Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.698
Filtrar
1.
Food Chem ; 346: 128926, 2021 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33484948

RESUMO

Food allergy is on the rise, and preventive/therapeutic procedures are needed. We explored a preventive protocol for milk allergy with the oral administration of a Gly-m-Bd-30K soy-derived peptide that contains cross-reactive epitopes with bovine caseins. B/T-cross-reactive epitopes were mapped using milk-specific human sera and monoclonal antibodies on overlapping and recombinant peptides of Gly-m-Bd-30K by SPOT and cell proliferation assays. Bioinformatics tools were used to characterize epitopes on the 3D-modelled molecule, and to predict the binding to HLA alleles. The peptide was orally administrated to mice that were then IgE-sensitized to milk proteins. Immunodominant B-epitopes were mainly located on the surface of the Nt-fragment. The use of a soy-peptide-containing an immunodominant cross-reactive T-epitope, along with a single B epitope, prevents IgE-mediated milk sensitization through the induction of Th1-mediated immunity and induction of blocking IgG. The use of a safe soy-peptide may represent a promising alternative for preventing milk allergy.


Assuntos
Reações Cruzadas , Hipersensibilidade a Leite/prevenção & controle , Fragmentos de Peptídeos/administração & dosagem , Fragmentos de Peptídeos/imunologia , Proteínas de Soja/imunologia , Administração Oral , Animais , Bovinos , Epitopos/imunologia , Humanos , Camundongos , Hipersensibilidade a Leite/imunologia
2.
Arch. argent. pediatr ; 118(6): 418-422, dic 2020. tab, ilus
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-1146110

RESUMO

Introducción: Las alergias alimentarias afectan, mayoritariamente, a los niños en los primeros años de vida. Existen escasos datos epidemiológicos en nuestro país.Objetivos: Determinar los agentes causales, describir la prevalencia y características de los pacientes con alergia alimentaria en una población pediátrica argentina.Pacientes y métodos: Estudio retrospectivo observacional, de corte transversal, de pacientes menores de 18 años. Resultados: Se incluyeron 321 pacientes; se confirmó alergia alimentaria en un 64 % (207) de los casos. El 53 % (109) presentó mecanismo mediado por inmunoglobulina E; el 68 % (140), alergia a las proteínas de la leche de vaca; el 20 % (41), alergia al huevo, y el 12 % (24), anafilaxia como manifestación clínica. La prevalencia global de alergia alimentaria fue del 0,87 % (IC 95 %: 0,7-0,9).Conclusiones: La prevalencia global de alergia alimentaria fue del 0,87 %. La leche de vaca resultó el principal alérgeno incluso en adolescentes.


Introduction: Food allergies affect mostly children in their first years of life. Epidemiological data obtained in Argentina are scarce. Objectives: To determine offending foods and describe the prevalence and characteristics of patients with food allergy in an Argentine pediatric population. Patients and methods: Observational, retrospective, cross-sectional study on patients younger than 18 years. Results:A total of 321 patients were included; food allergy was confirmed in 64 % (207) of cases. An immunoglobulin E-mediated mechanism was observed in 53 % (109); cow's milk protein allergy, in 68 % (140); egg allergy, in 20 % (41); and anaphylaxis as clinical manifestation, in 12 % (24). The overall prevalence of food allergy was 0.87 % (95 % confidence interval: 0.7-0.9). Conclusions: The overall prevalence of food allergy was 0.87 %. Cow's milk was the main allergen, even among adolescents


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Hipersensibilidade Alimentar/diagnóstico , Imunoglobulina E/imunologia , Estudos Epidemiológicos , Estudos Transversais , Estudos Retrospectivos , Hipersensibilidade a Leite
3.
Arch. argent. pediatr ; 118(6): e554-e557, dic 2020. ilus
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1146221

RESUMO

La alergia alimentaria se define como una reacción adversa que resulta de una respuesta inmunológica específica y reproducible desencadenada por la exposición al alimento. La respuesta inmune puede ser mediada por inmunoglobulina E, no mediada por inmunoglobulina E o mixta. Durante el primer año de vida, la proteína de la leche de vaca es la primera proteína a la cual se enfrentan los niños alimentados mediante lactancia materna o artificial, motivo por el cual constituye la forma de alergia alimentaria más frecuente en los primeros meses de la vida. El objetivo de este trabajo es presentar un caso clínico grave y poco frecuente de alergia a la proteína de la leche de vaca en el período neonatal.


