RESUMEN
Objective: To analyze in silico the evidence of molecular mimicry between human beta-cell autoantigens and cow's milk proteins as a potential type 1 diabetes mellitus (T1DM) trigger. Materials and methods: The in silico analysis was performed using bioinformatics tools to compare the amino acid sequences of cow's milk proteins (bovine serum albumin [BSA] and beta-lactoglobulin [BLG]) and human beta-cell autoantigens (glutamic acid decarboxylase-65 [GAD-65], insulin, and zinc transporter 8 [ZnT8]). The structural and functional characteristics of the proteins were analyzed to identify potential molecular mimicry mechanisms. Results: The results of the in silico analysis showed significant sequence similarity between BSA/BLG and GAD-65/human insulin/ZnT8, ranging from 19.64% to 27.27%. The cow's milk proteins evaluated shared structural features with the beta-cell antigens selected for comparison, indicating a potential for molecular mimicry between these proteins. Conclusion: The findings of this study provide further evidence for a potential role of cow's milk proteins in triggering T1DM. The in silico analysis suggests that molecular mimicry mechanisms between cow's milk proteins and human beta-cell antigens may contribute to the autoimmune response leading to T1DM.
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Diabetes Mellitus Tipo 1 , Células Secretoras de Insulina , Proteínas de la Leche , Diabetes Mellitus Tipo 1/inmunología , Humanos , Animales , Bovinos , Proteínas de la Leche/inmunología , Células Secretoras de Insulina/inmunología , Lactoglobulinas/inmunología , Imitación Molecular/inmunología , Insulina , Autoantígenos/inmunología , Transportador 8 de Zinc/inmunología , Glutamato Descarboxilasa/inmunología , Simulación por Computador , Secuencia de Aminoácidos , Albúmina Sérica Bovina/inmunología , Biología ComputacionalRESUMEN
PURPOSE: To review the literature on the relationship of milk fat globule EGF and factor V/VIII domain containing (MFGE8) in periodontal osteoimmunology and the clinical significance of MFGE8 in periodontal disease. METHODS: Two reviewers carried out a computer-based literature search using PubMed, Scopus, and Web of Science to identify papers published up to November 2023. The keywords used in the investigation were "MFGE8" and various words related to periodontal disease (periodontal, periodontitis, gingival, gingivitis, gingiva, and periodontium). RESULTS: MFGE8 plays a critical role in the etiology of periodontal disease via regulating pro-inflammatory cytokines and bone cells. In addition, MFGE8 may be applied as a diagnostic biomarker and a therapeutic target in periodontal disease. CLINICAL SIGNIFICANCE: MFGE8-mediated periodontal osteoimmunology fills the vacant part of the pathogenesis in periodontal disease. This review provides a comprehensive perspective on the potential of MFGE8 in periodontal disease therapy.
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Proteínas de la Leche , Enfermedades Periodontales , Humanos , Enfermedades Periodontales/inmunología , Proteínas de la Leche/inmunología , Antígenos de Superficie/inmunología , Citocinas/metabolismo , Biomarcadores , Periodontitis/inmunologíaRESUMEN
In many parts of the world, goat milk has been part of the human diet for millennia. Allergy to goat's milk, not associated with allergy to cow's milk, is a rare disorder, although some cases have been described. Goat milk proteins have substantial homology with cow's milk proteins and even show cross-reactivity; therefore, they are not advised as an alternative to cow's milk for infants with IgE-mediated cow's milk allergies. However, there are indications that, due to the composition of the goat milk proteins, goat milk proteins show lower allergenicity than cow's milk due to a lower αS1-casein content. For this reason, goat milk might be a better choice over cow's milk as a first source of protein when breastfeeding is not possible or after the breastfeeding period. Additionally, some studies show that goat milk could play a role in specific types of non-IgE-mediated cow milk allergy or even in the prevention of sensitization to cow's milk proteins. This review discusses a possible role of goat milk in non-IgE mediated allergy and the prevention or oral tolerance induction of milk allergy.
