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Cow's milk protein allergy: immunological response in children with cow's milk protein tolerance.
Asian Pac J Allergy Immunol. 2014 Jun; 32(2):171-7.AP

Abstract

OBJECTIVE

To study changes in immunological responses in patients with CMPA during symptomatic and asymptomatic episodes of cow's milk protein tolerance status.

METHODS

27 CMPA patients were enrolled and underwent diagnostic evaluation, including CM challenge test, skin prick test and specific IgE to CM. Blood samples were collected in two periods from those who became tolerant (n = 13) and those with persistent CMA (n = 14), in order to measure in vitro PBMC responses to cow's milk protein (IL-10, IFN-γ, IL-5), IgG4 to β-lactoglobulin, casein, BLG-IgG4/IgE ratio and the CAS-IgG4/IgE ratio.

RESULTS

Seventy percent of CMPA patients in our study were male with a mean age at diagnosis of 8 months and mean age of onset of 3 months. The reaction time to CM ranged from within 7 minutes to within 14 days. Positive IgE-sensitization was defined as either a specific IgE to CM of more than 0.35 kUA/L (N=11) or SPTs positive for CM and/or fresh cow's milk (N=20). Forty-eight percent of the patients (n = 13) could tolerate CM by 13.38 months (8-19 months). Mean specific-IgE levels to CM were 4.1 kUA/L (range 0.35-14.3 kUA/L). Determination of the cytokine (IL-10, IFN-γ, IL-5) response to BLG revealed significantly higher IL-10 levels during the tolerance phase (212.93 vs 142.46 pg/ml, P = .011). There was a significant increase in BLG-IgG4 and the BLG-IgG4/IgE ratio in the tolerance phase when compared to the symptomatic phase.

CONCLUSIONS

IL-10, BLG-IgG4 and the BLG-IgG4/IgE ratio were higher in CMPA patients during the tolerance phase compared to the symptomatic phase.

Authors+Show Affiliations

Division of Allergy/Immunology/Rheumatology, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25003732

Citation

Sommanus, Sirasuda, et al. "Cow's Milk Protein Allergy: Immunological Response in Children With Cow's Milk Protein Tolerance." Asian Pacific Journal of Allergy and Immunology, vol. 32, no. 2, 2014, pp. 171-7.
Sommanus S, Kerddonfak S, Kamchaisatian W, et al. Cow's milk protein allergy: immunological response in children with cow's milk protein tolerance. Asian Pac J Allergy Immunol. 2014;32(2):171-7.
Sommanus, S., Kerddonfak, S., Kamchaisatian, W., Vilaiyuk, S., Sasisakulporn, C., Teawsomboonkit, W., & Benjaponpitak, S. (2014). Cow's milk protein allergy: immunological response in children with cow's milk protein tolerance. Asian Pacific Journal of Allergy and Immunology, 32(2), 171-7. https://doi.org/10.12932/AP0319.32.2.2013
Sommanus S, et al. Cow's Milk Protein Allergy: Immunological Response in Children With Cow's Milk Protein Tolerance. Asian Pac J Allergy Immunol. 2014;32(2):171-7. PubMed PMID: 25003732.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cow's milk protein allergy: immunological response in children with cow's milk protein tolerance. AU - Sommanus,Sirasuda, AU - Kerddonfak,Saowanee, AU - Kamchaisatian,Wasu, AU - Vilaiyuk,Soamarat, AU - Sasisakulporn,Cherapat, AU - Teawsomboonkit,Wanlapa, AU - Benjaponpitak,Suwat, PY - 2012/10/29/received PY - 2013/06/12/accepted PY - 2014/7/9/entrez PY - 2014/7/9/pubmed PY - 2014/8/19/medline SP - 171 EP - 7 JF - Asian Pacific journal of allergy and immunology JO - Asian Pac. J. Allergy Immunol. VL - 32 IS - 2 N2 - OBJECTIVE: To study changes in immunological responses in patients with CMPA during symptomatic and asymptomatic episodes of cow's milk protein tolerance status. METHODS: 27 CMPA patients were enrolled and underwent diagnostic evaluation, including CM challenge test, skin prick test and specific IgE to CM. Blood samples were collected in two periods from those who became tolerant (n = 13) and those with persistent CMA (n = 14), in order to measure in vitro PBMC responses to cow's milk protein (IL-10, IFN-γ, IL-5), IgG4 to β-lactoglobulin, casein, BLG-IgG4/IgE ratio and the CAS-IgG4/IgE ratio. RESULTS: Seventy percent of CMPA patients in our study were male with a mean age at diagnosis of 8 months and mean age of onset of 3 months. The reaction time to CM ranged from within 7 minutes to within 14 days. Positive IgE-sensitization was defined as either a specific IgE to CM of more than 0.35 kUA/L (N=11) or SPTs positive for CM and/or fresh cow's milk (N=20). Forty-eight percent of the patients (n = 13) could tolerate CM by 13.38 months (8-19 months). Mean specific-IgE levels to CM were 4.1 kUA/L (range 0.35-14.3 kUA/L). Determination of the cytokine (IL-10, IFN-γ, IL-5) response to BLG revealed significantly higher IL-10 levels during the tolerance phase (212.93 vs 142.46 pg/ml, P = .011). There was a significant increase in BLG-IgG4 and the BLG-IgG4/IgE ratio in the tolerance phase when compared to the symptomatic phase. CONCLUSIONS: IL-10, BLG-IgG4 and the BLG-IgG4/IgE ratio were higher in CMPA patients during the tolerance phase compared to the symptomatic phase. SN - 0125-877X UR - https://www.unboundmedicine.com/medline/citation/25003732/Cow's_milk_protein_allergy:_immunological_response_in_children_with_cow's_milk_protein_tolerance_ L2 - http://apjai-journal.org/wp-content/uploads/2016/10/11CowsmilkproteinAPJAIVol32No2June2014P171.pdf DB - PRIME DP - Unbound Medicine ER -