Guidelines for diagnosis and nutritional intervention of mild to moderate non-IgE mediated cow′s milk protein allergy in Chinese infants / 中华实用儿科临床杂志

Cow′s milk protein allergy (CMPA) is one of the most common presentations of food allergy seen in early childhood.It is an abnormal immune response caused by cow′s milk protein.CMPA can be clinically subdivided into either immediate-onset IgE mediated or delayed onset non-IgE mediated, or both.At present, concerns regarding the early and timely diagnosis of CMPA have been high-lighted over the years and there are many expert consensus on CMPA in China, but these consensus did not distinguish IgE mediated or non-IgE mediated CMPA.In view of the obvious clinical differences between the two type of CMPA and non-IgE mediated CMPA is more common in infancy, experts focus on pediatric gastroenterology, allergy/immunology, dermatology, nutrition and child healthcare convened by the Allergy Prevention and Control Professional Committee of Chinese Preventive Medicine Association present this guideline to help practitioners in primary care settings to early recognize and make suitable management of non-IgE mediated CMPA in China.The guideline incorporates the cutting-edge international guidance and the actual situation of Chinese children describing in detail the types, clinical features, diagnosis and nutritional intervention of non-IgE mediated CMPA.There are 42 recommendations in 7 categories in total referring to the common questions related to non-IgE mediated CMPA.

Advance in human coronaviruses research of host interactions / 中华实用儿科临床杂志

2019-novel coronavirus (2019-nCoV) is a highly pathogenic human CoV that first emerged in Wuhan in 2019.2019-nCoV has a zoonotic origin and poses a major threat to public health.However, little is known about the viral factors contributing to the high virulence of 2019-nCoV.Many animal viruses, including CoVs, encode proteins that interfere with host gene expression, including those involved in antiviral immune responses, and these viral proteins are often major virulence factors.Human coronaviruses (HCoVs) are known respiratory pathogens associated with a range of respiratory infection.In the past 17 years, the onset of 2019-nCoV, severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) have thrust HCoVs into spotlight of the research community due to their high pathogenicity in humans.The recent study of HCoVs-host interactions has contributed extensively to our understanding of infection pathogenesis of 2019-nCoV.This review discuss various host physiopathologic mechanism, such as apoptosis, innate immunity, endoplasmic reticulum (ER) stress response, mitogen-activated protein kinase (MAPK) pathway and nuclear factor kappa B (NF-κB) pathway that may be modulated by HCoVs and provides evidence for the intensive investigate of 2019-nCoV infection.

Advance in human coronaviruses research of host interactions / 中华实用儿科临床杂志

2019-novel coronavirus (2019-nCoV) is a highly pathogenic human CoV that first emerged in Wuhan in 2019.2019-nCoV has a zoonotic origin and poses a major threat to public health.However, little is known about the viral factors contributing to the high virulence of 2019-nCoV.Many animal viruses, including CoVs, encode proteins that interfere with host gene expression, including those involved in antiviral immune responses, and these viral proteins are often major virulence factors.Human coronaviruses (HCoVs) are known respiratory pathogens associated with a range of respiratory infection.In the past 17 years, the onset of 2019-nCoV, severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) have thrust HCoVs into spotlight of the research community due to their high pathogenicity in humans.The recent study of HCoVs-host interactions has contributed extensively to our understanding of infection pathogenesis of 2019-nCoV.This review discuss various host physiopathologic mechanism, such as apoptosis, innate immunity, endoplasmic reticulum (ER) stress response, mitogen-activated protein kinase (MAPK) pathway and nuclear factor kappa B (NF-κB) pathway that may be modulated by HCoVs and provides evidence for the intensive investigate of 2019-nCoV infection.

Basic and clinical research of lymphocytic variant hypereosinophilic / 临床儿科杂志

Eosinophil disorders are a range of heterogeneous diseases, which manifest as persistent increase of eosinophile granulocyte in blood and tissue, and may cause microenvironment change and irreversible chronic organ damage. According to World Health Organization, eosinophil diseases were divided into hypereosinophilia (HE) and hypereosinophilia syndrome (HES) by whether the organ is involved. Besides familial HE, HE were also divided into secondary (reactive) HE, primary (clonal/neoplastic) HE, and idiopathic HE. Lymphocytic variant HE is a special kind of secondary HE. With the study of the molecular mechanism of lymphocytic variant HE, the diagnosis is gradually clear. Moreover, some targeted therapeutic drugs, such as anti IL-5 monoclonal antibody (Mepolizumab) and anti CD 52 monoclonal antibody (Alemtuzumab) were also appeared. In this paper, the current basic and clinical researches of lymphocytic variant HE are reviewed.