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Cabras , Hipersensibilidad a la Leche , Proteínas de la Leche , Leche , Hipersensibilidad a la Leche/inmunología , Hipersensibilidad a la Leche/prevención & control , Animales , Humanos , Leche/inmunología , Leche/química , Bovinos , Proteínas de la Leche/inmunología , Proteínas de la Leche/efectos adversos , Inmunoglobulina E/inmunología , Lactante , FemeninoRESUMEN
Cow milk protein allergy (CMPA) is one of the most common food allergies in the pediatric age worldwide. Prevalence, persistence, and severity of this condition are on the rise, with a negative impact on the health-related quality of life of the patients and families and on the costs related to its management. Another relevant issue is that CMPA in early life may be the first stage of the "allergic march," leading to the occurrence of other atopic manifestations later in life, especially asthma, atopic eczema, urticaria, and rhinoconjunctivitis. Thus, "disease modification" options that are able to modulate the disease course of pediatric patients affected by CMPA would be very welcomed by affected families and healthcare systems. In this review, we report the most relevant progress on this topic.
Asunto(s)
Hipersensibilidad a la Leche , Proteínas de la Leche , Humanos , Hipersensibilidad a la Leche/inmunología , Hipersensibilidad a la Leche/terapia , Animales , Proteínas de la Leche/inmunología , Bovinos , Alérgenos/inmunología , Niño , Calidad de VidaRESUMEN
A large proportion of prescriptions for extensively hydrolyzed cow's milk protein (CMP) in newborns are not based on any scientific data justifying the indication. Many of these prescriptions are old habits or are based on incomplete data. The aim of this article is to analyze these practices and propose recommendations. The following points are covered: (a) indications for extensively hydrolyzed formula based on studies demonstrating their benefits in these situations-newborns with a proven allergy to CMP and occasional prescription of supplements to breastfeeding; (b) possible indications not based on a high level of evidence-re-initiation of feeding due to necrotizing enterocolitis, short bowel syndrome, re-initiation of feeding of newborns following intestinal surgery, and laparoschisis if neither the mother's own milk nor milk from a lactarium is available; (c) unjustified indications-newborns at risk of atopy, prematurity, severe neurological pathologies, newborns who are hemodynamically unstable and/or have congenital cardiopathy, neonatal hypoxic-ischemic encephalopathy treated with hypothermia, and newborns with esophageal atresia or diaphragmatic hernia. By following this classification, the prescriber will be guided to use the milk best suited to the pathology, bearing in mind that each situation must be adapted individually and the tolerance and effectiveness of the food reassessed from a nutritional and functional point of view.
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Fórmulas Infantiles , Hipersensibilidad a la Leche , Proteínas de la Leche , Animales , Bovinos , Humanos , Recién Nacido , Enterocolitis Necrotizante/prevención & control , Proteínas de la Leche/inmunología , Proteínas de la Leche/efectos adversos , Hidrolisados de Proteína/administración & dosificaciónRESUMEN
BACKGROUND: Complete avoidance of milk is the usual management for IgE-mediated cow's milk protein allergy (CMPA). A baked milk ladder is a method of dietary advancement therapy in IgE-mediated CMPA in Ireland, while in Spain, avoidance of milk awaiting natural tolerance acquisition through an oral food challenge (OFC) is employed. The aim of this study was to evaluate the use of dietary advancement therapy using a milk ladder compared with complete avoidance of milk for managing IgE-mediated CMPA. METHODS: This is a retrospective chart review of 371 pediatric patients from the population who have been treated for IgE-mediated CMPA between 2011 and 2020, with the milk ladder (Ireland) or complete avoidance followed by an OFC (Spain). The main outcome was the introduction of cow's milk. RESULTS: Milk ladder patients were 3.67 times more likely to succeed in comparison with milk avoidance (p < .001). Anaphylaxis during the treatment period occurred in 34 patients in the milk avoidance groups, while three patients in the milk ladder group experienced anaphylaxis due to accidental exposure to milk (p < .001). Failure to complete treatment was associated with a higher skin prick test in the milk avoidance group and a raised specific IgE in the milk ladder group. CONCLUSION: This is the first study that compares outcomes of dietary advancement therapy to complete avoidance for CMPA management, demonstrating that cow's milk can be successfully and safely reintroduced using dietary advancement therapy using a milk ladder.
