Interleukin 10 (IL10) and transforming growth factor 1 (TGF1) gene polymorphisms in persistent IgE-mediated cow's milk allergy

OBJECTIVES: The aim of this cross-sectional study was to evaluate whether interleukin 10 (IL10) and transforming growth factor β1 (TGFβ1) gene polymorphisms were associated with persistent IgE-mediated cow's milk allergy in 50 Brazilian children. The diagnostic criteria were anaphylaxis triggered by cow's milk or a positive double-blind, placebo-controlled food challenge. Tolerance was defined as the absence of a clinical response to a double-blind, placebo-controlled food challenge or cow's milk exposure. METHOD: The genomic DNA of the 50 patients and 224 healthy controls (HCs) was used to investigate five IL10 gene polymorphisms (-3575A/T, -2849A/G, -2763A/C, -1082G/A, -592C/A) and one TGFβ1 polymorphism (-509C/T). RESULTS: Among the five IL10 polymorphisms analyzed, homozygosis for the G allele at the -1082 position was significantly higher in the patients compared with the healthy controls (p = 0.027) and in the persistent cow's milk allergy group compared with the healthy controls (p = 0.001). CONCLUSIONS: Homozygosis for the G allele at the IL10 -1082G/A polymorphism is associated with the persistent form of cow's milk allergy. .

Conhecimento da rotulagem de produtos industrializados por familiares de pacientes com alergia a leite de vaca / Knowledge of industrialized dairy products labels by parents of patients allergic to cow's milk

OBJETIVO: Avaliar a capacidade de identificação dos termos relacionados ao leite de vaca em rótulos de produtos industrializados por familiares de pacientes com alergia à bebida. MÉTODOS: Estudo transversal, descritivo, baseado em entrevista com familiares de pacientes. Inicialmente, aplicou-se um questionário sobre o hábito de leitura de rótulos e identificação de termos relacionados ao leite e, posteriormente, apresentaram-se rótulos de 12 produtos industrializados para que os familiares decidissem sobre a sua exclusão da dieta do paciente. RESULTADOS: Dos 52 entrevistados, 80,8 por cento eram mães e 79,0 por cento apresentavam nível médio ou superior de escolaridade. A mediana do tempo em seguimento já com orientação para dieta de exclusão era de dois anos e sete meses (três meses a 17 anos e seis meses). A leitura habitual de rótulos de alimentos, medicamentos e cosméticos foi relatada por 57,7 por cento, 59,6 por cento e 46,2 por cento dos familiares, respectivamente. Entre as reações alérgicas ocorridas no seguimento, 39,5 por cento foram relacionadas a erros na leitura de rótulos. Lactose, caseína e caseinato foram os termos identificados por 92,3 por cento, 38,5 por cento e 23,1 por cento dos familiares, respectivamente. Lactato foi interpretado como presença de leite de vaca por 51,9 por cento dos entrevistados. Na segunda etapa, os familiares identificaram a lactose (55,8 por cento), a caseína (26,9 por cento) e o caseinato (5,8 por cento) como substâncias relacionadas ao leite. CONCLUSÕES: Constatou-se deficiente compreensão e identificação, por parte dos pais, dos termos relacionados ao leite apesar das orientações recebidas. É fundamental a adequação da rotulagem e a adoção de novas estratégias para orientação da leitura de rótulos, possibilitando a busca e a identificação de produtos que contenham leite de vaca.

OBJECTIVE: To evaluate the ability of relatives of patients with cow's milk allergy to identify terms related to cow's milk on labels of manufactured products. METHODS: Cross-sectional descriptive study based on interviews with relatives of patients with cow's milk allergy. Initially, a questionnaire about the habit of reading labels and the identification of terms related to cow's milk was applied. Next, 12 original labels of manufactured products were shown to the interviewees so that they could decide whether to exclude or not those products from the patient's diet. RESULTS: Of the 52 interviewees, 80.8 percent were mothers and 79.0 percent had at least 8 years of schooling. The median time of follow-up after receiving information about exclusion diet was 2 years and 7 months (from 3 months to 17 years and 6 months). The habit of reading labels of foods, drugs and cosmetics was reported by 57.7, 59.6, and 46.2 percent of the relatives, respectively. Among the allergic reactions during follow-up, 39.5 percent were related to mistakes when reading labels. Lactose, casein, and caseinate were the terms identified by 92.3, 38.5, and 23.1 percent of the family members, respectively. Lactate was interpreted as presence of cow's milk by 51.9 percent of the interviewees. During the second phase of the study, family members identified lactose (55.8 percent), casein (26.9 percent) and caseinate (5.8 percent) as related to cow's milk. CONCLUSION: There was a deficient understanding and identification of cow's milk-related terms in spite of previous counseling. It is important to improve labels and to establish new strategies that allow lay people to identify labels of products containing cow's milk.