The progress in defensin research / 临床儿科杂志

Defensin is a cysteine-rich, low molecular weight and cationic antimicrobial peptide. Human breast milk con-tains high level of defensin. The defensin in human breast milk can not only inhibit the growth of various pathogenic microorgan-isms, but also promote the development of infant immune system and reduce the incidence of infantile upper respiratory infection. Nowadays, the roles of defensin in breast milk is more recognized. This paper focuses on the molecular characteristics of human defensin, its antibacterial and antiviral roles, and the latest progress in defensin research.

The role of urinary kidney injury molecule-1 in pediatric Henoch-Sch?nlein purpura / 临床儿科杂志

Objective To study the role of urinary kidney injury molecule-1 (KIM-1) in pediatric Henoch-Sch?nlein purpura (HSP). Methods Urinary levels of KIM-1 were examined using ELISA in 48 children with HSP including 23 HSPN children (HSPN group) and 25 non-HSPN children (HSP group), and 20 healthy children. The levels of urinary creatinine and 24-hour urine protein were also detected. The results were analyzed and compared among groups. Results The ratio of urinary KIM-1/creatinine (Cr) in HSPN children was signiifcantly higher than that in the other two groups (P0.05). The ratio of urinary KIM-1/Cr had no correlation with 24-hour urine protein in all HSP children (r=0.239, P=0.590). Conclusions Urinary KIM-1 may play a role in the pathogenesis of pediatric HSPN.

Hypogammaglobulinaemia with low natural killer cell numbers:a case report with four year of follow-up / 临床儿科杂志

Objective To explore the immune characteristic of a patient with hypogammaglobulinaemia and low natural killer(NK)cell numbers. Methods Case histories were analyzed repeatedly to grasp important characteristics of the disease. A routine blood examination and peripheral blood immunological detection was done. Complete neutrophil function test,lymphocyte proliferation ability and cytokine profile were evaluated. Results A 3-year-old boy was referred to the hospital because of fever and abdominal pain as well as partial intestinal obstruction. Laboratory examination revealed low immunoglobulin,reduced absolute numbers of B and NK cells and deficient B cell function of lower IFN-γ and IL-12 production. The patient also had mesenteric lymphadenopathy and a caecal mass with histology suggestive of ileocecal junctional tuberculosis. The patient was infected with cytomegalovirus(CMV)and fungus,which are not common in simple antibody deficiencies. The patient was followed for four years and during this period the patient had recurrent periodontitis resulting in the loss of one tooth. Conclusions Although the precise mechanism of the defect is unclear,we speculate that the case may cast new light on primary immunodeficiencies predominantly with antibody deficiency.(J Clin Pediatr,2011,29(7):601-608)

Clinical significance of food allergen-specific IgG detection / 上海交通大学学报（医学版）

Objective To explore the clinical significance of detection of 14 kinds of food allergen-specific IgG. Methods Fourteen kinds of food allergen-specific IgG were detected by ELISA method in 211 patients with allergic diseases,and IgG positive rates of various foods were compared among patients with different sex,age and allergic diseases. Results Positive food allergen-specific IgG was detected in 193(91.4%)patients.Among 14 kinds of foods,the positive rate of food allergen-specific IgG was the highest for eggs(73.9%),and milk came the second.However,no elevated food allergen-specific IgG was observed for chicken and meat.Milk was the most common sensitizers for 0-12 month-old patients,and egg was the first cause for the other age groups.There were significant differences in the positive rates of food allergen-specific IgG for milk among different age groups(P<0.01).There was no significant difference in the positive rate of food allergen-specific IgG between males and females(P>0.05).The positive rate of food allergen-specific IgG in patients with eczema was the highest(96.4%),and the lowest(83.3%)was found in those with chronic diarrhea,while there was no significant difference among different diseases(P>0.05).The positive rate of food allergen-specific IgG for milk differed significantly among different diseases(P<0.01).Positive food allergen-specific IgG was detected in 12 kinds of food(except for chicken and meat) for patients with allergic purpura. Conclusion Food intolerance is a complex allergy.The food allergen-specific IgG detection is of great importance as reference for etiologic diagnosis of allergic diseases.