Asunto(s)
Inmunoglobulina E , Hipersensibilidad a la Leche , Proteínas de la Leche , Humanos , Hipersensibilidad a la Leche/inmunología , Hipersensibilidad a la Leche/terapia , Estudios Retrospectivos , Inmunoglobulina E/sangre , Inmunoglobulina E/inmunología , Femenino , Masculino , Preescolar , Animales , Proteínas de la Leche/inmunología , Niño , Lactante , España , Leche/inmunología , Irlanda , Anafilaxia/prevención & control , Anafilaxia/inmunología , Anafilaxia/etiología , Pruebas Cutáneas , Tolerancia Inmunológica , Bovinos , Alérgenos/inmunología , Alérgenos/administración & dosificación , Resultado del TratamientoRESUMEN
BACKGROUND: The Trial to Reduce IDDM in the Genetically at Risk (TRIGR) (NCT00179777) found no difference type 1 diabetes risk between hydrolyzed and regular infant formula. However, cow milk consumption during childhood is consistently linked to type 1 diabetes risk in prospective cohort studies. OBJECTIVES: Our primary aim was to study whether humoral immune responses to cow milk and cow milk consumption are associated with type 1 diabetes in TRIGR children. METHODS: TRIGR comprised 2159 children with genetic susceptibility to type 1 diabetes born between 2002 and 2007 in 15 countries. Children were randomly assigned into groups receiving extensively hydrolyzed casein or a regular cow milk formula and followed up until age 10 y. Type 1 diabetes-related autoantibodies and antibodies to cow milk proteins were analyzed. Infant formula intake was measured by structured dietary interviews and milk consumption with a food frequency questionnaire. Associations of milk antibodies and milk consumption with risk to develop type 1 diabetes were analyzed using Cox survival model. RESULTS: Cow milk antibody concentrations both in cord blood [hazards ratio (HR) for islet autoimmunity: 1.30; 95% CI: 1.05, 1.61; HR for type 1 diabetes: 1.32; 95% CI: 1.02, 1.71] and longitudinally from birth to 3 years (HR for islet autoimmunity: 1.39; 95% CI: 1.07, 1.81; HR for type 1 diabetes: 1.43; 95% CI: 1.04, 1.96) were associated with increased risk of developing type 1 diabetes. The amount of regular infant formula was associated with reduced islet autoimmunity risk in the regular infant formula group (HR: 0.92; 95% CI: 0.85, 0.99). Furthermore, frequent liquid milk consumption after infancy was associated with increased risk of islet autoimmunity or type 1 diabetes. CONCLUSIONS: Elevated cow milk antibody concentrations and high consumption of liquid milk after infancy are related to type 1 diabetes development in children with an increased genetic susceptibility to type 1 diabetes. Enhanced antibody concentrations to cow milk may provide a biomarker of immune system prone to develop islet autoimmunity. This trial was registered at clinicaltrials.gov as NCT00179777.
Asunto(s)
Autoinmunidad , Diabetes Mellitus Tipo 1 , Inmunoglobulina G , Fórmulas Infantiles , Islotes Pancreáticos , Proteínas de la Leche , Leche , Diabetes Mellitus Tipo 1/genética , Diabetes Mellitus Tipo 1/inmunología , Humanos , Animales , Lactante , Femenino , Masculino , Inmunoglobulina G/sangre , Islotes Pancreáticos/inmunología , Bovinos , Proteínas de la Leche/inmunología , Preescolar , Autoanticuerpos/sangre , Predisposición Genética a la Enfermedad , Factores de Riesgo , Niño , Dieta , Estudios de Seguimiento , Caseínas/inmunologíaRESUMEN
Background: Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy characterized by gastrointestinal symptom onset within 1-4 hours from trigger food ingestion. In the literature, some authors have previously described the possibility that a patient with FPIES may develop an IgE-mediated allergy to the same trigger food, especially cow's milk (CM). Case Presentation: We reported five cases of CM-FPIES converting to IgE-mediated CM allergy presented at our tertiary pediatric Allergy Unit and performed a review of the literature, aiming to characterize the clinical features of patients who are at risk of developing such conversion. Conclusions: This phenomenon raises the question of whether IgE-mediated and non-IgE-mediated allergies represent a spectrum of the same disease and highlights the need for further investigation to understand the pathophysiological mechanisms of this process.
