Eosinophils ; immunology ; Food Hypersensitivity ; etiology ; Gastritis ; etiology ; Humans ; Infant ; Male ; Milk Hypersensitivity ; complications ; immunology ; Milk Proteins ; immunology

Female ; Humans ; Immunoglobulin E ; blood ; Infant ; Male ; Milk Hypersensitivity ; diagnosis ; Milk Proteins ; immunology

OBJECTIVE: To study the association between maternal Th1/Th2 immune level at different pregnancy stages and cow's milk protein allergy (CMPA) in infants. METHODS: The healthy women with a singleton pregnancy, as well as their offspring, who attended Yidu Central Hospital of Weifang and Qingzhou Traditional Chinese Medicine Hospital from July 2016 to December 2018 were enrolled. The maternal levels of interleukin-2 (IL-2), interferon gamma (IFN-γ), interleukin-4 (IL-4), and interleukin-10 (IL-10) at the second and third trimesters of pregnancy were measured. A CMPA questionnaire survey was conducted within one year after birth. Food avoidance and cow's milk oral challenge tests were performed in infants suspected of CMPA. The 48 infants who met the diagnostic criteria for CMPA were included in the observation group, and the remaining 977 normal infants were included in the control group. A univariate analysis was performed on the infants with CMPA. A Poisson regression analysis was used to determine the association between maternal Th1/Th2 immune factors at different pregnancy stages and CMPA. RESULTS: The detection rate of CMPA was 4.68%. The clinical manifestations included the symptoms of the digestive system, skin, and respiratory system and other symptoms. The univariate analysis showed that compared with the control group, the observation group had significantly higher incidence rates of maternal food allergy and maternal history of allergic diseases (P<0.05) and a significantly lower breastfeeding rate (P<0.05). The observation group had significantly lower maternal levels of IL-2 (second and third trimesters) and IFN-γ (third trimester) than the control group (P<0.05). Maternal low IFN-γ at the third trimester and maternal low IL-2 at the second and third trimesters were significantly associated with CMPA in infants (P<0.05). After correction of the factors of breastfeeding, maternal food allergy, and maternal history of allergic diseases, it was found that maternal low IL-2 and IFN-γ at the third trimester were still significantly associated with CMPA in infants (P<0.05). CONCLUSIONS The maternal decrease in Th1 level at the third trimester of pregnancy may lead to the change in fetal immunity and thus increase the risk of CMPA in offspring.
Allergens ; Animals ; Breast Feeding ; Cattle ; Female ; Humans ; Infant ; Milk Hypersensitivity ; Milk Proteins/immunology* ; Pregnancy

OBJECTIVETo compare the growth and symptom remission of infants with cow's milk protein allergy, who were fed with an amino acid formula, an extensively hydrolyzed formula or soy formula.

METHODInfants who were diagnosed as cow's milk protein allergy and can not be breastfed were enrolled in the intervention group, and were assigned to three special formulae (amino acid formula, extensively hydrolyzed formula or soy formula ) according to the will of parents from March 2009 to March 2010 (n = 74). A non-randomized control group was made up of age-matched healthy children (n = 21). Anthropometric measurements and symptoms were evaluated after 30, 60, 90, and 180 days. The differences of physical growth and the therapeutic effects among each group were calculated by SPSS 13.0 package.

RESULTAfter 180 days follow-up, the weight for age Z score and length for weight Z score were -0.43 +/- 0.88 and -0.31 +/- 0.78 in patients fed with soy formula substitute, which were significantly lower than those of patients fed with amino acid formula (0.11 +/- 0.77, 0.20 +/- 0.69) , extensively hydrolyzed formula (0.10 +/- 0.62, 0.18 +/- 0.70) and control group (0.22 +/- 0.54, 0.22 +/- 0.64) (P<0.05). However, there were no significant differences in physical growth among patients fed with amino acid formula, extensively hydrolyzed formula and control group (P>0.05). Moreover, no significant difference was found in length for age and head circumference for age among four groups (P>0.05). All hypoallergenic formulae were much helpful in remission of the symptoms of eczema (P<0.05). However, amino acid formula and extensively hydrolyzed formula were more effective and rapid in relieving symptoms than soy formula (1 mo vs 2 mo) (P = 0.003).