Effects of Epstein-Barr virus on apoptosis of cord blood monocytes-derived dendritic cells / 上海交通大学学报（医学版）

Objective To investigate the effects of Epstein-Barr virus (EBV) infection on apoptosis of cord blood monocytes-derived dendritic cells (DC) in neonates. Methods Cord blood monocytes were induced into DC by 50 ng/mL recombinant human granulocyte macrophage colony-stimulating factor(rhGM-CSF)and 10 ng/mL recombinant human interleukin-4 (rhIL-4),and DC were divided into three groups:①4G group:rhGM-CSF and rhIL-4 were added separately on the day of cell separation;②4G+0d EBV group:rhGM-CSF,rhIL-4 and B95.8 cell supernatants were added simultaneously on the day of cell separation;③4G+5d EBV group:hGM-CSF and rhIL-4 were added on the day of cell separation,and B95.8 cell supernatants were added on the 5th day.Percents of DC apoptosis were measured using Annexin V-FITC and PI staining by flow cytometry.The expression of X-linked inhibitor of apoptosis protein (XIAP) was detected by Western Blot.Results Percent of DC apoptosis in 4G+0d EBV group was significantly higher than that in 4G group on the 6th to 14th day(P<0.05),and percent of DC apoptosis in 4G+5d EBV group was significantly higher than that in 4G group on the 7th to 14th day(P<0.05).The effects of EBV infection on percent of DC apoptosis had relations with infection time points.The expression of XIAP in DC decreased significantly after EBV infection. Conclusion EBV promotes apoptosis of cord blood monocytes-derived DC,which is associated with the differentiation and maturation status of DC.

Relationship between transforming growth factor-β1 and interleukin-10 in breast milk and allergic diseases in infants / 中华围产医学杂志

Objective To verify the relationship between transforming growth factor-β1(TGF-β1) and interleukin-10 (IL-10) in breast milk and allergic diseases development in infants. Methods Totally 191 mothers (99 allergics and 92 controls) and their full-term newborns participated in this prospective study on development of children atopy. Maternal blood, cord blood, colostrum and mature milk were assayed for TGF-β1 and IL-10 by enzyme-linked immunosorbent assay. Infants underwent pediatrician evaluation for allergic diseases at six months old. Concentrations of TGF-β1 and IL-10 from allergic and non-allergic mothers and prevalence of allergic diseases of infants were compared. Results The level of IgE in allergic mothers was 30 750 IU/L(6600-410000 IU/L),lower than that in non-allergic mothers[50000 IU/L(7100-610000 IU/L)](Z=-3. 444,P=0. 001).No difference in the concentration of TGF-β1, IL-10 and IgE in mature milk was observed between allergic and non-allergic mothers. TGF-β1, IL-10 and IgE levels in colostrum of allergic mothers were 2300 pg/ml(620-7000 pg/ml), 12. 8 pg/ml(7.5-560.0 pg/ml)and 7000 IU/L(5100-56000 IU/L),significantly higher than those in non-allergic mothers[1830 pg/ml(1240-9400 pg/ml), 11. 1 pg/ml (7. 2-630.0 pg/ml)and 6700 IU/L(5200-35000 IU/L)] (Z=-2. 215, -2. 730 and -2. 706,P＜0.05).In both allergic and non-allergic mothers, TGF-β1 and IL-10 levels in cord blood were higher than those in maternal blood, while IgE was lower. TGF-βl and IL-10 and IgE levels in colostrum were higher than mature milk(P＜0.05). At six months old, the prevalence of allergic diseases of infants from allergic mothers(59. 6%, 59/99) was significantly higher than those from non-allergic mothers (21. 7%, 20/92)(x2= 28. 177, P= 0. 000). The prevalence of allergic diseases of infants who completed two weeks' colostrum-fed after birth (44.5 %, 73/164) was significantly higher than those who did not (22.2%,6/27)(x2 =4. 749,P-=0. 029). Conclusions High concentration of TGF-βl and IL-10 in colostrum does not show any protective effect against allergic diseases in infants. The prevalence of allergic diseases of colostrum-fed infants is significantly higher than non colostrum-fed infants, showing that colostrum-fed might play a role in allergic diseases development.