Asunto(s)
Enterocolitis , Inmunoglobulina E , Hipersensibilidad a la Leche , Humanos , Enterocolitis/inmunología , Enterocolitis/etiología , Enterocolitis/diagnóstico , Hipersensibilidad a la Leche/inmunología , Hipersensibilidad a la Leche/diagnóstico , Inmunoglobulina E/inmunología , Inmunoglobulina E/sangre , Femenino , Lactante , Masculino , Animales , Proteínas de la Leche/efectos adversos , Proteínas de la Leche/inmunología , Síndrome , Preescolar , Bovinos , Leche/efectos adversos , Leche/inmunología , Hipersensibilidad a los Alimentos/inmunología , Hipersensibilidad a los Alimentos/etiología , Hipersensibilidad a los Alimentos/diagnósticoRESUMEN
This study aimed to clarify the composition and bioactivity differences between goat and cow milk fat globule membrane (MFGM) protein by proteomic, and the immunomodulatory activity of MFGM proteins was further evaluated by using mouse splenic lymphocytes in vitro. A total of 257 MFGM proteins showed significant differences between goat and cow milk. The upregulated and unique MFGM proteins in goat milk were significantly enriched in the positive regulation of immune response, negative regulation of Interleukin-5 (IL-5) secretion, and involved in nucleotide-binding oligomerization domain (NOD)-like receptor signaling. The contents of IL-2 and Interferon-γ in the supernatant of spleen lymphocytes treated with goat MFGM proteins were much higher than those of IL-4 and IL-5, suggesting a Th1-skewed immune response. These results revealed that goat MFGM proteins could possess better immunomodulatory effects as compared to cow milk. Our findings may provide new insights to elucidate the physiological functions and nutritional of goat milk.
Asunto(s)
Glucolípidos , Glicoproteínas , Cabras , Gotas Lipídicas , Leche , Proteómica , Animales , Cabras/inmunología , Gotas Lipídicas/química , Gotas Lipídicas/metabolismo , Gotas Lipídicas/inmunología , Glicoproteínas/química , Glicoproteínas/inmunología , Glicoproteínas/genética , Glucolípidos/química , Glucolípidos/inmunología , Bovinos , Ratones , Leche/química , Factores Inmunológicos/farmacología , Factores Inmunológicos/química , Linfocitos/inmunología , Femenino , Proteínas de la Leche/química , Proteínas de la Leche/inmunología , Proteínas de la Leche/metabolismoRESUMEN
The serological surveillance of bluetongue in bulk tank milk is an efficient and cost-effective method for the early detection of bluetongue virus incursions in unvaccinated free areas of the disease. In addition, the availability of standardized and reliable reagents and refined diagnostic procedures with high sensitivity and specificity are essential for surveillance purposes. However, no available reference materials for bluetongue virus serological surveillance in bulk tank milk exist. This study shows the production and characterization of reference material for the implementation of a commercially available bluetongue milk ELISA test in official laboratories, as well as the evaluation of a procedure to increase the sensitivity in samples with low levels of antibodies. This procedure, based on milk protein concentration, allowed us to notably increase the ELISA test's analytical sensitivity, which is useful for milk samples from farms with low within-herd prevalence or pools of bulk tank milk samples. The standardized milk reference material produced here, together with the evaluated procedure to improve analytical sensitivity, could be applied as tools to ensure an accurate diagnosis by official laboratories in bluetongue unvaccinated free areas.
