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1.
Nutrients ; 16(17)2024 Sep 02.
Article in English | MEDLINE | ID: mdl-39275265

ABSTRACT

OBJECTIVE: The aim of our study was to investigate whether a 1-month-long milk-free diet results in a reduction in faecal calprotectin (FC) and faecal-zonulin-related proteins (FZRP) in children with milk-protein-induced allergic proctocolitis (MPIAP). MATERIALS AND METHODS: This is a single-centre, prospective, observational cohort study involving 86 infants with MPIAP, aged 1-3 months, and 30 healthy controls of the same age. The FC and FZRP were marked using the ELISA method (IDK® Calprotectin or Zonulin ELISA Kit, Immunodiagnostik AG, Bensheim, Germany). The diagnosis of MPIAP was confirmed with an open milk challenge test. RESULTS: FFC and FZRP proved useful in evaluating MPIAP treatment with a milk-free diet, and the resolution of allergic symptoms and a significant (p = 0.0000) decrease in the concentrations of both biomarkers were observed after 4 weeks on the diet. The FC and FZRP concentrations were still higher than in the control group. A high variability of FC concentrations was found in all the study groups. An important limitation is the phenomenon of FZRP not being produced in all individuals, affecting one in five infants. CONCLUSIONS: FC and FZRP can be used to monitor the resolution of colitis in infants with MPIAP treated with a milk-free diet, indicating a slower resolution of allergic inflammation than of allergic symptoms. The diagnosis of MPIAP on the basis of FC concentrations is subject to considerable error, due to the high individual variability of this indicator. FZRP is a better parameter, but this needs further research, as these are the first determinations in infants with MPIAP.


Subject(s)
Biomarkers , Feces , Haptoglobins , Leukocyte L1 Antigen Complex , Milk Hypersensitivity , Milk Proteins , Proctocolitis , Protein Precursors , Humans , Leukocyte L1 Antigen Complex/analysis , Leukocyte L1 Antigen Complex/metabolism , Feces/chemistry , Infant , Female , Prospective Studies , Male , Biomarkers/analysis , Proctocolitis/diagnosis , Haptoglobins/analysis , Haptoglobins/metabolism , Milk Hypersensitivity/diagnosis , Milk Hypersensitivity/diet therapy , Protein Precursors/analysis , Protein Precursors/metabolism , Milk Proteins/analysis , Cholera Toxin/analysis , Follow-Up Studies
2.
Nutrients ; 13(11)2021 Nov 19.
Article in English | MEDLINE | ID: mdl-34836392

ABSTRACT

Characteristics of chronic milk-dependent food protein-induced enterocolitis syndrome (FPIES) in children from the region of Western Pomerania were studied. Prospectively, 55 children were diagnosed at a median of 2.2 months. The open food challenges (OFC), morphologies, milk-specific IgE (sIgE) (FEIA method, CAP system), and skin prick tests (SPTs) were examined. Vomiting and diarrhea escalated gradually but quickly led to growth retardation. Of the infants, 49% had BMI < 10 c, 20% BMI < 3 c; 25% had anemia, and 15% had hypoalbuminemia. During the OFCs we observed acute symptoms that appeared after 2-3 h: vomiting diarrhea and pallor. A total of 42% children required intravenous hydration. Casein hydrolysates or amino acids formulae (20%) were used in treatment. In 25% of children, SPT and milk sIgE were found, in 18%-other food SPTs, and in 14% allergy to other foods. A transition to IgE-dependent milk allergy was seen in 3 children. In the twelfth month of life, 62% of children had tolerance to milk, and in the twenty-fifth month-87%. Conclusions. Chronic milk-dependent FPIES resolves in most children. By the age of 2 children are at risk of multiple food sensitization, and those who have milk sIgE are at risk to transition to IgE-mediated milk allergy. Every OFC needs to be supervised due to possible severe reactions.


Subject(s)
Enterocolitis/immunology , Milk Hypersensitivity/immunology , Milk Proteins/immunology , Child , Child, Preschool , Chronic Disease , Enterocolitis/epidemiology , Female , Humans , Immunoglobulin E/blood , Infant , Infant, Newborn , Male , Milk Hypersensitivity/blood , Milk Hypersensitivity/epidemiology , Poland/epidemiology , Prospective Studies , Syndrome
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