 19 males and 5 females were studies who were age and sex matched with healthy children and served as a control group. Serum levels of specific IgE against cow’s milk protein and gluten were undetectable among the 2 groups as their level was below 0.35 ku/l. Boys had significantly higher levels of specific IgE against beta lactoglobulin compared to autistic girls in female ranging from (0.01-0.2) while in males (0.06-0.33) (p = 0.04). Specific IgE to casein was positively correlated to IQ level of the studied patients (r = 0.499, p = 0.13). Conclusion Although milk and gluten intolerance were identified in autistic children, the underlying mechanism is mostly not related to atopy. Further studies should be encouraged to identify the other possible mechanisms.