Food allergy is defined as a reproducible adverse reaction that results from a specific and reproducible immune response triggered by exposure to food. The immune response can be mediated by immunoglobulin E, not mediated by immunoglobulin E or both. During the first year, cow´s milk protein is the first protein faced by children fed with breast milk or artificial milk. For that reason, it constitutes the form of food allergy most frequent in the first months of life. The objective of this paper is to describe a serious and rare clinical case of milk hypersensitivity in the neonatal period.


Assuntos
Humanos , Masculino , Recém-Nascido , Hipersensibilidade a Leite , Aleitamento Materno , Proteínas do Leite
4.
Appl Environ Microbiol ; 86(21)2020 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-32826221

RESUMO

Cow's milk allergy is a worldwide public health issue, especially since there is no effective treatment, apart from milk and dairy product avoidance. The aim of this study was to assess the beneficial role of three probiotic strains previously selected for their prophylactic properties in a mouse model of ß-lactoglobulin allergy. Administration of Lactobacillus rhamnosus LA305, L. salivarius LA307, or Bifidobacterium longum subsp. infantis LA308 for 3 weeks post-sensitization and challenge modified the composition of the gut microbiota, with an increase in the Prevotella NK3B31 group and a decrease in Marvinbryantia, belonging to the Lachnospiraceae family. Although no impact on markers of sensitization was detected, modifications of foxp3, tgfß, and il10 ileal gene expression, as well as plasma metabolomic alterations in the tryptophan pathway, were observed. Moreover, ex vivo studies showed that all probiotic strains induced significant decreases in cytokine production by ß-lactoglobulin-stimulated splenocytes. Taken together, these results suggest that the three probiotic strains tested lead to alterations in immune responses, i.e., induction of a tolerogenic anergy and anti-inflammatory responses. This anergy could be linked to cecal microbiota modifications, although no impact on fecal short-chain fatty acid (SCFA) concentrations was detected. Anergy could also be linked to a direct impact of probiotic strains on dendritic cells, since costimulatory molecule expression was decreased following coincubation of these strains with bone marrow-derived dendritic cells (BMDCs). To conclude, all three candidate probiotic strains induced strain-specific gut microbiota and metabolic changes, which could potentially be beneficial for general health, as well as anergy, which could contribute to oral tolerance acquisition.IMPORTANCE We showed previously that three probiotic strains, i.e., Lactobacillus rhamnosus LA305, L. salivarius LA307, and Bifidobacterium longum subsp. infantis LA308, exerted different preventive effects in a mouse model of cow's milk allergy. In this study, we evaluated their potential benefits in a curative mouse model of cow's milk allergy. When administered for 3 weeks after the sensitization process and a first allergic reaction, none of the strains modified the levels of sensitization and allergic markers. However, all three strains affected gut bacterium communities and modified immune and inflammatory responses, leading to a tolerogenic profile. Interestingly, all three strains exerted a direct effect on dendritic cells, which are known to play a major role in food sensitization through their potentially tolerogenic properties and anergic responses. Taken together, these data indicate a potentially beneficial role of the probiotic strains tested in this model of cow's milk allergy with regard to tolerance acquisition.


