Activation of Eosinophil in Cow's Milk Allergy(CMA)-Related Chronic Diarrhea / 소아알레르기및호흡기학회지

ABSTRACT

PURPOSE: Cow's milk allergy(CMA) is one of common problems during first yearof life. Sometimes it causes chronic intractable diarrhea and serious nutritional problems in young infants. CMA is defined as an immunologically mediated adverse reaction against cow's milk antigens. Eosinophil granules contain cationic proteins, which have been known to be tissue-destructive. Detection of eosinophil-derived granular proteins reflects earlier activation and degranulation or cytolysis of eosinophils and provides evidence of involvement of these cells. The purpose of this study was to investigate the involvement of eosinophils in the mechanism of immunoinflammatory reaction of CMA-related chronic diarrhea. METHODS: The study population included 13 patients, aged from 18 days to 124 days who were admitted with chronic diarrhea and proved to have CMA by challenge test with cow's milk. The activation of eosinophil was evaluated by measurement of serum and urine eosinophil cationic protein(ECP) levels(by CAP, Pharmacia). The measurement were repeated on admission, and before and mean 27 hours after the challenge with cow's milk. RESULTS: 1) Serum and urine ECP levels on admission showed no significant difference from those of age matched controls. 2) During cow's milk challenge, serum ECP level increased from 5.49+/-3.08micorgram/L to 13.6+/-8.3micorgram/L(P<0.005) without significant change in urine ECP level. CONCLUSION: The activation of eosinophil might be one of important immunologic mechanisms of CMA-related chronic diarrhea in young infants.