Asunto(s)
Virus de la Lengua Azul , Lengua Azul , Ensayo de Inmunoadsorción Enzimática , Proteínas de la Leche , Leche , Sensibilidad y Especificidad , Animales , Leche/virología , Leche/química , Lengua Azul/diagnóstico , Lengua Azul/virología , Virus de la Lengua Azul/inmunología , Virus de la Lengua Azul/aislamiento & purificación , Ensayo de Inmunoadsorción Enzimática/métodos , Ovinos , Bovinos , Proteínas de la Leche/análisis , Proteínas de la Leche/inmunología , Anticuerpos Antivirales/sangre , Pruebas Serológicas/métodos , Pruebas Serológicas/normas , Estándares de Referencia , FemeninoRESUMEN
Infant formulas based on hydrolysed cow's milk proteins are used when breastfeeding is not feasible in cow's milk allergic infants. Camel milk has been shown to be well-tolerated by the majority of children with cow's milk allergy (CMA) and may be a substitute in management of CMA. Here we aimed to evaluate the impact of processing on immunogenicity, sensitising, antibody-binding and cross-reactive capacity of cow's and camel milk. Cow's and camel milk were processed by means of enzyme hydrolysis or heat treatment. Brown Norway rats were immunised with PBS, non-processed, enzyme hydrolysed or heat-treated cow's or camel milk. In vivo tests were performed for evaluation of clinical signs. Blood and faecal samples were analysed for levels and specificity of antibody responses. Cow's and camel milk showed similar sensitising capacity. Processing decreased the sensitising capacity of cow's milk, yet only enzyme hydrolysis but not heat treatment decreased the sensitising capacity of camel milk. Processing affected the specificity of antibodies raised in the rats, though the effect differed between cow's and camel milk. The study showed a low cross-reactivity between cow's and camel milk, which was decreased with processing, suggesting that processing of camel milk may improve its usefulness in CMA management.
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Camelus , Reacciones Cruzadas , Hipersensibilidad a la Leche , Proteínas de la Leche , Leche , Animales , Camelus/inmunología , Hipersensibilidad a la Leche/inmunología , Hipersensibilidad a la Leche/prevención & control , Ratas , Bovinos , Leche/química , Leche/inmunología , Proteínas de la Leche/inmunología , Femenino , Ratas Endogámicas BN , Manipulación de Alimentos/métodos , MasculinoRESUMEN
The presence of various components in the food matrix makes allergen detection difficult and inaccurate, and pretreatment is an innovative breakthrough point. Food matrices were categorised based on their composition. Subsequently, a pretreatment method was established using a combination of ultrasound-assisted n-hexane degreasing and weakly alkaline extraction systems to enhance the detection accuracy of bovine milk allergens. Results showed that more allergens were obtained with less structural destruction, as demonstrated using immunological quantification and spectral analysis. Concurrently, allergenicity preservation was confirmed through liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis, a KU812 cell degranulation model, and western blotting. The method exhibited good accuracy (bias, 8.47%), repeatability (RSDr, 1.52%), and stability (RSDR, 5.65%). In foods with high lipid content, such as chocolate, the allergen content was 2.29-fold higher than that of commercial kits. Laser confocal scanning microscopy (LCSM) and scanning electron microscopy (SEM) analyses revealed a significant decrease in fat content after post-pretreatment using our method. In addition, colloidal stability surpassed that achieved using commercial kits, as indicated through the PSA and zeta potential results. The results demonstrated the superiority of the extractability and allergenicity maintenance of lipid matrix-specific pretreatment methods for improving the accuracy of ELISA based allergen detection in real food.
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Alérgenos , Ensayo de Inmunoadsorción Enzimática , Lípidos , Leche , Animales , Alérgenos/inmunología , Alérgenos/química , Alérgenos/análisis , Bovinos , Lípidos/química , Lípidos/inmunología , Leche/química , Espectrometría de Masas en Tándem , Hipersensibilidad a la Leche/inmunología , Humanos , Proteínas de la Leche/química , Proteínas de la Leche/inmunologíaRESUMEN
Alpha-gal syndrome (AGS) is a mammalian meat allergy associated with tick bites and specific IgE to the oligosaccharide galactose-α-1,3-galactose (α-gal). Recent studies have shown that 10-20% of AGS patients also react to the dairy proteins. Considering the already described role of the meat lipid fraction in AGS manifestations, the aim of this work has been to investigate whether the milk fat globule proteins (MFGPs) could be involved in AGS. The MFGPs are extracted and their recognition by the IgE of AGS patients is proved through immunoblotting experiments. The identification of the immunoreactive proteins by LC-HRMS analysis allows to demonstrate for the first time that butyrophillin, lactadherin, and xanthine oxidase (XO) are α-gal glycosylated. The role of xanthine oxidase seems to be prevalent since it is highly recognized by both the anti-α-gal antibody and AGS patient sera. The results obtained in this study provide novel insights in the characterization of α-Gal carrying glycoproteins in bovine milk, supporting the possibility that milk, especially in its whole form, may give reactions in AGS patients. Although additional factors are probably associated with the clinical manifestations, the avoidance of milk and milk products should be considered in individuals with AGS showing symptoms related to milk consumption.