Assuntos
Microbioma Gastrointestinal , Tolerância Imunológica/imunologia , Hipersensibilidade a Leite/microbiologia , Probióticos/administração & dosagem , Animais , Bifidobacterium longum subspecies infantis/química , Bovinos , Feminino , Lactobacillus rhamnosus/química , Lactobacillus salivarius/química , Camundongos , Camundongos Endogâmicos BALB C , Probióticos/química
5.
Medicine (Baltimore) ; 99(27): e21055, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32629732

RESUMO

Food allergen and aeroallergen sensitization are common allergic diseases worldwide, with widely varying estimates of prevalence in children. Our study investigated the characteristics of ingestion and inhalation allergy among children from Sichuan province in Southwest China, so as to get public awareness of these disorders.A total of 1722 children between 0 and 14 years' old were enrolled in this study. They were outpatients in the West China Second University Hospital during June 2019 to September 2019. Serum specific IgE specific to 10 types of food allergen and 10 types of aeroallergen were estimated. Nutrition indicators were tested by electrochemical luminescence.59.70% children were allergic to at least 1 allergen, comprising 24.90% to aeroallergen and 38.81% to food allergen, respectively, whereas 36.28% children were allergic to both aeroallergen and food allergen. Milk was the most common food allergen, and egg came in second place. With regard to aeroallergen, house dust mite held the maximum proportion (65.02%), whereas dust mite followed behind. Inhalation allergy was more commonly seen in boys than girls. Bronchitis was the most common symptom of both allergies. In addition, the highest incidence age for children to be sensitive to food allergen and aeroallergen were 0∼2 years' old and 3∼5 years' old, respectively. It is worth mentioning that there was no significant difference in nutritional status between children with or without allergic diseases.Our findings reveal that milk, egg, house dust mite, and dust mite are the most common allergens among children in Sichuan province. Boys are more susceptible to aeroallergen than girls. Furthermore, the prevalence of ingestion and inhalation allergy varies from different age groups, and has no correlation with nutritional status. In brief, the analysis of the pattern of food allergen and aeroallergen sensitization is invaluable to effective diagnosis and treatment of allergic diseases.


Assuntos
Alérgenos/imunologia , Hipersensibilidade Alimentar/epidemiologia , Imunização/métodos , Adolescente , Alérgenos/efeitos adversos , Animais , Conscientização , Bronquite/epidemiologia , Bronquite/imunologia , Criança , Pré-Escolar , China/epidemiologia , Ingestão de Alimentos/imunologia , Hipersensibilidade a Ovo/epidemiologia , Hipersensibilidade a Ovo/imunologia , Feminino , Hipersensibilidade Alimentar/imunologia , Humanos , Imunoglobulina E/sangue , Incidência , Lactente , Recém-Nascido , Inalação/imunologia , Masculino , Hipersensibilidade a Leite/epidemiologia , Hipersensibilidade a Leite/imunologia , Estado Nutricional/imunologia , Prevalência , Pyroglyphidae/imunologia
6.
Toxicol Lett ; 333: 312-321, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-32473296

RESUMO

INTRODUCTION: This 4-center study is part of a project to validate a food allergy murine model for safety testing of hydrolyzed infant formulas. AIM: The aim of the current multi-center experiment was to evaluate the residual allergenicity of three partial hydrolyzed whey proteins (pWH) in a multiple-parameter cow's milk allergy murine model and to compare to the classically used guinea pig model. Previous work showed differences in the magnitude of the allergic response to whey between centers. To get a first insight in the effect of housing on the robustness of the mouse model, microbiota composition of non-sensitized mice was analyzed and compared between centers. METHODS: Mice were sensitized intragastrically (i.g.) with whey, pWH or eWH using cholera toxin as an adjuvant. In mice, whey-IgE/IgG1, acute allergic symptoms were determined upon whey challenge. Guinea pigs were orally sensitized ad libitum via the drinking water (day 0-37) and challenged intravenously with whey on day 49. The microbial composition in fecal samples was determined in non-sensitized mice in all 4 research centers before and after conduct of the study. RESULTS: Elevated levels of whey-IgG1 were detected in whey-sensitized mice in all centers. Except for pWH-A in center 4, we observed elevated levels of whey-IgE in whey-sensitized mice and mice sensitized with pWH-A, -B, -C. Center 2 was excluded from further analysis because of non-significant IgE levels in the positive control. In contrast to whey-mice, pWH-A treated mice showed no acute skin response, mMCP-1 release or change in body temperature upon whey challenge in all centers, which corresponds with the absence of anaphylactic shock symptoms in both the mouse and guinea pig model. pWH-B and -C induced anaphylactic shock symptoms in the guinea-pig and mice whereas results on the remaining allergic outcomes in mice were inconclusive. No differences in microbiota composition were measured in response to the challenge and Microbiota composition depended on the location of the centers. CONCLUSIONS: Both animal models showed comparable results on the residual allergenicity of partial hydrolyzed whey proteins, but none of the centers was able to differentiate between the residual sensitizing capacities of the pWH-B and -C based on a single elicitation parameter in the murine model. Differences in microbiota composition might contribute to the robustness of the food allergy murine model. For a well-balanced prediction on the potential allergenicity of hydrolyzed infant formulas a multiple murine parameter model is suggested to decrease the risk of false positive or false negative results. A future challenge is to develop an overall scoring system for proper risk assessment, taking all parameters into account.