CONCLUSIONBoth amino acid formula and extensively hydrolyzed formula can maintain the normal growth of infants with cow's milk protein allergy. While, the growth of patients fed with soy formula was significantly slower than that of the other three groups. All hypoallergenic formulae can be effective in relieving allergy symptoms, and amino acid formula or extensively hydrolyzed formula seems to be superior to soy formula.

Child Development ; Female ; Humans ; Infant ; Infant Formula ; Infant, Newborn ; Male ; Milk Hypersensitivity ; Milk Proteins ; immunology ; Treatment Outcome

This study was aimed to evaluate the prevalence of soy protein hypersensitivity in cow's milk protein-sensitive children in Korea. A total of 1,363 patients with atopic dermatitis, urticaria, enterocolitis syndrome, bronchial asthma or allergic rhinitis were recruited. First, we estimated the prevalence of sensitization to soy in children sensitized to cow's milk. Specific IgE levels > 0.7 kU/L by CAP assay were considered positive. Next, the prevalence of soy allergy in cow's milk allergy (CMA) patients was investigated. Those children whose parents agreed to participate the open challenge test with soy had a convincing history of allergic reactions elicited by cow's milk and these symptoms were relieved by elimination. All of them had negative soy-specific IgE. Patients with positive soy-specific IgE accounted for 18.3% of 224 children sensitized to cow's milk protein. The prevalence of sensitization to soy decreased with age (36.8% in the first year of life, 16.4% in the second year, and 13.7% in the third year). Of 21 CMA patients, 42.9% (n=9) were determined to have soy allergy (mean age 10.3 months). Our results suggest that soy protein formula should be carefully used as a substitute for cow's milk in CMA patients, especially during infancy.
Adolescent ; Age Factors ; Allergens ; Asthma/immunology ; Child ; Child, Preschool ; Dermatitis, Atopic/immunology ; Enterocolitis/immunology ; Female ; Food Hypersensitivity/*epidemiology/immunology ; Human ; Hypersensitivity ; Immunoglobulin E/blood/metabolism ; Infant ; Korea ; Male ; Milk Hypersensitivity/*epidemiology/immunology ; Prevalence ; Rhinitis/immunology ; Soybean Proteins/*chemistry ; Urticaria/immunology

Presented are guidelines for the prevention, diagnosis, and treatment of cow's milk protein allergy (CMPA) which is the most common food allergy in infants. It manifests through a variety of symptoms that place a burden on both the infant and their caregivers. The guidelines were formulated by evaluation of existing evidence-based guidelines, literature evidence and expert clinical experience. The guidelines set out practical recommendations and include algorithms for the prevention and treatment of CMPA. For infants at risk of allergy, appropriate prevention diets are suggested. Breastfeeding is the best method for prevention; however, a partially hydrolyzed formula should be used in infants unable to be breastfed. In infants with suspected CMPA, guidelines are presented for the appropriate diagnostic workup and subsequent appropriate elimination diet for treatment. Exclusive breastfeeding and maternal dietary allergen avoidance are the best treatment. In infants not exclusively breastfed, an extensively hydrolyzed formula should be used with amino acid formula recommended if the symptoms are life-threatening or do not resolve after extensively hydrolyzed formula. Adherence to these guidelines should assist healthcare practitioners in optimizing their approach to the management of CMPA and decrease the burden on infants and their caregivers.
Allergy and Immunology ; Breast Feeding ; Caregivers ; Consensus* ; Delivery of Health Care ; Diagnosis* ; Diet ; Food Hypersensitivity ; Humans ; Hypersensitivity* ; Infant ; Infant Formula ; Middle East* ; Milk Hypersensitivity ; Milk Proteins*