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Glucolípidos , Glicoproteínas , Gotas Lipídicas , Leche , Humanos , Animales , Bovinos , Leche/química , Alérgenos/inmunología , Butirofilinas/metabolismo , Femenino , Proteínas de la Leche/inmunología , Inmunoglobulina E/inmunología , Hipersensibilidad a los Alimentos/inmunología , Mordeduras de Garrapatas , Adulto , Masculino , Antígenos de Superficie/inmunología , Persona de Mediana Edad , alfa-Galactosidasa , DisacáridosRESUMEN
Information regarding protein expression and phosphorylation modifications in the bovine milk fat globule membrane is scarce, particularly throughout various lactation periods. This study employed a complete proteome and phosphoproteome between bovine colostrum and mature milk. A total of 11 proteins were seen in both protein expression and phosphorylation levels. There were 400 proteins identified in only protein expression, and 104 phosphoproteins identified in only phosphorylation levels. A total of 232 significant protein characteristics were identified within the proteome and significant phosphorylation sites within 86 phosphoproteins of the phosphoproteome. Biological activities and pathways primarily exhibited associations with the immune system. Simultaneously, a comprehensive analysis of proteins and phosphorylation sites using a multi-omics approach. Hence, the data we have obtained has the potential to expand our understanding of how the bovine milk fat globule membrane might be utilized as a beneficial component in dairy products.
Asunto(s)
Glucolípidos , Glicoproteínas , Lactancia , Gotas Lipídicas , Leche , Fosfoproteínas , Proteómica , Animales , Bovinos , Glicoproteínas/química , Glicoproteínas/inmunología , Glicoproteínas/metabolismo , Gotas Lipídicas/química , Gotas Lipídicas/metabolismo , Glucolípidos/química , Glucolípidos/metabolismo , Femenino , Fosfoproteínas/química , Fosfoproteínas/metabolismo , Fosfoproteínas/genética , Fosfoproteínas/inmunología , Leche/química , Proteínas de la Leche/química , Proteínas de la Leche/metabolismo , Proteínas de la Leche/inmunología , Fosforilación , Proteoma/química , Proteoma/inmunología , Proteoma/análisisRESUMEN
INTRODUCTION AND OBJECTIVES: Food allergy has several negative nutritional consequences and may persist beyond the first year of lives. This study aimed to assess the role of a complete oral amino acid-based supplement in the diet of children on cow's milk protein elimination diet because of food allergy. MATERIALS AND METHODS: This study included two groups of children aged 1-5 years paired by age and socioeconomic status: (1) study group, on cow's milk protein elimination diet plus an oral amino acid-based supplement, and (2) control group, on cow's milk protein elimination diet. Sociodemographic, clinical, anthropometric, and dietary data were obtained through online interviews. Two 24-h dietary recalls were collected on nonconsecutive days. Both groups comprised mostly boys. RESULTS: The study group presented lower values of body mass index. The frequency of feeding difficulties was similar between groups. The study group had a higher intake of energy, protein, carbohydrates, calcium, iron, zinc, phosphorus, magnesium, copper, selenium, vitamins D, E, B1, B2, B6, and B12, niacin, and folic acid compared to the control group. A higher proportion of children in the study group had adequate intake according to the recommendations made for energy, carbohydrates, iron, phosphorus, selenium, vitamins A, D, E, B1, B2, and B6, and folic acid. CONCLUSIONS: The use of a complete oral amino acid-based supplement has a positive effect on the diet quality of preschoolers on cow's milk elimination diet because of food allergy, promoting higher intake of energy, calcium, vitamin D, and other essential nutrients.