Assuntos
Modelos Animais de Doenças , Hipersensibilidade Alimentar/imunologia , Hipersensibilidade a Leite/imunologia , Proteínas do Leite/imunologia , Proteínas do Soro do Leite/imunologia , Animais , Cobaias , Humanos , Imunoglobulina E/sangue , Imunoglobulina G/sangue , Lactente , Fórmulas Infantis , Laboratórios/normas , Camundongos , Hipersensibilidade a Leite/sangue
7.
PLoS One ; 15(4): e0230472, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32315306

RESUMO

BACKGROUND: Numerous studies have shown that specific components of breast milk, considered separately, are associated with disease status in the mother or the child using univariate analyses. However, very few studies have considered multivariate analysis approaches to evaluate the relationship between multiple breast milk components simultaneously. AIM: Here we aimed at visualizing breast milk component complex interactions in the context of the allergy status of the mother or the child. METHODS: Milk samples were collected from lactating mothers participating in the Leipziger Forschungszentrum für Zivilisationskrankheiten (LIFE) Child cohort in Leipzig, Germany. A total of 156 breast milk samples, collected at 3 months after birth from mother/infant pairs, were analyzed for 51 breast milk components. Correlation, principal component analysis (PCA) and graphical discovery analysis were used. RESULT: Correlations ranging from 0.40 to 0.96 were observed between breast milk fatty acid and breast milk phospholipids levels and correlations ranging from 0 to 0.76 between specific human milk oligosaccharides (HMO) were observed. No separation of the data based on the risk of allergy in the infants was identified using PCA. When graphical discovery analysis was used, dependencies between maternal plasma immunoglobulin E (IgE) level and the breast milk immune marker transforming growth factor-beta 2 (TGF-ß2), between TGF-ß2, breast milk immunoglobulin A (IgA) and TGF-ß1 as well as between breast milk total protein and birth weight were observed. Graphical discovery analysis also exemplifies a possible competition for the fucosyl group between 2'FL, LNFP-I and 3'FL in the HMO group. Additionally, dependencies between immune component IgA and specific HMO (6'SL and blood group A antigen tetraose type 5 or PI-HMO) were identified. CONCLUSION: Graphical discovery analysis applied to complex matrices such as breast milk composition can aid in understanding the complexity of interactions between breast milk components and possible relations to health parameters in the mother or the infant. This approach can lead to novel discoveries in the context of health and diseases such as allergy. Our study thus represents the first attempt to visualize the complexity and the inter-dependency of breast milk components.


Assuntos
Imunoglobulina A/metabolismo , Hipersensibilidade a Leite/etiologia , Leite Humano/química , Oligossacarídeos/metabolismo , Adulto , Aleitamento Materno , Criança , Estudos de Coortes , Dermatite Alérgica de Contato , Feminino , Humanos , Imunoglobulina E/sangue , Lactente , Lactação , Metacrilatos/efeitos adversos , Análise de Componente Principal/métodos , Fatores de Crescimento Transformadores/metabolismo
8.
Scand J Immunol ; 92(1): e12891, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32302416