This study was performed to identify clinical factors that facilitate the diagnosis of typical cow's milk protein-induced enterocolitis (CMPIE). Data from 142 consecutive patients (aged 15 to 45 days, cow's milk formula- or cow's milk and breast milk mixed-fed) admitted due to vomiting and/or diarrhea were retrospectively analyzed. These 142 subjects were divided into three groups: the CMPIE, infection, and non-infection group. Each group was composed of 16 (11.3%), 102 (71.8%), and 24 (16.9%) patients, respectively. On admission, poor weight gain (p=0.003), hypoalbuminemia (p=0.035), peripheral leukocytosis (p=0.012), and metabolic acidosis (p=0.015) were found to be more significant in the CMPIE group than those in other two groups. In CMPIE, serum albumin levels decreased from 3.3+/-0.9 g/dL on admission to 2.6+/-0.3 g/dL during admission (p<0.05), and methemoglobinemia was observed in 3 patients (18.8%) (p=0.012). Multiple logistic regression analysis showed that the independent predictors of CMPIE versus the infection group were failure to gain weight (OR, 10.75 [95% CI, 1.53-66.12]) (p= 0.014) and hypoalbuminemia (OR, 9.53 [95% CI, 1.62-49.01]) (p=0.010). The early recognition of indexes of suspicion for CMPIE may be of help in the diagnosis and treatment of this disorder.
Acidosis/etiology ; Animals ; Cattle ; Enterocolitis/*diagnosis/etiology ; Female ; Humans ; Infant ; Infant, Newborn ; Leukocyte Count ; Logistic Models ; Male ; Methemoglobinemia/etiology ; Milk Hypersensitivity/*diagnosis ; Milk Proteins/*immunology ; Serum Albumin/analysis ; Weight Gain

Animals ; China ; epidemiology ; Clinical Trials as Topic ; Evidence-Based Medicine ; Humans ; Infant ; Infant, Newborn ; Milk Hypersensitivity ; diagnosis ; epidemiology ; therapy ; Milk Proteins ; adverse effects ; immunology ; Practice Guidelines as Topic ; standards ; Skin Tests ; methods

OBJECTIVETo study the feasibility of transfecting breast cancer BA46 gene into dendritic cells (DCs) using adeno-associated virus (AAV) to induce specific cellular immunity.

METHODSMononuclear cells (DC precursor) were isolated from the peripheral blood of healthy donors by density gradient centrifugation and infected with rAAV/BA46/Neo virus stock (transfection group) or pulsed with 293 cell lysate (control group). In both groups, maturation of the DC precursor was induced by granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-4 (IL-4) and tumor necrosis factor-alpha(TNF-alpha). On day 7, the DCs were collected and mixed with T cells at the ratio of 1 to 20 to induce cytotoxic T lymphocytes (CTL). The capacity of the DCs in stimulating T lymphocyte proliferation was assessed using (3)H-thymidine incorporation assay. The expressions of interferon-gamma (IFN-gamma), IL-4, CD4, CD8, CD25 and CD69 in the CTLs were analyzed with cytometry, and the cytotoxicity of the CTLs was evaluated with (51)Cr-release assay using BA46-positive breast cancer cell line Hs578T as the target.

RESULTSThe DCs transfected with BA46 gene exhibited potent capacity to stimulate T lymphocyte proliferation. The CTL population induced by the transfected DCs expressed high levels of CD8, CD69 and IFN-gamma, and showed strong cytotoxicity against BA46-positive breast cancer cell line Hs578T, which was BA46 antigen-specific and MHC-limited.

CONCLUSIONThe success in BA46 gene transfer in the DCs that induce specific cellular immunity provides the experimental basis for breast cancer immunotherapy using genetically modified cells.

Antigens, Surface ; genetics ; metabolism ; Breast Neoplasms ; genetics ; immunology ; Cells, Cultured ; Dendritic Cells ; immunology ; metabolism ; Dependovirus ; genetics ; metabolism ; Female ; Granulocyte-Macrophage Colony-Stimulating Factor ; pharmacology ; Humans ; Immunity, Cellular ; Immunotherapy ; Interleukin-4 ; pharmacology ; Milk Proteins ; genetics ; metabolism ; T-Lymphocytes, Cytotoxic ; immunology ; Transfection