Asunto(s)
Aminoácidos , Suplementos Dietéticos , Hipersensibilidad a la Leche , Animales , Bovinos , Preescolar , Femenino , Humanos , Lactante , Masculino , Aminoácidos/administración & dosificación , Estudios Transversales , Dieta de Eliminación , Leche/inmunología , Proteínas de la Leche/administración & dosificación , Proteínas de la Leche/inmunologíaRESUMEN
BACKGROUND: Cow's milk protein allergy (CMPA) remains relatively understudied in Latin America. METHODS: In this observational study, we enrolled 64 patients with a median age of 3 months, of whom 60% were male. Patients included had a history of IgE-mediated reactions with IgE sensitization or non-IgE-mediated reactions or symptoms following exposure to cow's milk. They underwent skin prick test, ImmunoCAP, fecal calprotectin (FC), and fecal eosinophil-derived neurotoxin (EDN), in addition to double-blinded placebo-controlled oral food challenges (DBPCFC), with clinical evolution and tolerance acquisition observed over 1 year. RESULTS: Malnutrition was present in 78.1% of patients, and 87.5% had a family history of atopy, with 51.6% receiving exclusive breastfeeding. Gastrointestinal manifestations were prevalent in 90.6% of patients, followed by dermatological manifestations (10.9%), with only 2 experiencing anaphylaxis. IgE-mediated CMPA was observed in only six patients. In those with non-IgE-mediated CMPA, FC had a median of 284 mg/dL (IQR: 138.5-415.5), while EDN had a median of 508.5 mg/dL (IQR: 160.25-868). One year after diagnosis, median FC significantly decreased (p < 0.0001), and malnutrition prevalence reduced to 17.1%. Moreover, 81% of patients acquired tolerance following DBPCFC, with 52% utilizing nutritional replacement formulas at diagnosis. Notably, 94% of those extensively hydrolyzed casein-based formulas achieved tolerance (p = 0.08). CONCLUSION: Our findings provide a foundational framework for future investigations into CMPA diagnosis, tolerance acquisition, and the utilization of hypoallergenic formulas tailored to the unique characteristics of our region.
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Tolerancia Inmunológica , Inmunoglobulina E , Hipersensibilidad a la Leche , Proteínas de la Leche , Pruebas Cutáneas , Humanos , Hipersensibilidad a la Leche/inmunología , Hipersensibilidad a la Leche/epidemiología , Hipersensibilidad a la Leche/diagnóstico , Hipersensibilidad a la Leche/sangre , Masculino , Lactante , Femenino , Perú/epidemiología , Proteínas de la Leche/inmunología , Inmunoglobulina E/inmunología , Inmunoglobulina E/sangre , Animales , Alérgenos/inmunología , Bovinos , Heces , Complejo de Antígeno L1 de Leucocito/análisisRESUMEN
Neonatal immune regulation transitions from fetal immunity and varies with maturation status, but its role in neonatal cow's milk protein allergy (CMPA) remains unknown. We studied the association between maturation status at birth and neonatal CMPA. Clinical and laboratory data of neonates presenting with CMPA symptoms were retrospectively collected from two tertiary hospitals. Patients were assessed according to gestational age at birth: preterm, late-preterm, and full-term. Fifty-five infants (26 females, 14 preterm, 15 late-preterm, and 26 full-term) were included; 44 were negative for milk-specific immunoglobulin E. Neonatal CMPA was common during moderately premature periods. Preterm infants exhibited longer latency from initial CM exposure to disease onset, lower incidence of bloody stool, and absence of elevated monocyte counts. However, immunoreactivity to CM antigens was retained in all infants. Neonatal CMPA features varied with infant maturation status at birth. Our results improve the understanding of intestinal immunity development, fetal/neonatal immune regulation, and CMPA pathogenesis.