Application of flow cytometry in the diagnosis of X-linked hyper-IgM syndrome / 中华检验医学杂志

Objective To develop a flow cytometrie assay to for diagnosis of X-Linked Hyper.1gM Syndrome(XHIM).Methods Heparinized peripheral blood obtained from patient,mother and a healthy control was diluted with RPMI- 1640(unstimulated control)or with RPMI-1640 containing 15μl PMA(1 rig/μl)and 6 trl ionomycin(50 ng/μl)(stimulated cell).Using directly labeled antibodies,we have examined CD40 ligand levels on CD3+ CD8- lymphocyte surface,and CD69 levels on CD;lymphocyte Surface to determine whether the cells were activated.Results CD69 levels on CD3+ lymphocyte surface from stimulated group and from unstimulated group were above 96% and below 3%,respectively.CD40L levels Oil CD3 CDs-T lymphocyte surface from stimulated group were 0.8% (patient),60.04%(mother) and 62.87%(healthy contr01).CD40L levels on CD3+ CD8-T lymphocyte surface from unstimulated group were 0.88% (patient),4.15%(mother)and 5.51%(healthy contr01).Conclusion This flow cytometric assayis accurate and convenient,which Can be used in neonatal screening.

Expression of HSP70 Gene in Rat Brain after Exposures to Repeated +Gz / 航天医学与医学工程

Objective To study the changes of mRNA expression of heat shock protein 70 (HSP70) in the rat brain exposed to repeated +Gz. Method The mRNA expression levels of HSP70 in rat brain were measured by semi-quantitative reverse transcription polymerase chain reaction (RT-PCR). Result The HSP70 mRNA expression levels in rat brains taken 30 min and 6 h after repeated +Gz exposures were significantly higher than those in control group, while the difference between the levels of control group and those of experimental rat brains taken 24 h after +Gz exposure was not significant. Conclusion It is suggested that HSP70 mRNA expression in rat brain can be induced by repeated +Gz exposures and the increased HSP70 mRNA expression may play an important role in self-protection against brain damage induced by+Gz exposures.

Effect of intravenous immunoglobulin on IFN-? and IL-4 production of cord blood lymphocytes in neonates / 中华围产医学杂志

Objective To study the effects of intravenous immunoglobulin (IVIG) on neonatal lymphocyte immune function. Methods Cord blood mononuclear cells (CBMCs) and CD3+ T lymphocytes were isolated from 8 neonates and were cultured with IVIG and/or/without phytohemagglutinin (PHA)based on which divided into five groups, i. e. (l)control group, (2)PHA activation group, (3) IVIG pre-inhibition group, (4) PHA pre-activation group and (5) PHA+IVIG group. The production of IFN-? and IL-4 of CBMCs and cord blood CD3+ T lymphocytes was measured with ELISA and the expression of IL-2 and IL-4 mRNA was measured with RT-PCR. The results were compared with peripheral blood mononuclear cells(PBMCs) of 8 adults. Results The production of IFN-y by CBMCs and cord blood CD3+ T lymphocytes induced by PHA decreased after IVIG was given, while more remarkable decrease in the CBMCs was shown without any association with IVIG was given or not before or after PHA was used [Group 2; (313. 34?108. 00)pg/ml, Group 3: (17. 68?17. 98) pg/ml, group 4 : (170. 72?38. 25) pg/ml, group 5: (11. 10?8. 92)pg/ml]. For the CD3+ T lymphocytes, the decrease of IFN-? production was only observed in group 3, 4 and group 5 [(35. 30 ?12. 21)pg/ml, (8. 61?6. 21) pg/ml and (8. 54?1. 57)pg/ml]. The degree of decrease of IFN-? production by CBMCs was much lower [group 2: (1121. 11 ? 344. 58)pg/ml, group 3: (29. 08 ? 11. 20)pg/ml, group 4: (339. 63?47. 43) pg/ml, group 5: (26.40?21. 97)pg/ml]. The secretion for IL-4 did not changed when stimulated by PHA alone, but IL-2 and IL-4 mRNAs expression can be detected in CBMCs after repeated stimulation by PMA, PHA and rIL-2 which decreased after IVIG was given. Conclusions IVIG can suppress the production of IFN-? in cord blood T lymphocyte directly or mediated by other immune cells or molecules. IVIG can also decreased the expression of IL-2 mRNA and IL-4 mRNA in CBMCs. The effect of IVIG on the proliferation of cord blood lymphocytes and production of immunoglobulin in B lymphocytes might be associated with these inhibition.