RESUMO

There is a need for efficient methods to treat food allergy; however, no immunotherapeutic method has yet been satisfactory due to the high rate of unpredictable severe reactions and the limited efficacy. Therefore, modified versions of food allergens have been suggested as alternatives to the parent proteins for immunotherapy. The aim of the study was to compare the inherent allergenicity of the native and denatured version of the cow's milk proteins ß-lactoglobulin and α-lactalbumin, and to study the impact of the use of Al(OH)3 as an adjuvant. Brown Norway rats were immunized intraperitoneally with either native or denatured ß-lactoglobulin or α-lactalbumin, with or without the use of Al(OH)3 as adjuvant. Antibody responses were analysed in various ways by means of different ELISAs. Both the immunogenicity and the sensitizing capacity of the cow's milk allergens were influenced by their globular folding, with the native version being more allergenic than the denatured counterpart. The native folded proteins mainly raised antibodies against conformational epitope, whereas the denatured versions predominantly raised antibodies against linear epitopes. Most interestingly, the study showed that the use of Al(OH)3 , besides increasing immunogenicity and sensitizing capacity of the cow's milk allergens, caused a modification of the specificity of the antibodies raised against the native version of the proteins. Adsorption of the native forms of the allergens to Al(OH)3 caused a significant greater proportion of antibodies raised against linear epitopes, stressing that the adsorption induced a partly unfolding of the proteins. This may have implications for IT safety and efficacy.


Assuntos
Adjuvantes Imunológicos/farmacologia , Hidróxido de Alumínio/farmacologia , Lactalbumina/imunologia , Lactoglobulinas/imunologia , Leite/imunologia , Alérgenos/imunologia , Animais , Dessensibilização Imunológica/métodos , Modelos Animais de Doenças , Epitopos/imunologia , Imunização , Lactalbumina/metabolismo , Lactoglobulinas/metabolismo , Hipersensibilidade a Leite/imunologia , Desnaturação Proteica , Ratos
9.
Allergol. immunopatol ; 48(2): 202-210, mar.-abr. 2020. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-191826

RESUMO

Cow's milk protein allergy (CMPA) is the most common type of food-allergy in younger children. Prognosis is usually good, with most children developing tolerance before school age. Children may present with a wide spectrum of symptoms that range from mild to severe; skin reactions such as angioedema and urticaria and gastrointestinal symptoms are the most common presentations of CMPA. Approximately one-third of CMPA patients suffer from multiple food-allergies; severe conditions such as anaphylactic shock (9%), eosinophilic esophagitis (4.7%), and food-protein induced enterocolitis (1%) may also develop in some children. Timely and accurate diagnosis and management is essential for proper growth and development of children with CMPA. In this expert consensus report, we aimed to adapt current understandings in the CMPA field to the specific conditions in Turkey and health system to help physicians with their day-to-day decision making


No disponible


Assuntos
Humanos , Criança , Hipersensibilidade a Leite/diagnóstico , Consenso , Hipersensibilidade a Leite/epidemiologia , Prognóstico , Hipersensibilidade a Leite/imunologia , Turquia/epidemiologia , Hipersensibilidade Imediata/diagnóstico
10.
J Dairy Sci ; 103(5): 4109-4120, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32113777

RESUMO

Bovine ß-lactoglobulin (ß-LG) is recognized as a major allergen in milk. This study aimed to investigate ultrasound-assisted irradiation for reducing the allergenicity of ß-LG, since irradiation can reduce the allergenicity of cow milk proteins and ultrasound can improve the quality of milk. The structural changes induced in high purity ß-LG, treated by irradiation, with or without sonication, were characterized by native PAGE, circular dichroism spectroscopy, and fluorescence spectroscopy. The changes in allergenicity were measured by IgE binding capacity to, and inflammatory mediator secretion by, human basophil KU812 cells. Surface hydrophobicity was reduced and aggregation of ß-LG increased after treatment by irradiation, both with and without sonication. The IgE binding capacity and release of inflammatory mediators were reduced significantly and the reduction induced by irradiation before sonication was the greatest, suggesting that irradiation after sonication can be a safe and effective method to reduce the allergenicity of ß-LG in dairy processing.