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Recien Nacido Prematuro , Hipersensibilidad a la Leche , Proteínas de la Leche , Estudios Retrospectivos , Hipersensibilidad a la Leche/inmunología , Humanos , Femenino , Recién Nacido , Masculino , Proteínas de la Leche/inmunología , Proteínas de la Leche/efectos adversos , Recien Nacido Prematuro/inmunología , Edad Gestacional , Inmunoglobulina E/sangre , Inmunoglobulina E/inmunología , Animales , BovinosRESUMEN
Extremely sensitive food-allergic patients may react to very small amounts of allergenic foods. Precautionary allergen labelling (PAL) warns from possible allergenic contaminations. We evaluated by oral food challenge the reactivity to a brand of PAL-labelled milk- and egg-free biscuits of children with severe milk and egg allergy. We explored the ability of proteomic methods to identify minute amounts of milk/egg allergens in such biscuits. Traces of milk and/or egg allergens in biscuits were measured by two different liquid-chromatography-mass spectrometry methods. The binding of patient's serum with egg/milk proteins was assessed using immunoblotting. None of the patients reacted to biscuits. Egg and milk proteins were undetectable with a limit of detection of 0.6 µg/g for milk and egg (method A), and of 0.1 and 0.3 µg /g for milk and egg, respectively (method B). The immunoblots did not show milk/egg proteins in the studied biscuits. Milk/egg content of the biscuits is far lower than 4 µg of milk or egg protein per gram of product, the minimal doses considered theoretically capable of causing reactions. With high sensitivity, proteomic assessments predict the harmlessness of very small amount of allergens in foods, and can be used to help avoiding unnecessary PAL.
Asunto(s)
Alérgenos/análisis , Hipersensibilidad al Huevo/inmunología , Hipersensibilidad al Huevo/prevención & control , Etiquetado de Alimentos , Hipersensibilidad a la Leche/inmunología , Hipersensibilidad a la Leche/prevención & control , Adolescente , Niño , Preescolar , Hipersensibilidad al Huevo/etiología , Proteínas del Huevo/análisis , Proteínas del Huevo/inmunología , Femenino , Análisis de los Alimentos/métodos , Humanos , Lactante , Masculino , Espectrometría de Masas , Hipersensibilidad a la Leche/etiología , Proteínas de la Leche/análisis , Proteínas de la Leche/inmunología , Gravedad del Paciente , Estudios Prospectivos , Proteómica/métodosRESUMEN
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.
Asunto(s)
Enterocolitis/inmunología , Hipersensibilidad a la Leche/inmunología , Proteínas de la Leche/inmunología , Niño , Preescolar , Enfermedad Crónica , Enterocolitis/epidemiología , Femenino , Humanos , Inmunoglobulina E/sangre , Lactante , Recién Nacido , Masculino , Hipersensibilidad a la Leche/sangre , Hipersensibilidad a la Leche/epidemiología , Polonia/epidemiología , Estudios Prospectivos , SíndromeRESUMEN
The purpose of this study was to evaluate the diagnosis and management of infants presenting with symptoms attributable to cow's milk allergy (CMA) in a real life setting and to test how the Cow's Milk-related Symptom Score (CoMiSS®) can be used to support the awareness to diagnose cow's milk protein allergy in primary care practice. The CoMiSS is an awareness tool based on various symptoms such as crying, gastrointestinal symptoms, dermatological and respiratory symptoms. The study was conducted on 268 infants from four countries (Belgium, Czech Republic, Germany, UK) aged 0 to 18 months consulting for CMA related symptoms. The analysis was based on two visits of these subjects. The results show an average CoMiSS of 11 at the first visit. After a therapeutic dietary intervention, the score at the second visit, which happened 3 weeks ± 5 days after the first one, dropped to an average value of 4. A satisfaction questionnaire completed by the primary care practitioners suggested an overall high level of satisfaction with the application of the CoMiSS tool in routine practice. These data highlight a huge discrepancy in the diagnosis and management of infants suspected of CMA in the different countries. The findings suggest that the CoMISS questionnaire is an effective tool in aiding awareness of CMPA in primary health care.