Assuntos
Alérgenos/química , Lactoglobulinas/química , Lactoglobulinas/imunologia , Leite/química , Alérgenos/imunologia , Animais , Bovinos , Pré-Escolar , Dicroísmo Circular , Eletroforese em Gel de Poliacrilamida , Feminino , Humanos , Interações Hidrofóbicas e Hidrofílicas , Imunoglobulina E/imunologia , Lactente , Lactoglobulinas/efeitos da radiação , Masculino , Hipersensibilidade a Leite , Conformação Proteica , Sonicação , Espectrometria de Fluorescência
12.
PLoS One ; 15(2): e0229356, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32092100

RESUMO

Food allergy is an emerging clinical condition in pediatrics, so recommendations on its management have been widely published. Studying pediatricians' adherence to these clinical practice guidelines (CPG) and understanding the reasons for their non-compliance can help to promote better management of this condition. A cross-sectional study was conducted by a survey among Brazilian pediatricians, randomly selected during the 38th Brazilian Congress of Pediatrics, which took place in October, 2017. A validated questionnaire with 16 questions addressing knowledge and practice on food allergy, as well as self-reported adherence to international guidelines was applied. Of the total of 415 pediatricians from all regions of the country who were surveyed, only 69 (16.7%) had a satisfactory adherence rate (≥80%). Adequate adherence to the guidelines was associated with the variables: 'evaluating more than 10 children with suspected cow's milk allergy (CMA) per month'; 'having read the Brazilian consensus'; or 'being aware of any international food allergy guideline'. In 8 of the 10 questions that assessed conscious adherence, a minority of those surveyed (20.3-42.3% variation) stated that they knew that their response was in line with the guidelines. This finding was statistically significant (p<0.05) in 7 of these 8 questions. The self-reported adherence of Brazilian pediatricians to international food allergy guidelines was low. Pediatricians who evaluated a higher number of children with suspected CMA or who were aware of the recommendations, had a higher rate of adherence. The results of the survey found that lack of resource was the major reported barrier to guideline adherence but lack of awareness must be a relevant non perceived barrier. This study shows the pediatricians´ self-reported adherence to food allergy guidelines in a widely overview for the first time in Brazil. More studies are necessary to investigate adherence to guidelines by pediatricians in other countries and to develop strategies to improve adherence.


Assuntos
Hipersensibilidade Alimentar/terapia , Fidelidade a Diretrizes/estatística & dados numéricos , Pediatras/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Adulto , Conscientização , Brasil/epidemiologia , Estudos Transversais , Feminino , Hipersensibilidade Alimentar/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Hipersensibilidade a Leite/epidemiologia , Hipersensibilidade a Leite/terapia , Pediatras/normas , Padrões de Prática Médica/normas , Inquéritos e Questionários
13.
Nutrients ; 12(2)2020 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-32069783

RESUMO

Objectives-Failure to thrive (FTT) in infants is characterized by growth failure. Although, cow's milk allergy (CMA) may have an impact on growth and leads to FTT, data are still limited. We focused on FTT as a possible clinical marker for an early diagnosis of CMA. The aim of the present study was to evaluate the implications of cow's milk hypersensitivity in infants with FTT and the growth catch-up after a cow's milk-free diet (CMFD). Methods-A cross-sectional study of all consecutive infants evaluated at the Pediatric Nutrition and Allergy Unit of the University Hospital of Bari (Italy) from January 2016 to April 2018 with a medical-driven diagnosis of FTT. Eligible infants were investigated for possible IgE mediated or non-IgE mediated CMA. Results-43 infants were included, mean age 5.7 months. 33/43 (77%) FTT presented a CMA related disease: 3/43 (7%) were diagnosed as presenting an IgE mediated CMA, 30 (93%) had a non IgE-mediated CMA, confirmed by the elimination diet for diagnostic purposes, that led to a significant improvement of symptoms and recrudescence after milk reintroduction. A total of 29 out of 30 patients (one patient was lost at follow-up) moved up to their original growth percentile after dietary changes. Growth z-scores were computed based on WHO anthropometric data. In 10 out of 43 patients (23%) were diagnosed with gastro-esophageal reflux disease (GERD). Conclusions-when evaluating an infant with FTT, physicians should include in their evaluation an extensive search for IgE mediated and non IgE mediated CMA. When in vivo and in vitro analysis are not conclusive, a 4- to 8-weeks trial of CMFD and a consecutive re-introduction of milk proteins may be helpful in less common diagnoses.


Assuntos
Insuficiência de Crescimento/diagnóstico , Hipersensibilidade a Leite/diagnóstico , Leite/efeitos adversos , Animais , Biomarcadores/análise , Estudos Transversais , Diagnóstico Precoce , Insuficiência de Crescimento/etiologia , Feminino , Humanos , Lactente , Itália , Masculino , Hipersensibilidade a Leite/complicações
14.
J Dairy Sci ; 103(3): 2153-2166, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31928755

RESUMO

Horse milk is a valuable raw material and a very attractive alternative for scientific research to address the issue of cow milk (CM) allergy due to its protein profile. A decrease in immunoreactive properties can be achieved by thermal, enzymatic, and hydrolytic processing. Therefore, the aim of this study was to explore the possibility of reducing the immunoreactivity of horse milk proteins by microbial transglutaminase (TG) polymerization. To determine how TG linking alters immunoreactivity under simulated digestion of the examined milk, analyses were performed before, during, and after digestion. The dose-dependent (1, 10, and 100 U) effects of microbial TG on horse and cow milk were analyzed. A consecutive 3-stage digestion was simulated with salivary, gastric, and intestinal fluids. The effects of digestion were analyzed by SDS-PAGE, particle size analysis, and size-exclusion chromatography. Immunoreactivity was assessed using competitive ELISA (ß-lactoglobulin and α-casein) and immunodot (sera from 7 patients aged 3 to 13 years who are allergic to CM proteins). Horse milk contained almost half of the amount of total proteins in CM. The dose 1 U/g of total milk protein changed the immunoreactivity of both cow and horse milk. With increasing TG doses, α-casein immunoreactivity increased, and ß-lactoglobulin decreased. After total digestion, horse milk was characterized by 2.4-fold lower average IgE and 4.8-fold lower IgG reactivity than CM. We found that TG alters the IgE and IgG reactivity of CM after in vitro digestion. Horse milk was less reactive to IgE and IgG than was CM, with animal and patient sera. The effect of TG on immunoreactivity depends on enzyme quantity and milk protein type. The diet based on modified horse milk proteins could be an alternative for some patients with CM protein allergy; however, confirmation through clinical trials is needed.


Assuntos
Bovinos , Cavalos , Hipersensibilidade a Leite/imunologia , Proteínas do Leite/imunologia , Transglutaminases/metabolismo , Adolescente , Animais , Criança , Pré-Escolar , Reações Cruzadas , Eletroforese em Gel de Poliacrilamida , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Imunoglobulina E/imunologia , Imunoglobulina G/imunologia , Microbiota , Leite/química , Proteínas do Leite/análise
15.
BMJ Case Rep ; 13(1)2020 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-31919067

RESUMO

Immune-mediated reactions to dairy products may vary depending on the mammalian source. We present a case of anaphylaxis to goat/sheep's milk with tolerance to cow's milk. A 4-year-old boy of Eastern European descent presented with gastrointestinal and respiratory symptoms within minutes after eating a goat/sheep's milk-derived food product. The tryptase level measured 1 hour post initial symptoms and 1 month after the allergic reaction were 14.6 µg/L and 5.1 µg/L, respectively (norm: 0.0-13.5 µg/L), confirming the diagnosis of anaphylaxis. A skin prick test performed 1 month after the reaction was highly positive for goat/sheep's milk, but negative for cow's milk. Skin prick tests may establish a life-threatening goat/sheep's milk allergy. Goat/sheep's milk allergy should always be considered in cow's milk-tolerant patients who present with an allergic reaction to dairy products, or when undergoing/have completed of oral immunotherapy for cow's milk allergy.


Assuntos
Anafilaxia/etiologia , Queijo/efeitos adversos , Cabras , Hipersensibilidade a Leite/imunologia , Ovinos , Anafilaxia/tratamento farmacológico , Animais , Pré-Escolar , Diagnóstico Diferencial , Humanos , Masculino , Hipersensibilidade a Leite/tratamento farmacológico , Testes Cutâneos
16.
Pharm Res ; 37(3): 35, 2020 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-31950282

RESUMO

PURPOSE: Epicutaneous immunotherapy (EPIT) involving the skin's immune system is easy to use, painless and has a low risk of systemic side effects; it can be applied to food allergies that have a high morbidity rate in children. In this study, we evaluated the safety and efficacy of hydrophilic gel patch (HG) for EPIT. METHODS: Milk protein concentrate (MPC)-containing HG was applied to the skin that maintained a barrier function or formed puncture holes with microneedle, and MPC-specific antibodies were measured. The clinical study was conducted involving patients with severe milk allergy. RESULTS: No specific immune response was induced when immunizing to intact skin, and antibody production was observed by forming puncture holes. It was suggested that MPC contained in HG has immunogenicity and a very small amount of MPC was delivered to intact skin. In the clinical study, the symptom induction threshold increased in four of eight subjects, allowing them to consume milk and switch to oral immunotherapy. Although local skin reactions and temporary elevation of specific IgE antibodies were observed, no systemic side effects appeared throughout the study. CONCLUSIONS: EPIT using HG is a safe method to enable oral administration even in patients with severe milk allergies.


Assuntos
Resinas Acrílicas/química , Imunoglobulina E/imunologia , Hipersensibilidade a Leite/imunologia , Proteínas do Leite/imunologia , Adesivo Transdérmico , Administração Cutânea , Animais , Bovinos , Criança , Pré-Escolar , Modelos Animais de Doenças , Feminino , Humanos , Interações Hidrofóbicas e Hidrofílicas , Imunoglobulina E/análise , Imunoterapia , Masculino , Camundongos , Microinjeções , Proteínas do Leite/administração & dosagem , Agulhas , Projetos Piloto , Pele/metabolismo , Resultado do Tratamento
17.
Zhongguo Dang Dai Er Ke Za Zhi ; 22(1): 42-46, 2020 Jan.
Artigo em Chinês | MEDLINE | ID: mdl-31948523

RESUMO

OBJECTIVE: To investigate the risk factors for cow's milk protein allergy (CMPA) among infants through a multicenter clinical study. METHODS: A total of 1 829 infants, aged 1-12 months, who attended the outpatient service of the pediatric department in six hospitals in Shenzhen, China from June 2016 to May 2017 were enrolled as subjects. A questionnaire survey was performed to screen out suspected cases of CMPA. Food avoidance and oral food challenge tests were used to make a confirmed diagnosis of CMPA CMPA. A multivariate logistic regression analysis was used to investigate the risk factors for CMPA. RESULTS: Among the 1 829 infants, 82 (4.48%) were diagnosed with CMPA. The multivariate logistic regression analysis showed that maternal food allergy (OR=4.91, 95%CI: 2.24-10.76, P<0.05), antibiotic exposure during pregnancy (OR=3.18, 95%CI: 1.32-7.65, P<0.05), and the introduction of complementary food at an age of <4 months (OR=3.55, 95%CI: 1.52-8.27, P<0.05) were risk factors for CMPA, while exclusive breastfeeding (OR=0.21, 95%CI: 0.08-0.58, P<0.05) and the introduction of complementary food at an age of >6 months (OR=0.38, 95%CI: 0.17-0.86, P<0.05) were protective factors. CONCLUSIONS: The introduction of complementary food at an age of <4 months, maternal food allergy, and antibiotic exposure during pregnancy are risk factors for CMPA in infants.


Assuntos
Hipersensibilidade a Leite , Animais , Bovinos , China , Feminino , Humanos , Lactente , Proteínas do Leite , Gravidez , Fatores de Risco , Inquéritos e Questionários
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA