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Satitsuksanoa P, van de Veen W, Tan G, Lopez JF, Wirz O, Jansen K, Sokolowska M, Mirer D, Globinska A, Boonpiyathad T, Schneider SR, Barletta E, Spits H, Chang I, Babayev H, Tahralı İ, Deniz G, Yücel EÖ, Kıykım A, Boyd SD, Akdis CA, Nadeau K, Akdis M. Allergen-specific B cell responses in oral immunotherapy-induced desensitization, remission, and natural outgrowth in cow's milk allergy. Allergy 2024. [PMID: 38989779 DOI: 10.1111/all.16220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 06/04/2024] [Accepted: 06/10/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND Antigen-specific memory B cells play a key role in the induction of desensitization and remission to food allergens in oral immunotherapy and in the development of natural tolerance (NT). Here, we characterized milk allergen Bos d 9-specific B cells in oral allergen-specific immunotherapy (OIT) and in children spontaneously outgrowing cow's milk allergy (CMA) due to NT. METHODS Samples from children with CMA who received oral OIT (before, during, and after), children who naturally outgrew CMA (NT), and healthy individuals were received from Stanford biobank. Bos d 9-specific B cells were isolated by flow cytometry and RNA-sequencing was performed. Protein profile of Bos d 9-specific B cells was analyzed by proximity extension assay. RESULTS Increased frequencies of circulating milk allergen Bos d 9-specific B cells were observed after OIT and NT. Milk-desensitized subjects showed the partial acquisition of phenotypic features of remission, suggesting that desensitization is an earlier stage of remission. Within these most significantly expressed genes, IL10RA and TGFB3 were highly expressed in desensitized OIT patients. In both the remission and desensitized groups, B cell activation-, Breg cells-, BCR-signaling-, and differentiation-related genes were upregulated. In NT, pathways associated with innate immunity characteristics, development of marginal zone B cells, and a more established suppressor function of B cells prevail that may play a role in long-term tolerance. The analyses of immunoglobulin heavy chain genes in specific B cells demonstrated that IgG2 in desensitization, IgG1, IgA1, IgA2, IgG4, and IgD in remission, and IgD in NT were predominating. Secreted proteins from allergen-specific B cells revealed higher levels of regulatory cytokines, IL-10, and TGF-β after OIT and NT. CONCLUSION Allergen-specific B cells are essential elements in regulating food allergy towards remission in OIT-received and naturally resolved individuals.
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Affiliation(s)
| | - Willem van de Veen
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Davos, Switzerland
| | - Ge Tan
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Davos, Switzerland
- Functional Genomics Center Zürich, ETH Zürich, Zürich, Switzerland
| | - Juan-Felipe Lopez
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Davos, Switzerland
| | - Oliver Wirz
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Davos, Switzerland
- Department of Pathology, Stanford University, Stanford, California, USA
| | - Kirstin Jansen
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Davos, Switzerland
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Davos, Switzerland
- Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - David Mirer
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Davos, Switzerland
| | - Anna Globinska
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Davos, Switzerland
| | - Tadech Boonpiyathad
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Davos, Switzerland
| | - Stephan R Schneider
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Davos, Switzerland
| | - Elena Barletta
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Davos, Switzerland
- Swiss Institute of Bioinformatics, Laussane, Switzerland
| | - Hergen Spits
- Department of Experimental Immunology, Academic Medical Center of the University of Amsterdam, Amsterdam, the Netherlands
| | - Iris Chang
- Sean N. Parker Center for Allergy and Asthma Research, Stanford, California, USA
| | - Huseyn Babayev
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Davos, Switzerland
| | - İlhan Tahralı
- Department of Immunology, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
| | - Gunnur Deniz
- Department of Immunology, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
| | - Esra Özek Yücel
- Division of Pediatrics, Department of Pediatric Allergy and Immunology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
- Department of Pediatric Allergy and Immunology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ayca Kıykım
- Department of Pediatric Allergy and Immunology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Scott D Boyd
- Department of Pathology, Stanford University, Stanford, California, USA
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Davos, Switzerland
- Christine Kühne-Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Kari Nadeau
- Sean N. Parker Center for Allergy and Asthma Research, Stanford, California, USA
| | - Mübeccel Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zürich, Davos, Switzerland
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Wang M, Schedel M, Gelfand EW. Gene editing in allergic diseases: Identification of novel pathways and impact of deleting allergen genes. J Allergy Clin Immunol 2024; 154:51-58. [PMID: 38555980 PMCID: PMC11227406 DOI: 10.1016/j.jaci.2024.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 02/14/2024] [Accepted: 03/04/2024] [Indexed: 04/02/2024]
Abstract
Gene editing technology has emerged as a powerful tool in all aspects of health research and continues to advance our understanding of critical and essential elements in disease pathophysiology. The clustered regularly interspaced short palindromic repeats (CRISPR) gene editing technology has been used with precision to generate gene knockouts, alter genes, and identify genes that cause disease. The full spectrum of allergic/atopic diseases, in part because of shared pathophysiology, is ripe for studies with this technology. In this way, novel culprit genes are being identified and allow for manipulation of triggering allergens to reduce allergenicity and disease. Notwithstanding current limitations on precision and potential off-target effects, newer approaches are rapidly being introduced to more fully understand specific gene functions as well as the consequences of genetic manipulation. In this review, we examine the impact of editing technologies of novel genes relevant to peanut allergy and asthma as well as how gene modification of common allergens may lead to the deletion of allergenic proteins.
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Affiliation(s)
- Meiqin Wang
- Department of Pediatrics, Division of Cell Biology, National Jewish Health, Denver, Colo
| | - Michaela Schedel
- Department of Pediatrics, Division of Cell Biology, National Jewish Health, Denver, Colo; Department of Pulmonary Medicine, University Hospital Essen-Ruhrlandklinik, Essen, Germany; Department of Pulmonary Medicine, University Hospital, Essen, Germany
| | - Erwin W Gelfand
- Department of Pediatrics, Division of Cell Biology, National Jewish Health, Denver, Colo.
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侯 林, 马 紫, 晁 爽, 李 中, 张 宇, 刘 毅, 张 俊, 武 文, 黄山 雅, 刘 捷. [Risk factors for cow's milk protein allergy in infants: a multicenter prospective nested case-control study]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2024; 26:230-235. [PMID: 38557373 PMCID: PMC10986379 DOI: 10.7499/j.issn.1008-8830.2309105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/29/2023] [Indexed: 04/04/2024]
Abstract
OBJECTIVES To explore the risk factors associated with cow's milk protein allergy (CMPA) in infants. METHODS This study was a multicenter prospective nested case-control study conducted in seven medical centers in Beijing, China. Infants aged 0-12 months were included, with 200 cases of CMPA infants and 799 control infants without CMPA. Univariate and multivariate logistic regression analyses were used to investigate the risk factors for the occurrence of CMPA. RESULTS Univariate logistic regression analysis showed that preterm birth, low birth weight, birth from the first pregnancy, firstborn, spring birth, summer birth, mixed/artificial feeding, and parental history of allergic diseases were associated with an increased risk of CMPA in infants (P<0.05). Multivariate logistic regression analysis revealed that firstborn (OR=1.89, 95%CI: 1.14-3.13), spring birth (OR=3.42, 95%CI: 1.70-6.58), summer birth (OR=2.29, 95%CI: 1.22-4.27), mixed/artificial feeding (OR=1.57, 95%CI: 1.10-2.26), parental history of allergies (OR=2.13, 95%CI: 1.51-3.02), and both parents having allergies (OR=3.15, 95%CI: 1.78-5.56) were risk factors for CMPA in infants (P<0.05). CONCLUSIONS Firstborn, spring birth, summer birth, mixed/artificial feeding, and a family history of allergies are associated with an increased risk of CMPA in infants.
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Affiliation(s)
| | | | | | | | | | | | | | - 文艳 武
- 北京华信医院(清华大学第一附属医院)儿科北京100016
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Ziętek M, Szczuko M, Machałowski T. Gastrointestinal Disorders and Atopic Dermatitis in Infants in the First Year of Life According to ROME IV Criteria-A Possible Association with the Mode of Delivery and Early Life Nutrition. J Clin Med 2024; 13:927. [PMID: 38398241 PMCID: PMC10889151 DOI: 10.3390/jcm13040927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/03/2024] [Accepted: 02/04/2024] [Indexed: 02/25/2024] Open
Abstract
Background: Functional gastrointestinal disorders are very common condition. The aim of this study is to evaluate the implications of the mode of pregnancy termination and early infant feeding on the incidence of gastrointestinal disorders and atopic dermatitis at birth and 3, 6, and 12 months of age. Methods: This study included 82 pregnant women and their newborns born at term. All newborns were examined at birth and 3, 6, and 12 months of age according to the ROME IV criteria. Results: In children born after cesarean section, the incidence of regurgitation was significantly higher. In children fed mostly or exclusively with formula, dry skin with allergic features was observed more often compared to breastfed children, but this relation was statistically significant only at the age of 12 months. The use of antibiotic therapy increased the risk of allergic skin lesions by almost seven times at 3 months of life. Gastrointestinal disorders in the form of regurgitation, colic, and constipation occur within the period of up to 12 months of the child's life and may be related to the mode of the termination of pregnancy via cesarean section and the use of artificial feeding or antibiotic therapy. The occurrence of atopic dermatitis in infants at 12 months of life is correlated with the mode of the termination of pregnancy after cesarean section. Conclusions: One of the risk factors for the occurrence of atopic dermatitis and gastrointestinal disorders in the period up to 12 months of the child's life may be a cesarean section and the use of formula feeding or antibiotic therapy.
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Affiliation(s)
- Maciej Ziętek
- Department of Perinatology, Obstetrics and Gynecology Pomeranian Medical University in Szczecin, 70-204 Szczecin, Poland;
| | - Małgorzata Szczuko
- Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, 70-204 Szczecin, Poland;
| | - Tomasz Machałowski
- Department of Perinatology, Obstetrics and Gynecology Pomeranian Medical University in Szczecin, 70-204 Szczecin, Poland;
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Baghlaf MA, Eid NM, Enani S, Kokandi S, Alhussaini B, Waked MS. Prevalence and Risk Factors for IgE and IgG Cow's Milk Protein Allergies in Saudi Arabia. Cureus 2023; 15:e50812. [PMID: 38125695 PMCID: PMC10730981 DOI: 10.7759/cureus.50812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 12/23/2023] Open
Abstract
Cow's milk protein allergies (CMPAs) particularly occur in infancy and early childhood due to an immunological allergic reaction to milk proteins. This issue is increasing in Saudi Arabia and requires research to improve health status and provide alternatives. Our study aims to investigate the important aspects of immunoglobulin E (IgE) and IgG CMPA in Saudi Arabia regarding its prevalence and association with demographic and health-related factors in both adult and pediatric populations. A descriptive retrospective cross-sectional study was conducted on 376 patients, comprising 314 adults aged between 19 and 86 years, and 62 pediatric patients aged between one and 12 years. The study focused on individuals who attended a private medical center in Jeddah city over the past five years. Laboratory results for food allergy of IgE and IgG tests, including cow's milk proteins (CMPs), serum 25-hydroxyvitamin D (25OHD), specific IgE inhalant allergy results, and other health-related factors were collected from an electronic record system. Results have shown that casein was the most common sensitizing allergen of CMPs in adults, whereas α-lactalbumin was the most common sensitizing allergen in pediatrics. The most frequent sensitizing allergen in IgG CMP was cow's milk in 54/92 (58.7%) adults, followed by cow's sour milk products 41 (44.6%). Cow's milk was the most common sensitizing allergen in 20/20 (100%) children. The rate of CMPA was significantly higher in children younger than five years old (P =0.003), while children who interacted with pets had a marginal significantly reduced rate (P = 0.054). Thus, cow's milk is the most sensitizing allergen in IgG CMPs in adults and pediatrics.
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Affiliation(s)
- Mashail A Baghlaf
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, SAU
| | - Noura M Eid
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, SAU
- King Fahd Center for Medical Research, King Abdulaziz University, Jeddah, SAU
| | - Sumia Enani
- Department of Food and Nutrition, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah, SAU
- Food, Nutrition, and Lifestyle Unit, King Fahd Center for Medical Research, King Abdulaziz University, Jeddah, SAU
| | - Samia Kokandi
- Department of Nutrition, International Medical Center, Jeddah, SAU
| | - Bakr Alhussaini
- Department of Pediatric Gastroenterology, Faculty of Medicine, King Abdulaziz University, Jeddah, SAU
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Hosaagrahara Ramakrishna S, Shah N, Acharyya BC, Durairaj E, Verma L, Sankaranarayanan S, Wadhwa N, Venter C. The Need for Culturally Appropriate Food Allergy Management Strategies: The Indian Milk Ladder. Nutrients 2023; 15:3921. [PMID: 37764705 PMCID: PMC10535525 DOI: 10.3390/nu15183921] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/28/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Cow's milk allergy (CMA) is one of the most common and complex food allergies affecting children worldwide and, with a few exceptions, presents in the first few months of life. Baked-milk-containing diets are well tolerated in the majority of milk-allergic children and allow dietary restrictions to be relaxed. In addition, the early introduction of tolerated forms of allergenic foods to an infant's diet in small amounts may enhance the outgrowth of their milk allergy through oral tolerance induction. The methods of milk introduction vary widely across the globe. METHODS We convened an expert group to develop a comprehensive milk ladder based on the calculated milk protein content of Indian foods. To validate the milk ladder, the foods chosen for the ladder were analyzed and the ladder was re-evaluated based on the cooked milk protein content. RESULTS Combining expert consensus and validation of milk protein content, we created the world's first milk ladder containing Indian foods. This is the first ladder that provides information on the timing and temperature of cooking, with validated milk protein content. CONCLUSIONS This is the first milk ladder based on the unique features of Indian food habits built by the consensus of Indian experts along with international collaboration with laboratory quantification of milk protein in each step. We believe the "The Indian Milk Ladder" will be a very helpful tool for pediatricians helping manage CMA in children as well as their parents and caregivers, not only in India, but in countries world-wide where these foods are commonly consumed.
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Affiliation(s)
| | - Neil Shah
- The Portland Hospital, London W1W 5AH, UK
- Reckitt Nutrition, Slough SL1 3UH, UK
| | - Bhaswati C Acharyya
- Department of Paediatric Hepatology & Gastroenterology, AMRI Hospitals, Kolkata 700028, India
- Department of Paediatric Hepatology & Gastroenterology, Institute of Child Health, Kolkata 700017, India
| | - Emmany Durairaj
- Department of Clinical Nutrition, Mazumdar Shaw Medical Centre, Narayana Health City, Bengaluru 560099, India
| | - Lalit Verma
- Department of Paediatric Hepatology & Gastroenterology, Global Hospitals, Mumbai 400012, India
| | - Srinivas Sankaranarayanan
- Department of Paediatric Hepatology & Gastroenterology, Kanchi Kamakoti CHILDS Trust Hospital, Chennai 600024, India
- Department of Paediatric Hepatology & Gastroenterology, Apollo Children Hospital, Chennai 600006, India
| | - Nishant Wadhwa
- Institute of Child Health, Division of Paediatric Gastroenterology, Hepatology & Nutrition, Sir Gangaram Hospital, New Delhi 110060, India
| | - Carina Venter
- Paediatrics, Section of Allergy & Immunology, Denver School of Medicine, University of Colorado, Denver, CO 80204, USA
- Paediatrics, Section of Allergy & Immunology, Children's Hospital Colorado, Denver, CO 80218, USA
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7
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Kansu A, Urganci N, Bukulmez A, Kutluk G, Gulcu Taskin D, Sahin Keskin L, Igde M, Molon L, Dogan Y, Sekerel BE, Yuksek M, Bostanci I, Gerenli N, Polat E, Dalgic B, Ayyildiz H, Usta M, Basturk A, Yuce Kirmemis O, Tuna Kirsaclioglu C, Gulerman HF, Alptekin Sarioglu A, Erdogan S. Growth, tolerance and safety outcomes with use of an extensively hydrolyzed casein-based formula in infants with cow's milk protein allergy. Front Pediatr 2023; 11:1230905. [PMID: 37601126 PMCID: PMC10433168 DOI: 10.3389/fped.2023.1230905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 07/18/2023] [Indexed: 08/22/2023] Open
Abstract
Objective To evaluate growth, tolerance and safety outcomes with use of an extensively hydrolyzed casein-based formula (eHCF) in infants with cow's milk protein allergy (CMPA). Methods A total of 226 infants (mean ± SD age: 106.5 ± 39.5 days, 52.7% were girls) with CMPA who received eHCF comprising at least half of the daily dietary intake were included. Data on anthropometrics [weight for age (WFA), length for age (LFA) and weight for length (WFL) z-scores] were recorded at baseline (visit 1), while data on infant feeding and stool records, anthropometrics and Infant Feeding and Stool Patterns and Formula Satisfaction Questionnaires were recorded at visit 2 (on Days 15 ± 5) and visit 3 (on Days 30 ± 5). Results From baseline to visit 2 and visit 3, WFA z-scores (from -0.60 ± 1.13 to -0.54 ± 1.09 at visit 2, and to -0.44 ± 1.05 at visit 3, p < 0.001) and WFL z-scores (from -0.80 ± 1.30 to -0.71 ± 1.22 at visit 2, and to -0.64 ± 1.13 at visit 3, p = 0.002) were significantly increased. At least half of infants never experienced irritability or feeding refusal (55.7%) and spit-up after feeding (50.2%). The majority of mothers were satisfied with the study formula (93.2%), and wished to continue using it (92.2%). Conclusions In conclusion, eHCF was well-accepted and tolerated by an intended use population of infants ≤ 6 months of age with CMPA and enabled adequate volume consumption and improved growth indices within 30 days of utilization alongside a favorable gastrointestinal tolerance and a high level of parental satisfaction.
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Affiliation(s)
- Aydan Kansu
- Department of Pediatric Gastroenterology, School of Medicine, Ankara University, Ankara, Turkey
| | - Nafiye Urganci
- Clinic of Pediatric Gastroenterology, Istanbul Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Aysegul Bukulmez
- Department of Pediatrics, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Gunsel Kutluk
- Clinic of Pediatric Gastroenterology, Istanbul Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey
| | - Didem Gulcu Taskin
- Clinic of Pediatric Gastroenterology, Adana City Training and Research Hospital, Adana, Turkey
| | - Lutfiye Sahin Keskin
- Clinic of Pediatric Gastroenterology, Istanbul Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Mahir Igde
- Department of Pediatric Allergy and Immunology, Faculty of Medicine, Istinye University, Istanbul, Turkey
| | - Lutfi Molon
- Department of Pediatrics, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Yasar Dogan
- Department of Pediatric Gastroenterology, Faculty of Medicine, Firat University, Elazig, Turkey
| | - Bulent Enis Sekerel
- Department of Pediatric Allergy, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mutlu Yuksek
- Department of Pediatric Immunology and Allergy, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Ilknur Bostanci
- Clinic of Pediatric Immunology and Allergy, Health Sciences University Dr. Sami Ulus Gynecology, Obstetrics and Child Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Nelgin Gerenli
- Clinic of Pediatric Gastroenterology, Istanbul Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Esra Polat
- Clinic of Pediatric Gastroenterology, Istanbul Umraniye Training and Research Hospital, Istanbul, Turkey
| | - Buket Dalgic
- Department of Pediatric Gastroenterology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Hasret Ayyildiz
- Clinic of Pediatric Gastroenterology, Istanbul Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Merve Usta
- Clinic of Pediatric Gastroenterology, Istanbul Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Basturk
- Department of Pediatric Gastroenterology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Ozlem Yuce Kirmemis
- Clinic of Pediatric Gastroenterology, Samsun Training and Research Hospital, Samsun, Turkey
| | - Ceyda Tuna Kirsaclioglu
- Department of Pediatric Gastroenterology, School of Medicine, Ankara University, Ankara, Turkey
| | - Hacer Fulya Gulerman
- Department of Pediatric Gastroenterology, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey
| | | | - Simge Erdogan
- Abbott Nutrition, Abbott Laboratories, Istanbul, Turkey
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8
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Alghasham YA, Alharbi AM, Alhumaidi KA, Alkhalifah YS. Primary Healthcare Center's Healthcare Providers' Perception and Practice Toward Pediatric Cow's Milk Allergy in Qassim Region, Saudi Arabia. Cureus 2023; 15:e41719. [PMID: 37575801 PMCID: PMC10414770 DOI: 10.7759/cureus.41719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND Cow's milk allergy (CMA) typically first manifests in the first year of life, and it is the most challenging food allergy to detect since the clinical symptoms can vary significantly in both types and severity. This study is carried out to evaluate the level of knowledge and practice of healthcare providers (HCPs) in the Qassim Region regarding CMA. RESEARCH METHODOLOGY This is a cross-sectional study conducted among HCPs in the Qassim Region, Saudi Arabia. A self-administered questionnaire was distributed among HCPs using face-to-face interviews compromising four governorates of Qassim such as Buraydah, Unaizah, AlRass, and Albukairyah. The questionnaire includes socio-demographic characteristics and questions to assess the knowledge and practice of HCPs regarding CMA. RESULTS Among 124 HCPs, 29% were aged between 25 and 30 years, 50.8% were males and 49.2% were females. Over three-quarters (77.4%) were categorized as having poor knowledge levels, while poor practice was also prevalent (83.1%). Factors associated with increased knowledge and practice were being non-Saudi, being a consultant/specialist, and having more than 10 years of experience. There was a significant positive correlation between knowledge and practice scores (p<0.001). CONCLUSION The knowledge and practice of HCPs regarding CMA were insufficient. Non-Saudi consultants/specialists with more years of experience tend to be more knowledgeable and have better skills in managing the disease. Further longitudinal studies are required to establish the level of knowledge and practices toward CMA.
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Affiliation(s)
- Yazeed A Alghasham
- Department of Pediatrics, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
| | - Aeshah M Alharbi
- College of Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
| | - Kadi A Alhumaidi
- College of Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
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Packi K, Rudek A, Matysiak J, Klimczak S, Matuszewska E, Rzetecka N, Matysiak J. Food Allergies and Parasites in Children. Foods 2023; 12:2465. [PMID: 37444203 DOI: 10.3390/foods12132465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/19/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
The dynamically growing incidence of food allergies forces the scientific community to develop new methods for their diagnosis, differentiation, and effective treatment. Parasitoses appear much less frequently in the scientific literature, as well as among the presumed causes of numerous conditions. The similarity of inflammatory mechanisms in allergies and parasitosis necessitates a revision of current diagnostic standards. A lack of specificity and the coincidence of symptoms at an early stage of disease can lead to misdiagnosis. In this paper, we attempted to perform a comparative analysis of the similarities and differences in symptoms for these two types of diseases. We described the molecular mechanisms and metabolic pathways of food allergy and parasitosis. We presented the available research methods and directions of ongoing studies aimed at implementing precise medical techniques for differential diagnosis. We discussed the allergenic properties of certain parasite proteins, using the example of myofibrillar tropomyosins from the nematode Anisakis simplex. The literature in the fields of allergology and parasitology leads to the conclusion that it is reasonable to run parallel allergological and parasitological diagnostics in patients with non-specific symptoms. This approach will facilitate accurate and early diagnosis and implementation of effective therapy.
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Affiliation(s)
- Kacper Packi
- Department of Inorganic and Analytical Chemistry, Poznan University of Medical Sciences, 60-806 Poznan, Poland
- AllerGen Center of Personalized Medicine, 97-300 Piotrkow Trybunalski, Poland
| | - Alicja Rudek
- AllerGen Center of Personalized Medicine, 97-300 Piotrkow Trybunalski, Poland
| | - Joanna Matysiak
- Faculty of Health Sciences, Calisia University-Kalisz, 62-800 Kalisz, Poland
| | - Sylwia Klimczak
- AllerGen Center of Personalized Medicine, 97-300 Piotrkow Trybunalski, Poland
- Department of Nucleic Acid Biochemistry, Medical University of Lodz, 92-213 Lodz, Poland
| | - Eliza Matuszewska
- Department of Inorganic and Analytical Chemistry, Poznan University of Medical Sciences, 60-806 Poznan, Poland
| | - Natalia Rzetecka
- Department of Inorganic and Analytical Chemistry, Poznan University of Medical Sciences, 60-806 Poznan, Poland
| | - Jan Matysiak
- Department of Inorganic and Analytical Chemistry, Poznan University of Medical Sciences, 60-806 Poznan, Poland
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10
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Zhang J, Cai Q, Ji W. Nutritional Composition of Plant Protein Beverages on China's Online Market: A Cross-Sectional Analysis. Nutrients 2023; 15:2701. [PMID: 37375604 DOI: 10.3390/nu15122701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/28/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023] Open
Abstract
Plant protein beverages are gaining popularity due to various reasons such as lactose intolerance, veganism and health claims. This study aimed to conduct a cross-sectional analysis of plant protein beverages sold online in China, with a focus on assessing their nutritional composition. A total of 251 kinds of plant protein beverages were analyzed, including coconut (n = 58), soy (n = 52), oats (n = 49), walnut (n = 14), almond (n = 11), peanut (n = 5), rice (n = 4), other beans (n = 5), mixed nuts (n = 5) and mixed beverages (n = 48), according to the nutrition label on the commercial package and retailer websites. The results showed that, except for soy beverages, plant protein beverages generally had low protein content, cereal beverages showed relatively high energy and carbohydrate levels, and all plant protein beverages had low sodium content. Additionally, the fortification rate of vitamins and minerals in the analyzed plant protein beverages was found to be extremely low, at only 13.1%. Given the substantial variation in the nutritional composition of plant protein beverages, consumers should pay more attention to the nutrition facts and ingredient information when choosing these beverages.
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Affiliation(s)
- Jialin Zhang
- Yangtze Delta Region Institute of Tsinghua University, Jiaxing 314000, China
| | - Qiang Cai
- Yangtze Delta Region Institute of Tsinghua University, Jiaxing 314000, China
| | - Wei Ji
- Yangtze Delta Region Institute of Tsinghua University, Jiaxing 314000, China
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11
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Kulalert P, Pongcharoen P, Sritipsukho P, Intraakhao S, Piriyanon P, Thaweekul P, Nanthapisal S, Poachanukoon O. Diagnostic accuracy of atopy patch test in children with cow's milk allergy. Clin Mol Allergy 2023; 21:2. [PMID: 37029394 PMCID: PMC10080736 DOI: 10.1186/s12948-023-00183-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 03/09/2023] [Indexed: 04/09/2023] Open
Abstract
BACKGROUND The accuracy of an atopy patch test (APT) for fresh cow's milk allergy is controversial. Few studies have focused on commercial extract solutions. We aimed to evaluate the diagnostic performance of the APT in cow's milk allergic children using fresh cow's milk and commercial extracts of cow's milk and its components including casein, α-lactalbumin, and β-lactoglobulin. METHODS A prospective study was carried out in children with a history of cow's milk allergy. Children underwent the skin prick test (SPT) and APT with fresh cow's milk, powdered cow's milk, and commercial extracts of cow's milk, casein, α-lactalbumin, and β-lactoglobulin. Oral food challenge (OFC) was confirmed in all children. RESULTS A total of 37 patients participated (mean age 13.14 ± 7.26 months). Only 5 (13.51%) patients had positive OFC to cow's milk. The sensitivity of the APT using fresh cow's milk was 40%, specificity was 65.6%, PPV was 15.4%, and NPV was 87.5%. The sensitivity of the APT using powdered cow's milk was 40%, 60.7% for specificity, 15.4% for PPV, and 58% for NPV. The sensitivity and PPV of the APT using commercial solutions of cow's milk, casein, α-lactalbumin, and β-lactoglobulin were zero. The specificities were 90.6%, 93.8%, 100%, and 100% for α-lactalbumin, cow's milk, casein, and β-lactoglobulin, respectively. CONCLUSIONS APT using commercial solutions showed higher specificity than fresh milk. The specificity increased using a protein component allergen.
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Affiliation(s)
- Prapasri Kulalert
- Department of Clinical Epidemiology, Faculty of Medicine, Thammasat University, Pathum Thani, 12120, Thailand.
- Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand.
- Center of Excellence in Applied Epidemiology, Thammasat University, Pathum Thani, Thailand.
- Center of Excellence for Allergy, Asthma and Pulmonary Disease, Thammasat University, Pathum Thani, Thailand.
| | - Padcha Pongcharoen
- Department of Medicine, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
| | - Paskorn Sritipsukho
- Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
- Center of Excellence in Applied Epidemiology, Thammasat University, Pathum Thani, Thailand
- Center of Excellence for Allergy, Asthma and Pulmonary Disease, Thammasat University, Pathum Thani, Thailand
| | - Sukkrawan Intraakhao
- Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
| | - Punnapat Piriyanon
- Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
| | - Patcharapa Thaweekul
- Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
| | - Sira Nanthapisal
- Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
- Center of Excellence in Applied Epidemiology, Thammasat University, Pathum Thani, Thailand
- Center of Excellence for Allergy, Asthma and Pulmonary Disease, Thammasat University, Pathum Thani, Thailand
| | - Orapan Poachanukoon
- Department of Pediatrics, Faculty of Medicine, Thammasat University, Pathum Thani, Thailand
- Center of Excellence in Applied Epidemiology, Thammasat University, Pathum Thani, Thailand
- Center of Excellence for Allergy, Asthma and Pulmonary Disease, Thammasat University, Pathum Thani, Thailand
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12
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Ursino FG, Orsi M, Mehaudy R, Micheletti ME, Parisi C, Petriz N, Parente C, Jauregui MB, Pagoto V. Cultural adaptation and validation of the Spanish version of the Cow's Milk-related Symptom Score (CoMiSS) for cow's milk protein allergy. REVISTA DE GASTROENTEROLOGIA DE MEXICO (ENGLISH) 2023; 88:44-49. [PMID: 34887216 DOI: 10.1016/j.rgmxen.2021.11.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 05/11/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND AIMS The prevalence of cow's milk protein allergy in the first year of life varies from 1.8 to 7.5%. The Cow's Milk-related Symptom Score (CoMiSS) was published in 2014 and facilitates the diagnosis of cow's milk protein allergy. It is not meant to replace the clinical diagnosis, but rather to guide the treating team in the diagnostic process and reduce unnecessary diets. The aim was to translate the CoMiSS from English to Spanish and culturally adapt and validate the resulting Spanish version. MATERIALS AND METHODS An adaptation and validation study on the CoMiSS questionnaire was carried out in two phases: First, the CoMiSS was translated from English to Spanish, after which interrater reliability of the translated score was assessed. Second, interrater reliability tests were carried out on 32 pediatric patients under 7 years of age that were treated for the first time at the Food Allergy Clinic of the Hospital Italiano de Buenos Aires, were suspected of having cow's milk protein allergy, and had not received any treatment, within the time frame of May 2018 and May 2019. RESULTS Thirty-two patients were evaluated, 14 of whom were females (45%), and the median patient age was 3 months (IQR 2-4). The median result of the first measurement of the scale was 7.0 (IQR 4.5-9.0) and the median of the second measurement was 5.0 (IQR 4.0-8.0). The final intraclass correlation coefficient was 0.80 (95% CI 0.63-0.9). CONCLUSION The Spanish translation of the CoMiSS was comparable to the original English version, with excellent interrater reliability. This simple and little-known tool has the benefit of being a noninvasive, rapid, reliable, and easy-to-use strategy.
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Affiliation(s)
- F G Ursino
- Departamento de Gastroenterología infantil, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
| | - M Orsi
- Departamento de Gastroenterología infantil, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - R Mehaudy
- Departamento de Gastroenterología infantil, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - M E Micheletti
- Departamento de Gastroenterología infantil, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - C Parisi
- Sección de Alergia Pediátrica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - N Petriz
- Sección de Alergia Pediátrica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - C Parente
- Sección de Alergia Pediátrica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - M B Jauregui
- Servicio de Alimentación, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - V Pagoto
- Departamento de Investigación, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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13
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Cresoe S, Setya A, Beasley G, Gonzalo DH, Chan A. Unusual Presentation of Cow's Milk Protein Allergy. JPGN REPORTS 2022; 3:e246. [PMID: 37168480 PMCID: PMC10158318 DOI: 10.1097/pg9.0000000000000246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 07/11/2022] [Indexed: 05/13/2023]
Abstract
Cow's milk protein allergy (CMPA) is an abnormal immunologic response to bovine protein that can result in various gastrointestinal and cutaneous manifestations including diarrhea, failure to thrive, malabsorption, and even protein-losing enteropathy. We describe a case of a 7-month-old breastfed male who presented with severe atopic dermatitis, emesis, oily diarrhea, failure to thrive, electrolyte disturbance, and hemodynamic instability. Following stabilization, additional evaluation revealed concern for abetalipoproteinemia. Ultimately, the patient's symptoms resolved with introduction of an elemental formula and returned with reinitiation of cow's milk protein, confirming the diagnosis of severe CMPA. It is important for the general practitioner to be aware of the various presentations and have a high index of suspicion for CMPA as no symptom or diagnostic test is pathognomonic for diagnosis. Even though it can mimic other causes of malabsorption, a trial with extensively hydrolyzed or elemental formula should be attempted before undertaking invasive testing.
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Affiliation(s)
- Samantha Cresoe
- From the Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL
| | - Aniruddh Setya
- Department of Pediatric Gastroenterology, Kidz Medical Services, Miami, FL
| | - Genie Beasley
- From the Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL
| | | | - Albert Chan
- From the Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL
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14
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Moriki D, Francino MP, Koumpagioti D, Boutopoulou B, Rufián-Henares JÁ, Priftis KN, Douros K. The Role of the Gut Microbiome in Cow's Milk Allergy: A Clinical Approach. Nutrients 2022; 14:4537. [PMID: 36364799 PMCID: PMC9656688 DOI: 10.3390/nu14214537] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/24/2022] [Accepted: 10/26/2022] [Indexed: 07/30/2023] Open
Abstract
Cow's milk allergy (CMA) is the most prevalent food allergy (FA) in infancy and early childhood and can be present with various clinical phenotypes. The significant increase in FA rates recorded in recent decades has been associated with environmental and lifestyle changes that limit microbial exposure in early life and induce changes in gut microbiome composition. Gut microbiome is a diverse community of microbes that colonize the gastrointestinal tract (GIT) and perform beneficial functions for the host. This complex ecosystem interacts with the immune system and has a pivotal role in the development of oral tolerance to food antigens. Emerging evidence indicates that alterations of the gut microbiome (dysbiosis) in early life cause immune dysregulation and render the host susceptible to immune-mediated diseases later in life. Therefore, the colonization of the gut by "healthy" microbes that occurs in the first years of life determines the lifelong health of the host. Here, we present current data on the possible role of the gut microbiome in the development of CMA. Furthermore, we discuss how gut microbiome modification might be a potential strategy for CMA prevention and treatment.
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Affiliation(s)
- Dafni Moriki
- Allergology and Pulmonology Unit, 3rd Pediatric Department, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Maria Pilar Francino
- Department of Genomics and Health, Fundación Para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valencia (FISABIO), 46020 Valencia, Spain
- CIBER en Epidemiología y Salud Pública, 28001 Madrid, Spain
| | - Despoina Koumpagioti
- Department of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Barbara Boutopoulou
- Department of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - José Ángel Rufián-Henares
- Departamento de Nutrición y Bromatología, Instituto de Nutrición y Tecnología de los Alimentos, Centro de Investigación Biomédica, Universidad de Granada, 18071 Granada, Spain
- Instituto de Investigación Biosanitaria ibs. GRANADA, Universidad de Granada, 18071 Granada, Spain
| | - Kostas N. Priftis
- Allergology and Pulmonology Unit, 3rd Pediatric Department, National and Kapodistrian University of Athens, 12462 Athens, Greece
| | - Konstantinos Douros
- Allergology and Pulmonology Unit, 3rd Pediatric Department, National and Kapodistrian University of Athens, 12462 Athens, Greece
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15
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Pulvirenti G, Sortino V, Manti S, Parisi GF, Papale M, Giallongo A, Leonardi S. Pathogenesis, diagnosis, dietary management, and prevention of gastrointestinal disorders in the paediatric population. Ital J Pediatr 2022; 48:172. [PMID: 36089576 PMCID: PMC9465927 DOI: 10.1186/s13052-022-01366-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 09/04/2022] [Indexed: 11/13/2022] Open
Abstract
Nutrition has a central role in child growth with long-term effects, and nutrition management in gastrointestinal disorders has great importance for child health and disease outcomes. Breast milk is the first choice for infant nutrition. When it is not available, special milk formulas are adopted in specific conditions, as a medical treatment. Moving from the strong guidelines, recommendations and the new possibilities of special diet treatment, this review will analyse the current diet treatment in different gastrointestinal disorders, including food allergy, cystic fibrosis, inflammatory bowel diseases, short-bowel syndrome, gastroesophageal reflux, and eosinophilic esophagitis. The review also aimed at understanding the role of diet and its effects on these diseases. The growth monitoring can prevent malnutrition and improve disease outcomes, particularly in children, and an appropriate dietary management targeted to specific disorders is the best therapeutic choice alone or in combination with pharmacological therapy.
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16
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Qin A, Li X, Yang F, Yang J, Li H, Li H, Yu J. Extensively hydrolysed sodium caseinate. Part I: selection of enzymes, molecular mass distribution, and allergy site analysis by liquid chromatography-mass spectrometry. Int Dairy J 2022. [DOI: 10.1016/j.idairyj.2022.105501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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17
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Anania C, Martinelli I, Brindisi G, De Canditiis D, De Castro G, Zicari AM, Olivero F. Hydrolyzed Rice Formula: An Appropriate Choice for the Treatment of Cow’s Milk Allergy. J Clin Med 2022; 11:jcm11164823. [PMID: 36013062 PMCID: PMC9410499 DOI: 10.3390/jcm11164823] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 11/29/2022] Open
Abstract
Cow’s milk allergy (CMA) is a common condition in the pediatric population. CMA can induce a diverse range of symptoms of variable intensity. It occurs mainly in the first year of life, and if the child is not breastfed, hypoallergenic formula is the dietary treatment. Extensively hydrolyzed cow’s milk formulas (eHF) with documented hypo-allergenicity can be recommended as the first choice, while amino acid-based formulas (AAF) are recommended for patients with more severe symptoms. Hydrolyzed rice-based formulas (HRFs) are a suitable alternative for infants with CMA that cannot tolerate or do not like eHF and in infants with severe forms of CMA. In the present paper, we reviewed the nutritional composition of HRFs as well as studies regarding their efficacy and tolerance in children, and we provided an updated overview of the recent evidence on the use of HRFs in CMA. The available studies provide evidence that HRFs exhibit excellent efficacy and tolerance and seem to be adequate in providing normal growth in healthy children as well as in children with CMA.
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Affiliation(s)
- Caterina Anania
- Department of Mother-Child, Urological Science, Sapienza University of Rome, 00161 Rome, Italy
- Correspondence:
| | - Ivana Martinelli
- Department of Mother-Child, Urological Science, Sapienza University of Rome, 00161 Rome, Italy
| | - Giulia Brindisi
- Department of Mother-Child, Urological Science, Sapienza University of Rome, 00161 Rome, Italy
| | | | - Giovanna De Castro
- Department of Mother-Child, Urological Science, Sapienza University of Rome, 00161 Rome, Italy
| | - Anna Maria Zicari
- Department of Mother-Child, Urological Science, Sapienza University of Rome, 00161 Rome, Italy
| | - Francesca Olivero
- Pediatric Clinic, Department of Pediatrics, Fondazione IRCSS Policlinico San Matteo, University of Pavia, 27100 Pavia, Italy
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18
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Duarte CM, Mota J, Assunção R, Martins C, Ribeiro AC, Lima A, Raymundo A, Nunes MC, Ferreira RB, Sousa I. New Alternatives to Milk From Pulses: Chickpea and Lupin Beverages With Improved Digestibility and Potential Bioactivities for Human Health. Front Nutr 2022; 9:852907. [PMID: 35911116 PMCID: PMC9333060 DOI: 10.3389/fnut.2022.852907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 06/08/2022] [Indexed: 11/13/2022] Open
Abstract
There is a strong demand for plant-based milk substitutes, often low in protein content (<1.5% w/v). Protein-rich pulse seeds and the right processing technologies make it possible to make relevant choices. The major objective of this study was to assess the impact of processing on the nutritional characteristics of beverages with a high impact on health, in particular on digestibility and specific bioactivities. The results suggest that pulse beverages are as high in protein content (3.24% w/v for chickpea and 4.05% w/v for lupin) as cow’s milk. The anti-nutrient level characteristics of pulses have been considerably reduced by strategic processing. However, when present in small quantities, some of these anti-nutritional factors may have health benefits. Controlling processing conditions play a crucial role in this fine balance as a tool to take advantage of their health benefits. There is evidence of protein hydrolysis by in vitro digestion and limited bioaccessibility of minerals. In addition to being highly digestible, lupin and chickpea beverages have anti-inflammatory and anti-carcinogenic potential evaluated through the inhibition of metalloproteinase MMP-9.
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Affiliation(s)
- Carla Margarida Duarte
- LEAF-Linking Landscape, Environment, Agriculture and Food, Instituto Superior de Agronomia, University of Lisbon, Lisbon, Portugal
| | - Joana Mota
- LEAF-Linking Landscape, Environment, Agriculture and Food, Instituto Superior de Agronomia, University of Lisbon, Lisbon, Portugal
| | - Ricardo Assunção
- IUEM, Instituto Universitário Egas Moniz, Egas Moniz-Cooperativa de Ensino Superior, CRL, Costa da Caparica, Portugal
- Department of Food and Nutrition, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
- CESAM, Centre for Environmental and Marine Studies, University of Aveiro, Aveiro, Portugal
| | - Carla Martins
- Department of Food and Nutrition, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal
- NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Ana Cristina Ribeiro
- LEAF-Linking Landscape, Environment, Agriculture and Food, Instituto Superior de Agronomia, University of Lisbon, Lisbon, Portugal
- Faculdade de Farmácia de Lisboa, University of Lisbon, Lisbon, Portugal
| | - Ana Lima
- LEAF-Linking Landscape, Environment, Agriculture and Food, Instituto Superior de Agronomia, University of Lisbon, Lisbon, Portugal
- Faculty of Veterinary Medicine, Lusófona University, Lisbon, Portugal
| | - Anabela Raymundo
- LEAF-Linking Landscape, Environment, Agriculture and Food, Instituto Superior de Agronomia, University of Lisbon, Lisbon, Portugal
| | - Maria Cristiana Nunes
- LEAF-Linking Landscape, Environment, Agriculture and Food, Instituto Superior de Agronomia, University of Lisbon, Lisbon, Portugal
| | - Ricardo Boavida Ferreira
- LEAF-Linking Landscape, Environment, Agriculture and Food, Instituto Superior de Agronomia, University of Lisbon, Lisbon, Portugal
| | - Isabel Sousa
- LEAF-Linking Landscape, Environment, Agriculture and Food, Instituto Superior de Agronomia, University of Lisbon, Lisbon, Portugal
- *Correspondence: Isabel Sousa,
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19
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Iida T, Nishimura T, Mizukoshi Y, Tsuruoka T, Hisano M. A case of 1-month-old female infant delaying peritoneal dialysis introduction by low-potassium anti-allergic formula treated with sodium polystyrene sulfonate. CEN Case Rep 2022; 11:482-486. [PMID: 35441977 DOI: 10.1007/s13730-022-00704-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 04/04/2022] [Indexed: 10/18/2022] Open
Abstract
The 8806H formula is the only renal formula available for pediatric patients with chronic kidney disease in Japan. A 1-month-old female infant could not be administered 8806H because of milk allergy. Administration of low-potassium anti-allergic formula treated with sodium polystyrene sulfonate maintained adequate serum potassium levels, and introduction of peritoneal dialysis could be delayed. The patient had severe renal dysfunction secondary to bilateral hypoplastic and multi-cystic kidneys. Although she received the 8806H formula, this product was switched to hydrolyzed casein formula because she developed allergy to 8806H at 28 days of age, which led to hyperkalemia. We initiated treatment with sodium polystyrene sulfonate at 40 days of age to lower the potassium concentration in milk, which prevented hyperkalemia and maintained the patient's nutritional status to ensure appropriate increase in body weight. We monitored electrolyte levels in milk and confirmed reduction in potassium levels before feeding. Although such condition is rare and there are few reports of potassium reduction in anti-allergic formulas, this strategy may be useful for pediatric patients with renal insufficiency who cannot be treated with renal formulas because of milk allergy.
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Affiliation(s)
- Takaya Iida
- Department of Nephrology, Chiba Children's Hospital, 579-1 heta-cho, midori-ku, Chiba-shi, Chiba, 266-0007, Japan.
| | - Tatsuya Nishimura
- Department of Nephrology, Chiba Children's Hospital, 579-1 heta-cho, midori-ku, Chiba-shi, Chiba, 266-0007, Japan
| | - Yoko Mizukoshi
- Department of Neonatology, Chiba Children's Hospital, Chiba, Japan
| | - Tomoko Tsuruoka
- Department of Neonatology, Chiba Children's Hospital, Chiba, Japan
| | - Masataka Hisano
- Department of Nephrology, Chiba Children's Hospital, 579-1 heta-cho, midori-ku, Chiba-shi, Chiba, 266-0007, Japan
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20
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Toca MC, Morais MB, Vázquez-Frias R, Becker-Cuevas DJ, Boggio-Marzet CG, Delgado-Carbajal L, Higuera-Carrillo MM, Ladino L, Marchisone S, Messere GC, Ortiz GJ, Ortiz-Paranza LR, Ortiz-Piedrahita C, Riveros-López JP, Sosa PC, Villalobos-Palencia NC. Consensus on the diagnosis and treatment of cow's milk protein allergy of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition. REVISTA DE GASTROENTEROLOGIA DE MEXICO (ENGLISH) 2022; 87:235-250. [PMID: 35623990 DOI: 10.1016/j.rgmxen.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/05/2022] [Indexed: 11/15/2022]
Abstract
Cow's milk protein allergy (CMPA) is the most frequent cause of food allergy in the first months of life. Despite the fact that there are different guidelines and recommendations on the management of children with CMPA, there continues to be great variability in diagnostic and therapeutic criteria in Latin America. The Food Allergy Working Group of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition summoned a group of Latin American experts to reach a consensus and formulate a document to unify diagnostic and therapeutic criteria for CMPA. Three teams were formed, each with a coordinator, and the members of each team developed a series of statements for their corresponding module: a) clinical manifestations and diagnosis; b) diagnostic tools, and c) treatment. A search of the medical literature was carried out to support the information presented in each module and 28 statements were then selected. The statements were discussed, after which they were evaluated by all the experts, utilizing the Delphi method. Their opinions on statement agreement or disagreement were anonymously issued. The final statements selected were those with above 75% agreement and their corresponding recommendations were formulated, resulting in the document presented herein.
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Affiliation(s)
- M C Toca
- Sección Gastroenterología, Hepatología y Nutrición, Hospital Nacional Alejandro Posadas, Buenos Aires, Argentina
| | - M B Morais
- Escuela Paulista de Medicina, Universidad Federal de Sao Paulo, Sao Paulo, Brazil
| | - R Vázquez-Frias
- Departamento de Gastroenterología y Nutrición, Instituto Nacional de Salud Hospital Infantil de México Federico Gómez, Mexico City, Mexico.
| | - D J Becker-Cuevas
- Servicio de Pediatría, Hospital de Clínicas, Universidad Nacional de Asunción, San Lorenzo, Paraguay
| | - C G Boggio-Marzet
- Gastroenterología y Nutrición Pediátrica, División Pediatría, Departamento Materno Infanto Juvenil, Hospital Gral. de Agudos «Dr. I. Pirovano», Ciudad Autónoma de Buenos Aires, Argentina
| | - L Delgado-Carbajal
- Servicio de Gastroenterología, Hepatología y Nutrición Pediátrica, Unidad de Endoscopia Digestiva Pediátrica, Hospital Universitario «Centro Hospitalario Pereira Rossell», Montevideo, Uruguay
| | | | - L Ladino
- Instituto de Investigación en Nutrición, Genética y Metabolismo IINGM, Facultad de Medicina, Universidad El Bosque, Bogotá, Colombia
| | - S Marchisone
- Servicio de Gastroenterología, Hospital Infantil de Córdoba, Córboba, Argentina
| | - G C Messere
- Sección Gastroenterología, Hepatología y Nutrición, Hospital Nacional Alejandro Posadas, Buenos Aires, Argentina
| | - G J Ortiz
- Sección de Gastroenterología, Hepatología y Nutrición Infantil, Servicio de Pediatría, Hospital Nacional Alejandro Posadas, El Palomar, Buenos Aires, Argentina
| | - L R Ortiz-Paranza
- Hospital General Pediátrico «Niños de Acosta Ñu», Ministerio de Salud Pública y Bienestar Social, San Lorenzo, Paraguay
| | - C Ortiz-Piedrahita
- Departamento de Pediatría, Servicio de Gastroenterología Infantil, Hospital Pablo Tobón Uribe, Medellín, Colombia
| | - J P Riveros-López
- Unidad de Gastroenterología Pediátrica Juan Pablo Riveros SAS, Bogotá, Colombia
| | - P C Sosa
- Sección Gastroenterología, Hepatología y Nutrición Infantil, Servicio de Pediatría, Hospital Nacional Alejandro Posadas, Buenos Aires, Argentina
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Bahbah WA, ElHodhod M, Salah M, AlRefaee F, AlTuraiki M, Mousa S, Al Mehaidib A, Ayesh WH, El-Bazzar AN, El Haddad J, El Khashab HY, El Zawahry A, Hasosah M, Shaaban SY, Vandenplas Y. A Survey to Identify the Current Management of Cow’s Milk Disorders and the Role of Goat Milk-Based Formulas in the Middle East and North Africa Region. Nutrients 2022; 14:nu14051067. [PMID: 35268042 PMCID: PMC8912394 DOI: 10.3390/nu14051067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 01/18/2022] [Accepted: 01/20/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Cow’s milk allergy (CMA) and cow’s milk intolerance (CMI) are the major cow’s milk disorders observed in infants and young children. This study investigates, for the first time, physician knowledge regarding CMA and CMI prevalence, diagnosis, and management in the Middle East and North Africa (MENA) region. In addition, we explore the role of goat milk-based formula as an alternative in infants suffering from CMI. Method: This cross-sectional survey was conducted from December 2020 to February 2021. A convenience sample of 2500 MENA-based physicians received the questionnaire, developed by a working group of pediatric experts. Results: 1868 physicians completed the questionnaire, including pediatric specialists (80.8%), training physicians (0.2%), dermatologists (0.1%), family/general physicians (12.9%), neonatologists (3.6%), neurosurgeons (0.2%), allergy nurse specialists (0.3%), pharmacists (2.1%), and public health workers (0.1%). Differentiation between CMA and CMI was recognized by the majority of respondents (80.7%), for which the majority of respondents (35.4%) identified that the elimination and challenge test was the best test to differentiate CMA from CMI, whereas 30.7% and 5.4% preferred the immunoglobulin E (IgE) test and skin prick test, respectively. In addition, 28.5% of respondents reported that there is no confirmatory test to differentiate CMA from CMI. The majority of respondents (47.3%) reported that amino acid-based formula (AAF)/ extensively hydrolyzed formula (EHF) is the cornerstone for the management of CMA. However, most respondents (33.7%) reported that lactose avoidance was best for the management of CMI. Overall, 65% of the respondents were aware of nutritionally adapted goat’s milk formula as an alternative to cow’s milk products and 37% would recommend its routine use in infants (≤2 years of age). Conclusion: The results of this survey demonstrate that the majority of physicians are aware of the underlying pathophysiology and management of CMA and CMI. However, a significant proportion of physicians do not follow the clinical guidelines concerning CMA/CMI diagnosis and management. Notably, this survey identified that goat’s milk formulas may offer a suitable alternative to AAF/EHF in infants with CMI as they contain β-casein protein which is easily digestible. In addition, goat’s milk formulas contain higher levels of oligosaccharides and medium-chained fatty acids compared with standard cow’s milk formulas, yet further clinical trials are warranted to support the inclusion of goat’s milk formulas in clinical guidelines.
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Affiliation(s)
- Wael A. Bahbah
- Department of Pediatrics, Faculty of Medicine, Menoufia University, Shebin El-Kom 32511, Egypt;
| | - Mostafa ElHodhod
- Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt;
- Faculty of Medicine, October 6 University, Giza 12511, Egypt
| | | | - Fawaz AlRefaee
- Department of Pediatrics, Al Adan Hospital, Ministry of Health, Kuwait City P.O. Box 46969, Kuwait;
| | - Muath AlTuraiki
- Department of Pediatrics, King Salman Hospital, Riyadh 12769, Saudi Arabia;
| | - Samira Mousa
- Medical Department, Faculty of Veterinary Medicine, Benha University, Benha 13518, Egypt;
| | - Ali Al Mehaidib
- Department of Pediatrics, King Faisal Specialist Hospital & Research Center, Riyadh 11211, Saudi Arabia;
| | - Wafaa Helmi Ayesh
- Department of Clinical Nutrition, Dubai Health Authority, Dubai P.O. Box 4545, United Arab Emirates;
| | - Ahmed N. El-Bazzar
- Department of Pediatrics, Ministry of Health Hospitals, Cairo 12613, Egypt;
| | - Joseph El Haddad
- Department of Pediatrics and Neonatology, Saint George University Hospital, Beirut 1100, Lebanon;
| | - Heba Y. El Khashab
- Department of Pediatrics, Sulaiman Al Habib Medical Group, Riyadh 12214, Saudi Arabia;
- Department of Pediatrics, Ain Shams University, Cairo 11566, Egypt
| | - Amr El Zawahry
- Pediatrics Department, King’s College Hospital London, Dubai P.O. Box 340901, United Arab Emirates;
- Department of Pediatrics, Sharjah University, Sharjah P.O. Box 27272, United Arab Emirates
| | - Mohammed Hasosah
- King Abdullah International Medical Research Center, Pediatric Gastroenterology Department, National Guard Hospital, King Saud Bin Abdulaziz University for Health Sciences, Jeddah 21482, Saudi Arabia;
| | - Sanaa Youssef Shaaban
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt;
| | - Yvan Vandenplas
- KidZ Health Castle, UZ Brussel, Vrije Universiteit Brussel, 1090 Brussels, Belgium
- Correspondence:
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22
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Assessment of egg and milk allergies among Indians by revalidating a food allergy predictive model. World Allergy Organ J 2022; 15:100639. [PMID: 35399818 PMCID: PMC8956949 DOI: 10.1016/j.waojou.2022.100639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 12/10/2021] [Accepted: 02/21/2022] [Indexed: 12/24/2022] Open
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Hong Y, Birse N, Quinn B, Montgomery H, Wu D, Rosas da Silva G, van Ruth SM, Elliott CT. Identification of milk from different animal and plant sources by desorption electrospray ionisation high-resolution mass spectrometry (DESI-MS). NPJ Sci Food 2022; 6:14. [PMID: 35149683 PMCID: PMC8837636 DOI: 10.1038/s41538-022-00129-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 01/19/2022] [Indexed: 11/09/2022] Open
Abstract
This study used desorption electrospray ionisation mass spectrometry (DESI-MS) to analyse and detect and classify biomarkers in five different animal and plant sources of milk for the first time. A range of differences in terms of features was observed in the spectra of cow milk, goat milk, camel milk, soya milk, and oat milk. Chemometric modelling was then used to classify the mass spectra data, enabling unique or significant markers for each milk source to be identified. The classification of different milk sources was achieved with a cross-validation percentage rate of 100% through linear discriminate analysis (LDA) with high sensitivity to adulteration (0.1-5% v/v). The DESI-MS results from the milk samples analysed show the methodology to have high classification accuracy, and in the absence of complex sample clean-up which is often associated with authenticity testing, to be a rapid and efficient approach for milk fraud control.
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Affiliation(s)
- Yunhe Hong
- ASSET Technology Centre, Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Northern Ireland, UK.
| | - Nicholas Birse
- ASSET Technology Centre, Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Northern Ireland, UK
| | - Brian Quinn
- ASSET Technology Centre, Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Northern Ireland, UK
| | - Holly Montgomery
- ASSET Technology Centre, Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Northern Ireland, UK
| | - Di Wu
- ASSET Technology Centre, Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Northern Ireland, UK
| | - Gonçalo Rosas da Silva
- ASSET Technology Centre, Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Northern Ireland, UK
| | - Saskia M van Ruth
- Food Quality and Design Group, Wageningen University and Research, western, the Netherlands
| | - Christopher T Elliott
- ASSET Technology Centre, Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Northern Ireland, UK
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24
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Campos RZ, Alonso LC, Martín MJF, Escusa PN, Fernández MT. Nutritional counselling for cow's milk protein allergy in infants from birth to two years of age: scoping review. Nutrition 2022; 98:111633. [DOI: 10.1016/j.nut.2022.111633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/29/2022] [Accepted: 02/09/2022] [Indexed: 11/25/2022]
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25
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A UCMPs@MIL-100 based thermo-sensitive molecularly imprinted fluorescence sensor for effective detection of β-lactoglobulin allergen in milk products. J Nanobiotechnology 2022; 20:51. [PMID: 35078480 PMCID: PMC8787952 DOI: 10.1186/s12951-022-01258-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 01/11/2022] [Indexed: 12/26/2022] Open
Abstract
In this study, a thermo-sensitive molecularly imprinted fluorescence sensor was developed for the specific detection of β-Lactoglobulin (β-LG) allergen in milk products. The metal–organic frameworks (MIL-100) with a high specific surface area was coated on the surface of upconversion micro-particles (UCMPs). As the core, an imprinted polymer layer allowing for swelling and shrinking with response to temperature was prepared, which exhibited high adsorption and mass transfer capabilities for β-LG allergen. The fluorescence intensity of UCMPs@MIL-100@MIP decreased linearly with the concentration of β-LG in the range of 0.1–0.8 mg mL−1, and the limit of detection was 0.043 mg mL−1. The imprinting factor reached 3.415, which indicated that excellent specificity of the UCMPs@MIL-100@MIP for β-LG allergen. In the analysis of β-LG allergen in actual milk samples, the proposed UCMPs@MIL-100@MIP fluorescence sensor produced reliable and accurate results (recovery: 86.0–98.4%, RSD: 2.8–6.8%), closely related to the results of standard HPLC method (correlation coefficient: 0.9949), indicating that its feasibility in the detection of β-LG allergen.
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26
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Predictive Factors for Oral Immune Modulation in Cow Milk Allergy. Nutrients 2022; 14:nu14030494. [PMID: 35276853 PMCID: PMC8840171 DOI: 10.3390/nu14030494] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 01/14/2022] [Accepted: 01/19/2022] [Indexed: 02/06/2023] Open
Abstract
Aim: The present study analyzed clinical and biological factors that might predict achievement of tolerance in patients with IgE-mediated cow milk allergy (CMA). Method: Seventy patients with IgE-mediated CMA (44.24 ± 24.16 months) were included in the study. The patients were evaluated clinically through skin prick test and sIgE to whole milk, casein, beta-lactoglobulin and alpha-lactalbumin. An eviction diet of 6 months was established, followed by oral food challenge test (OFC) and oral immunotherapy (OIT) with baked milk for 6 months. The tolerance was assessed after 2 years follow up. Results: Thirty percent of patients presented anaphylaxis of different degrees of severity as first manifestation of CMA. Sixty-two patients followed OIT or an accelerated reintroduction of milk. Ten patients (14.28%) did not obtain tolerance to milk within 2 years. A larger wheal in SPT and higher sIgE to milk, casein and betalactoglobulin were noted in patients with positive OFC. A basal level of <2.5 kU/l for sIgE to milk and <11.73 kU/l for sIgE to caseins predicted the occurrence of tolerance in patients with all types of clinical manifestations, including anaphylaxis. Conclusion: Basal levels of sIgE to milk and casein may help to identify patients that could become tolerant to milk.
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De S, Das G. Insights into the self-aggregating properties of a solvatochromic probe and interaction with β-lactoglobulin. NEW J CHEM 2022. [DOI: 10.1039/d2nj02787a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A solvatochromic benzothiazole compound is designed, which exhibits water-induced aggregation and selective detection of β-lactoglobulin at physiological pH.
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Affiliation(s)
- Sagnik De
- Department of Chemistry, Indian Institute of Technology Guwahati, Assam 781039, India
| | - Gopal Das
- Department of Chemistry, Indian Institute of Technology Guwahati, Assam 781039, India
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28
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Henderson D, Murphy CA, Glynn AC, Boyle MA, McCallion N. Feeding practices and the prevalence of cow's milk protein allergy in Irish preterm infants. J Hum Nutr Diet 2021; 35:535-541. [PMID: 34904759 DOI: 10.1111/jhn.12971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 11/05/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND The prevalence of cow's-milk protein allergy (CMPA) is between 2% and 3% and symptoms vary depending on underlying immune mechanism at play. Breast milk is the optimal nutrition for premature infants and breast milk fortifiers (BMF) are commonly used to optimise growth and nutrition. BMF are typically derived from cow's milk and, as such, preterm infants are exposed to cow's milk in the first weeks of life. Previously, preterm infants were suspected to have a higher risk of allergen development because of early antigen exposure and increased gut permeability. The primary aim of the present study was to evaluate the prevalence of CMPA among very preterm (<32 weeks) and/or very low birth weight (VLBW) infants. The secondary aim was to describe feeding practices, specifically the breastfeeding rates and specialist, non-standard formula use in this cohort over the first 6 months of life. METHODS This was a retrospective study performed in a large tertiary maternity hospital (8500 deliveries/year and 110 very preterm infants/year) in Dublin, Ireland over a 3-year period, 2017-2020. Infants born very preterm and/or VLBW who were followed in the outpatient clinic until 6 months corrected gestational age (CGA) were included. Hospital ethical approval was obtained. RESULTS One hundred and forty-four infants were included with a median birth weight of 1338 g. No infant had a diagnosis of CMPA when leaving the neonatal intensive care unit (NICU) but, by 6 months CGA, this increased to 1.4% (n = 2). Upon discharge from the NICU, 88 infants (61%) were receiving at least some breast milk, decreasing to 13 (9.1%) at 6 months CGA. Those who were receiving exclusive breast milk at discharge were significantly more likely to still be receiving any breast milk at three (p ≤ 0.001) and 6 months ( p ≤ 0.001) CGA compared to those combined feeding or exclusively formula feeding. At 6 months CGA, 18.9% (n = 27) were attending a dietician and 31.5% (n = 45) were using specialist, non-standard infant formula. CONCLUSIONS The prevalence of CMPA in this cohort was 1.4%, which is similar to the reported prevalence of CMPA in the general paediatric population. Infants who were discharged from NICU exclusively breastfeeding were more likely to be receiving any breast milk at outpatient follow-up. This highlights the importance of on going dietetic and lactation support in the outpatient setting for this vulnerable cohort.
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Affiliation(s)
| | - Claire A Murphy
- Department of Neonatology, Rotunda Hospital, Dublin, Ireland.,Department of Paediatrics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Michael A Boyle
- Department of Neonatology, Rotunda Hospital, Dublin, Ireland.,Department of Paediatrics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Naomi McCallion
- Department of Neonatology, Rotunda Hospital, Dublin, Ireland.,Department of Paediatrics, Royal College of Surgeons in Ireland, Dublin, Ireland
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Effects of Cow's Milk Components, Goat's Milk and Sheep's Milk Sensitivities on Clinical Findings, and Tolerance Development in Cow's Milk Allergy. MEDICAL BULLETIN OF SISLI ETFAL HOSPITAL 2021; 55:391-397. [PMID: 34712082 PMCID: PMC8526229 DOI: 10.14744/semb.2020.90688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 11/16/2020] [Indexed: 11/24/2022]
Abstract
Objective: Cow’s milk (CM) contains some proteins capable of causing an allergic reaction in a sensitized individual and one of the most common causes of food allergy in childhood. Most of the patients will develop tolerance by the age of 3. In this study, we aimed to evaluate sensitivity to CM allergen components as well as goat’s milk (GM) and sheep’s milk cross reactions in cow’s milk allergic (CMA) patients and to figure out the risk factors for tolerance non-development. Methods: This is a retrospective cross-sectional study including 66 patients for IgE-mediated CMA with mean age of 38 months. We evaluated the patients in two groups: Group 1 (n=50): Patients who have no tolerance in oral food challenge test; Group 2 (n= 16): Patients who were found tolerant to CM after elimination diet. Cow’s milk-spesific IgE(sIgE), α-lactalbumin(ALA)-sIgE, β-Lactoglobulin(BLG)-sIgE, casein-sIgE, goat’s milk-sIgE, sheep’s milk-sIgE, skin prick tests(SPTs) with CM and GM, eosinophils in peripheral blood were all compared between two groups. Results: In the whole group, goat’s milk-sIgE and sheep’s milk-sIgE were positive in 84.8% and ALA-sIgE, BLG-sIgE, casein-sIgE were positive in 69.7%, 62.7%, 77.3% of the patients, respectively. Two groups were similar in terms of age at onset and diagnosis, gender, median elimination period, total IgE levels, cow’s milk-sIgE and eosinophilia (p>0.05). Mean wheal diameters of CM and GM in SPT (p<0.001), goat’s milk-sIgE (p=0.03), sheep’s milk-sIgE (p=0.01) were significantly higher in Group 1. Cow’s milk-sIgE showed a positive correlation with total IgE (p=0.001), eosinophilia percentage (p=0.04), CM wheal diameter in SPT (p=0.001), casein-sIgE (p<0.001), goat’s milk-sIgE (p<0.001), sheep’s milk-sIgE (p<0.001) in Group 1. Patients with respiratory symptoms and history of anaphylaxis had higher cow’s milk-SPT, cow’s milk-sIgE, casein-sIgE, goat’s milk-sIgE, sheep’s milk-sIgE levels(p<0.05). Gastrointestinal and skin symptoms showed no relation with laboratory findings. Any patient with a history of anaphylaxis did not develop tolerance. Conclusions: As with cow’s milk-sIgE levels and high induration diameters in SPT; high casein-sIgE, sheep’s milk-sIgE and goat’s milk-sIgE levels are also risk factors for persistence of CMA. Anaphylaxis, as a first reaction, may also be a risk factor. High cow’s milk-sIgE, casein-sIgE, sheep’s milk-sIgE, goat’s milk-sIgE levels are associated with respiratory symptoms.
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30
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Oliveira KASD, Esper MT, Oliveira MLD, Tofoli MHC, Avelino MAG. Correlation between cow's milk protein allergy and otitis media: a systematic review. Braz J Otorhinolaryngol 2021; 88:803-811. [PMID: 34716104 PMCID: PMC9483997 DOI: 10.1016/j.bjorl.2021.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 06/22/2021] [Accepted: 07/05/2021] [Indexed: 11/26/2022] Open
Abstract
The correlation between cow’s milk protein allergy and otitis media has been investigated in recent decades. Allergic inflammation in the nasal mucosa is associated with Eustachian tube dysfunction, contributing to otitis media. Previous studies about cow’s milk protein allergy and otitis media have limitations, leading to controversial results. There is no reliable evidence that cow’s milk protein allergy is related to acute otitis media or otitis media with effusion.
Objectives To review the evidence pertaining to the association between cow’s milk protein allergy and recurrent acute otitis media and otitis media with effusion. Methods The CENTRAL, Web of Science, EMBASE, MEDLINE, LILACS databases, and gray literature were searched. Results Four studies were included, identifying the prevalence rates: 0.2% of delayed speech due to chronic otitis media with effusion in 382 children with cow’s milk protein allergy, 10.7% of cow’s milk protein allergy in 242 children who underwent ENT procedures, 40% of cow’s milk protein allergy in 25 children with recurrent otitis media with effusion and higher tendency to otitis media in children with cow’s milk protein allergy of 186 children (1.5 + 0.6 vs. 0.4 + 0.1; p < 0.1). Conclusion Considering the characteristics and methodological variations of the identified studies, it is not possible to state that there is reliable evidence of an association between cow’s milk protein allergy and otitis media.
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Affiliation(s)
| | - Marina Tomaz Esper
- Hospital Estadual Geral de Goiânia Dr. Alberto Rassi (HGG), Goiânia, Goiás, Brazil
| | | | | | - Melissa Ameloti Gomes Avelino
- Universidade Federal de Goiás (UFG), Faculdade de Medicina (FM) Goiânia, Goiás, Brazil; Universidade Federal de Goiás (UFG), Hospital das Clínicas (HC), Goiânia, Goiás, Brazil
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31
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Cudowska B, Lebensztejn DM. Immunogloboulin E-Mediated Food Sensitization in Children with Celiac Disease: A Single-Center Experience. Pediatr Gastroenterol Hepatol Nutr 2021; 24:492-499. [PMID: 34557401 PMCID: PMC8443858 DOI: 10.5223/pghn.2021.24.5.492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 07/26/2021] [Accepted: 07/29/2021] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Celiac disease (CD) is an autoimmune disorder of the small intestine caused by an abnormal immune response to gluten proteins and is often characterized by gastrointestinal symptoms. Food allergy (FA) is an adverse immune sensitivity to ingested food proteins leading to inflammation in various organs including the gastrointestinal tract. The relationship between CD and FA remains unclear. This study aimed to assess the prevalence and clinical relevance of immunoglobulin E (IgE)-mediated food sensitization in children with CD. METHODS Fifty-nine children diagnosed with CD were reviewed for clinical symptoms and evidence of IgE-sensitization to food and airborne allergens using the PolyCheck method. RESULTS IgE-mediated sensitization has been diagnosed in 20.3% of children with CD (CD/ A). In the CD/A group, 58.3% of children were sensitized to food and 66.7% to airborne allergens. Further, 41.7% of patients with CD and allergy reported gastrointestinal tract symptoms associated with the ingestion of sensitizing foods. Analysis of the clinical status revealed that the incidence of other allergic disorders in the CD/A group was as follows: atopic dermatitis (33.3%), asthma (25.0%), and allergic rhinitis (16.7%). The percentage of eosinophils was significantly higher in the CD/A group than in the CD group (0.33±0.25 vs. 0.11±0.09; p=0.006). CONCLUSION The diagnosis of CD does not exclude FA. The gastrointestinal symptoms in children with CD may be the result of both CD and FA; therefore, children with CD should be evaluated for the presence of FA regardless of age.
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Affiliation(s)
- Beata Cudowska
- Department of Pediatrics, Gastroenterology, Hepatology, Nutrition and Allergology, Medical University of Bialystok, Bialystok, Poland
| | - Dariusz M Lebensztejn
- Department of Pediatrics, Gastroenterology, Hepatology, Nutrition and Allergology, Medical University of Bialystok, Bialystok, Poland
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Vandenplas Y, Belohlavkova S, Enninger A, Frühauf P, Makwana N, Järvi A. How Are Infants Suspected to Have Cow's Milk Allergy Managed? A Real World Study Report. Nutrients 2021; 13:nu13093027. [PMID: 34578905 PMCID: PMC8464701 DOI: 10.3390/nu13093027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 12/12/2022] Open
Abstract
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.
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Affiliation(s)
- Yvan Vandenplas
- Vrije Universiteit Brussel (VUB), UZ Brussel, KidZ Health Castle, 1090 Brussels, Belgium
- Correspondence: ; Tel.: +32-475-748-794
| | | | - Axel Enninger
- Olgahospital, Zentrum für Kinder-, Jugend- und Frauenmedizin, Klinikum Stuttgart, 70174 Stuttgart, Germany;
| | - Pavel Frühauf
- Pediatric Clinics and Inherited Metabolic Disorders, 1st Faculty of Medicine Charles University, 12108 Prague, Czech Republic;
| | - Niten Makwana
- Sandwell and West Birmingham Hospitals, Birmingham B18 7QH, UK;
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Baghlaf MA, Eid NMS. Prevalence, Risk Factors, Clinical Manifestation, Diagnosis Aspects and Nutrition Therapy in Relation to both IgE and IgG Cow’s Milk Protein Allergies among a Population of Saudi Arabia: A Literature Review. CURRENT RESEARCH IN NUTRITION AND FOOD SCIENCE JOURNAL 2021. [DOI: 10.12944/crnfsj.9.2.02] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Cow milk protein allergy (CMPA) becoming a major public health issue that has attracted the attention of health professionals and researchers. This paper aimed to review the important aspects of both IgE and IgG types of cow’s milk protein allergy in terms of prevalence, clinical manifestation, risk factors, other health-related issues and nutritional therapy proposed for such allergies in the adult and pediatric population in Saudi Arabia. A search on “cow’s milk allergy” was done using PubMed, Google Scholar and Scopus Engine for published papers between 1993 and 2020 to find studies yielding knowledge on that context. The prevalence of cow’s milk protein allergy (CMPA) among infants is now in the range of 2–3%. This type of allergy is also detected in adulthood but less frequently. CMPA is defined as an immunological reaction to specific proteins in milk. CMPA is classified based on its type as an immunoglobulin E (IgE)-mediated form and an immunoglobulin G (IgG)-mediated form, each type representing different immunological pathways. The presence of Genetic aspects, family history and short duration of breastfeeding in the infant are among the risk factors contributing to this form of allergy. Its manifestations mainly present as skin presentation, followed by the gastrointestinal and respiratory presentation in most cases in addition to a life-threatening anaphylactic reaction that may occur in 12% of cases. food allergy committees have developed strict diagnosis criteria, including blood testing for food-specific immunoglobulin E (sIgE), a skin prick test and double-blind placebo-controlled food challenges (DBPCFC) as the gold standard. A diet free of cow’s milk protein (CMP) allergen and including the appropriate alternative milk formula is the first line of prevention recommended by many organizations and food allergy experts. As for Saudi Arabia, more research and clinical trials are required to discuss the various aspects of adult and pediatric CMPA and to provide a better understanding along with good control strategies implementation.
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Affiliation(s)
- Mashail A Baghlaf
- 1Faculty of Applied Medical Sciences, Department of Medical Laboratory Technology, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Noura M S Eid
- 2Faculty of Applied Medical Sciences, Department of Clinical Nutrition, King Abdulaziz University, Jeddah, Saudi Arabia
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Kozłowska-Jalowska A, Horvath A, Vandenplas Y, Szajewska H. Retrospective and Prospective Determination of the Cow's Milk-Related Symptom Score (CoMiSS™) Values in Symptomatic Infants. Pediatr Gastroenterol Hepatol Nutr 2021; 24:384-391. [PMID: 34316473 PMCID: PMC8279825 DOI: 10.5223/pghn.2021.24.4.384] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/20/2021] [Accepted: 05/15/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The Cow's Milk-related Symptom Score (CoMiSS™) was developed as an awareness tool for evaluating cow's milk-related symptoms in otherwise healthy children. Using a convenience sample of participants, this cross-sectional study aimed to determine CoMiSS™ values of symptomatic infants based on retrospectively or prospectively obtained information. METHODS CoMiSS™ values were determined in infants aged <12 months with symptoms suggestive of cow's milk protein allergy or functional gastrointestinal disorders. The exclusion criteria were previous diagnosis with acute or chronic disease, treatment with a therapeutic formula, and in case of breastfeeding, an elimination diet followed by the mother. Two CoMiSS™ values were assessed. A retrospective collection was defined as the collection of data after initial contact with the medical center but before the first medical consultation. A prospective collection was defined as the collection of data within 24 hours from the time of medical consultation but before starting any therapeutic intervention. The CoMiSS™ total and individual component scores obtained retrospectively or prospectively were compared between groups using the Wilcoxon signed-rank test. RESULTS This study was performed between August and November 2019. Data of 110 children (62 males and 48 females), with a mean±standard deviation age of 18.2±11.7 weeks, were obtained. The total CoMiSS™ value (p<0.001) and some individual component scores (crying, regurgitation, and stool) were significantly lower when collected prospectively than when collected retrospectively. CONCLUSION CoMiSS™ values were retrospectively and prospectively determined. Lower CoMiSS™ values were obtained during prospective evaluation. Possible differences should be considered when using CoMiSS™ in clinical practice.
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Affiliation(s)
| | - Andrea Horvath
- Department of Paediatrics, Medical University of Warsaw, Warsaw, Poland
| | - Yvan Vandenplas
- KidZ Health Castle, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Hania Szajewska
- Department of Paediatrics, Medical University of Warsaw, Warsaw, Poland
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Liu M, Thijssen S, van Nostrum CF, Hennink WE, Garssen J, Willemsen LEM. Inhibition of cow's milk allergy development in mice by oral delivery of β-lactoglobulin-derived peptides loaded PLGA nanoparticles is associated with systemic whey-specific immune silencing. Clin Exp Allergy 2021; 52:137-148. [PMID: 34145667 PMCID: PMC9291823 DOI: 10.1111/cea.13967] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 06/03/2021] [Accepted: 06/04/2021] [Indexed: 12/01/2022]
Abstract
Background Two to four percentage of infants are affected by cow's milk allergy (CMA), which persists in 20% of cases. Intervention approaches using early oral exposure to cow's milk protein or hydrolysed cow's milk formula are being studied for CMA prevention. Yet, concerns regarding safety and/or efficacy remain to be tackled in particular for high‐risk non‐exclusively breastfed infants. Therefore, safe and effective strategies to improve early life oral tolerance induction may be considered. Objective We aim to investigate the efficacy of CMA prevention using oral pre‐exposure of two selected 18‐AA β‐lactoglobulin‐derived peptides loaded poly (lactic‐co‐glycolic acid) (PLGA) nanoparticles (NPs) in a whey‐protein induced CMA murine model. Methods The peptides were loaded in PLGA NPs via a double emulsion solvent evaporation technique. In vivo, 3‐week‐old female C3H/HeOuJ mice received 6 daily gavages with PBS, whey, Peptide‐mix, a high‐ or low‐dose Peptide‐NPs or empty‐NP plus Peptide‐mix, prior to 5 weekly oral sensitizations with cholera toxin plus whey or PBS (sham). One week after the last sensitization, the challenge induced acute allergic skin response, anaphylactic shock score, allergen‐specific serum immunoglobulins and ex vivo whey‐stimulated cytokine release by splenocytes was measured. Results Mice pre‐treated with high‐dose Peptide‐NPs but not low‐dose or empty‐NP plus Peptide‐mix, were protected from anaphylaxis and showed a significantly lower acute allergic skin response upon intradermal whey challenge compared to whey‐sensitized mice. Compared with the Peptide‐mix or empty‐NP plus Peptide‐mix pre‐treatment, the high‐dose Peptide‐NPs‐pre‐treatment inhibited ex vivo whey‐stimulated pro‐inflammatory cytokine TNF‐α release by splenocytes. Conclusion & Clinical relevance Oral pre‐exposure of mice to two β‐lactoglobulin‐derived peptides loaded PLGA NPs induced a dose‐related partial prevention of CMA symptoms upon challenge to whole whey protein and silenced whey‐specific systemic immune response. These findings encourage further development of the concept of peptide‐loaded PLGA NPs for CMA prevention towards clinical application.
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Affiliation(s)
- Mengshan Liu
- Division of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.,Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Suzan Thijssen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Cornelus F van Nostrum
- Division of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Wim E Hennink
- Division of Pharmaceutics, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Johan Garssen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.,Department of Immunology, Nutricia Research B.V, Utrecht, The Netherlands
| | - Linette E M Willemsen
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
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Magan JB, O Callaghan TF, Kelly AL, McCarthy NA. Compositional and functional properties of milk and dairy products derived from cows fed pasture or concentrate-based diets. Compr Rev Food Sci Food Saf 2021; 20:2769-2800. [PMID: 33949109 DOI: 10.1111/1541-4337.12751] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 02/24/2021] [Accepted: 03/12/2021] [Indexed: 12/11/2022]
Abstract
Worldwide milk production is predominantly founded on indoor, high-concentrate feeding systems, whereas pasture-based feeding systems are most common in New Zealand and Ireland but have received greater attention recently in countries utilizing conventional systems. Consumer interest in 'pasture-fed' dairy products has also increased, arising from environmental, ethical, and nutritional concerns. A substantial body of research exists describing the effect of different feeding strategies on the composition of milk, with several recent studies focusing on the comparison of pasture- and concentrate-based feeding regimes. Significant variation is typically observed in the gross composition of milk produced from different supplemental feeds, but various changes in the discrete composition of macromolecular components in milk have also been associated with dietary influence, particularly in relation to the fatty acid profile. Changes in milk composition have also been shown to have implications for milk and dairy product processability, functionality and sensory properties. Methods to determine the traceability of dairy products or verify marketing claims such as 'pasture-fed' have also been established, based on compositional variation due to diet. This review explores the effects of feed types on milk composition and quality, along with the ultimate effect of diet-induced changes on milk and dairy product functionality, with particular emphasis placed on pasture- and concentrate-based feeding systems.
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Affiliation(s)
- Jonathan B Magan
- Food Chemistry and Technology, Teagasc Food Research Centre, Cork, Ireland.,School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Tom F O Callaghan
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Alan L Kelly
- School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Noel A McCarthy
- Food Chemistry and Technology, Teagasc Food Research Centre, Cork, Ireland
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Dogan E, Sevinc E. The vitamin D status and serum eosinophilic cationic protein levels in infants with cow's milk protein allergy. Am J Transl Res 2020; 12:8208-8215. [PMID: 33437393 PMCID: PMC7791503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 11/30/2020] [Indexed: 06/12/2023]
Abstract
Eosinophil cationic protein (ECP) is a cytotoxic protein released from eosinophils. The level of ECP increases in some allergic diseases. Recently, vitamin D deficiency has been suggested to be a risk factor for childhood allergic disease. The first aim of the study is to measure the serum vitamin D levels and ECP in infants with cow's milk protein allergy (CMPA) and compare them with controls. The second aim of this study is to investigate whether vitamin D levels are correlated with ECP or not. Sixty-two infants with CMPA were compared to 58 healthy, similar to distribution of age and sex normal infants as controls. The serum ECP levels were detected by an immunoassay system. Serum 25(OH)D levels were measured by using an enzyme-linked immunoassay kit. Vitamin D deficiency was defined as a serum 25(OH)D level of < 10 ng/mL and sufficient 30 ng/mL. The median serum ECP level in the CMPA group was significantly higher than in the control group (51.45 and 17.55 ng/mL, respectively, P = 0.001). There were no significant differences between groups with regards to median 25(OH)D levels (29.31 ± 1.67 and 27.32 ± 1.41 ng/mL, respectively, P = 0.646). The serum 25(OH)D levels were under 30 ng/mL in 38 of infants with CMPA (61.2%) and in 32 of controls (55.1%). Correlation analysis between the serum 25(OH)D level and ECP of infants with CMPA have revealed no significant relation (P = 0.888). Our results do not support the hypothesis that vitamin D deficiency may be a risk factor for CMPA.
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Affiliation(s)
- Erkan Dogan
- Department of Pediatric, Faculty of Medicine, Karabuk UniversityKarabuk, Turkey
| | - Eylem Sevinc
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Faculty of Medicine, Karabuk UniversityKarabuk, Turkey
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Flores A, Persaud YK. Systemic reaction to an extensively hydrolyzed formula in an infant with cow's milk anaphylaxis. JOURNAL OF FOOD ALLERGY 2020; 2:164-167. [PMID: 39022315 PMCID: PMC11250204 DOI: 10.2500/jfa.2020.2.200035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 07/20/2024]
Abstract
Background Cow's milk allergy is the most common cause of food allergy in young children. Ingestion of milk products in children with a milk protein allergy can lead to anaphylaxis and must be avoided. Some guidelines suggest the use of an extensively hydrolyzed formula (EHF) in these cases; however, rare allergic reactions can still occur. Here, we presented a 3-month-old boy who developed anaphylaxis to a cow's milk formula. Subsequently, he developed a rare systemic reaction to soy and to an EHF. Case The patient had an unremarkable medical history and presented with signs and symptoms consistent with anaphylaxis after being fed cow's milk formula for the first time. Symptoms included immediate vomiting, wheezing, stridor, angioedema of eyelids and lips. Although intramuscular epinephrine was given, the patient continued to clinically deteriorate, becoming more lethargic and necessitating admission to the pediatric intensive care unit. Subsequently, a trial of soy formula ingestion reproduced the symptoms and an EHF was given. However, immediately after taking an EHF, he developed facial angioedema and diffuse urticarial lesions. Conclusion In most patients with a cow's milk allergy, an extensively based formula can be tolerated safely due to a hydrolyzed protein chain. However, medical providers must be vigilant when switching formula because a rare systemic allergic reaction to EHF can still occur.
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Affiliation(s)
- Alvaro Flores
- From the Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Nebraska and Children's Hospital and Medical Center, Omaha, Nebraska, and
| | - Yudy K. Persaud
- Division of Allergy, BronxCare Health Systems. Bronx, New York
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Sun B, Feng D, Wang G, Yu X, Dong Z, Gao L. DL-propargylglycine administration inhibits TET2 and FOXP3 expression and alleviates symptoms of neonatal Cows' milk allergy in mouse model. Autoimmunity 2020; 53:467-475. [PMID: 33078976 DOI: 10.1080/08916934.2020.1836490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Cows' milk allergy (CMA) is a hypersensitivity immune reaction brought on by specific immunologic mechanisms to cow's milk proteins. As one of the most common food allergies in infants, the incidence of CMA during the first year of life is estimated to be nearly 7.5%. Due to the limitation in the knowledge of the pathological mechanism underlying CMA, however, the clinical interventions and therapies remain very unsatisfactory. AIM OF THE STUDY The transcriptional factor FOXP3 possesses crucial roles in CMA, and increased FOXP3 mRNA expression has a predictive function in faster acquisition of tolerance in infants with CMA. But the exact mechanism remains not fully elucidated. METHODS For PAG treatment, PAG (dissolved in saline 30 mg/mL, 0, 5, 10, 20 mg/kg BW) was administered daily intraperitoneally (ip) for one week at the time that 6 weeks after the CMP sensitisation. RESULTS In the present study, we revealed that the expression of FOXP3 is significantly up-regulated in PBMCs from CMA patients and CMA mice on mRNA and protein level. Furthermore, a dramatic reduction in the FOXP3 TSDR methylation and a significant increase in the expression of TET2 are observed in CMA patients and CMA mice. More importantly, we found that propargylglycine (PAG) significantly alleviates symptoms of CMA in mice by suppressing the expression of FOXP3 through restoring TET2 expression. CONCLUSIONS Our work revealed a novel function of PAG on CMA, which may provide a deeper insight into the pathomechanism of CMA and a novel therapy target for CMA clinical interventions.
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Affiliation(s)
- Beibei Sun
- Department of Gastroenterology, Xuzhou Children's Hospital, Xuzhou Medical University, Xuzhou, China
| | - Dongjin Feng
- Department of Gastroenterology, Xuzhou Children's Hospital, Xuzhou Medical University, Xuzhou, China
| | - Guangmeng Wang
- Department of Gastroenterology, Xuzhou Children's Hospital, Xuzhou Medical University, Xuzhou, China
| | - Xiaohong Yu
- Department of Gastroenterology, Xuzhou Children's Hospital, Xuzhou Medical University, Xuzhou, China
| | - Zhongmao Dong
- Department of Gastroenterology, Xuzhou Children's Hospital, Xuzhou Medical University, Xuzhou, China
| | - Ling Gao
- Department of Gastroenterology, Xuzhou Children's Hospital, Xuzhou Medical University, Xuzhou, China
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Lopes M, Pierrepont C, Duarte CM, Filipe A, Medronho B, Sousa I. Legume Beverages from Chickpea and Lupin, as New Milk Alternatives. Foods 2020; 9:foods9101458. [PMID: 33066342 PMCID: PMC7602080 DOI: 10.3390/foods9101458] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/08/2020] [Accepted: 10/09/2020] [Indexed: 02/07/2023] Open
Abstract
Recently, milk consumption has been declining and there is a high demand for non-dairy beverages. However, market offers are mainly cereal and nut-based beverages, which are essentially poor in protein (typically, less than 1.5% against the 3.5% in milk) and are not true milk replacers in that sense. In this work, new beverages from different pulses (i.e., pea, chickpea and lupin) were developed using technologies that enable the incorporation of a high level of seed components, with low or no discharge of by-products. Different processing steps were sequentially tested and discussed for the optimization of the sensorial features and stability of the beverage, considering the current commercial non-dairy beverages trends. The lupin beverage protein contents ranged from 1.8% to 2.4% (w/v) and the chickpea beverage varied between 1.0% and 1.5% (w/v). The “milk” yield obtained for the optimized procedure B was 1221 g/100 g of dry seed and 1247 g/100 g of dry seed, for chickpea beverage and lupin beverage, respectively. Sensory results show that chickpea beverage with cooking water has the best taste. All pulses-based beverages are typical non-Newtonian fluids, similarly to current non-dairy alternative beverages. In this respect, the sprouted chickpea beverage, without the cooking water, presents the most pronounced shear-thinning behavior of all formulations.
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Affiliation(s)
- Mariana Lopes
- LEAF-Linking Landscape, Environment, Agriculture and Food, Instituto Superior de Agronomia, University of Lisbon, Tapada da Ajuda, 1349-017 Lisboa, Portugal; (M.L.); (C.P.); (I.S.)
| | - Chloé Pierrepont
- LEAF-Linking Landscape, Environment, Agriculture and Food, Instituto Superior de Agronomia, University of Lisbon, Tapada da Ajuda, 1349-017 Lisboa, Portugal; (M.L.); (C.P.); (I.S.)
| | - Carla Margarida Duarte
- LEAF-Linking Landscape, Environment, Agriculture and Food, Instituto Superior de Agronomia, University of Lisbon, Tapada da Ajuda, 1349-017 Lisboa, Portugal; (M.L.); (C.P.); (I.S.)
- Correspondence:
| | - Alexandra Filipe
- CIEPQPF, Department of Chemical Engineering, University of Coimbra, Pólo II–R. Silvio Lima, 3030-790 Coimbra, Portugal;
| | - Bruno Medronho
- MED–Mediterranean Institute for Agriculture, Environment and Development, University of Algarve, Faculty of Sciences and Technology, Campus de Gambelas, Ed. 8, 8005-139 Faro, Portugal;
- FSCN, Surface and Colloid Engineering, Mid Sweden University, SE-851 70 Sundsvall, Sweden
| | - Isabel Sousa
- LEAF-Linking Landscape, Environment, Agriculture and Food, Instituto Superior de Agronomia, University of Lisbon, Tapada da Ajuda, 1349-017 Lisboa, Portugal; (M.L.); (C.P.); (I.S.)
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Eisenblaetter J, Bürklin S, Gschwend A, Relats C, Roduit C, Stalder K, Fischer I, Hofmann D, Schütt G, Herzog R, Gianelli D, Mura M, Martel P, Werder A, Martin L, Hickson M, Skypala I, Payne A. Development of a practice guideline for dietary counselling of children with IgE-mediated food allergy. ALLERGO JOURNAL 2020. [DOI: 10.1007/s15007-020-2568-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kubo C, Kurimoto M, Tanaka M, Ochi H, Abe F, Okochi M. Peptide array-based inhibition ELISA for evaluating antigenicity in infant formulas. J Biosci Bioeng 2020; 130:374-381. [PMID: 32713812 DOI: 10.1016/j.jbiosc.2020.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 06/02/2020] [Accepted: 06/16/2020] [Indexed: 11/16/2022]
Abstract
With increased awareness among consumers regarding food safety and security, food allergen control has become an indispensable requirement in the food industry. Although several methods for detecting allergens in food products are available, highly sensitive techniques are required. In this study, we developed a technique named as peptide array-based inhibition enzyme-linked immunosorbent assay (ELISA), Pep-iEIA, for evaluating antigenicity and detecting cow's milk antigen in infant formula products, using a peptide array consisting of a series of overlapping peptides found in allergenic milk proteins. Pep-iEIA was used to examine five cow's milk-based infant formulas with different degrees of hydrolyzation, and the assay offered both more sensitive detection and detailed analysis of remaining antigenic peptides in allergen compared to conventional ELISA. The antigenicity level of the allergenic peptides identified using Pep-iEIA was confirmed by surface plasmon resonance assay. We believe that Pep-iEIA will be highly useful for antigenicity evaluation of dairy products consumed by infants and patients with cow's milk allergy.
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Affiliation(s)
- Chisato Kubo
- Food Ingredients & Technology Institute, Morinaga Milk Industry Co., Ltd., 5-1-83 Higashihara, Zama, Kanagawa 252-8583, Japan
| | - Masaki Kurimoto
- Food Ingredients & Technology Institute, Morinaga Milk Industry Co., Ltd., 5-1-83 Higashihara, Zama, Kanagawa 252-8583, Japan
| | - Masayoshi Tanaka
- Department of Chemical Science and Engineering, Tokyo Institute of Technology, 2-12-1 O-okayama, Meguro-ku, Tokyo 152-8552, Japan
| | - Hiroshi Ochi
- Food Ingredients & Technology Institute, Morinaga Milk Industry Co., Ltd., 5-1-83 Higashihara, Zama, Kanagawa 252-8583, Japan
| | - Fumiaki Abe
- Food Ingredients & Technology Institute, Morinaga Milk Industry Co., Ltd., 5-1-83 Higashihara, Zama, Kanagawa 252-8583, Japan
| | - Mina Okochi
- Department of Chemical Science and Engineering, Tokyo Institute of Technology, 2-12-1 O-okayama, Meguro-ku, Tokyo 152-8552, Japan.
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Lezo A, Baldini L, Asteggiano M. Failure to Thrive in the Outpatient Clinic: A New Insight. Nutrients 2020; 12:E2202. [PMID: 32722001 PMCID: PMC7468984 DOI: 10.3390/nu12082202] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/17/2020] [Accepted: 07/21/2020] [Indexed: 12/31/2022] Open
Abstract
Failure to thrive (FTT) is an abnormal growth pattern determined by inadequate nutrition. It is a common problem in children, representing 5% to 10% of patients seen in an outpatient setting. Many definitions have been proposed based on anthropometric deterioration; however, they show poor concordance. No single definition is sufficiently sensitive in identifying faltering growth whilst a combination of multiple criteria seems more accurate. In light of the recent redefinition of pediatric malnutrition as a disequilibrium between requirements and intakes of energy, and macro- and micronutrients, a wider conception of FTT as an unsatisfactory nutritional status related to poor growth and health is useful. Although the most severe problems of micronutrient malnutrition are found in developing countries, people of all regions of the world can be affected by micronutrient deficiencies (MNDs), a form of undernutrition with relevant effects on growth and health. Changes in diets and lifestyle, elimination diets, food insecurity, and food intake disorders create the conditions at risk of faltering growth and MNDs. This new insight integrates the "classical" anthropometric criteria for definition and treatment, in the aim of warranting both a regular increase in size and an overall adequate development and health status.
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Affiliation(s)
- Antonella Lezo
- Dietetic and Clinical Nutrition Unit, Children’s Hospital Regina Margherita, AOU Città della Salute e della Scienza, 10126 Turin, Italy;
| | - Letizia Baldini
- Department of Public Health and Pediatrics, School of Pediatrics, University of Turin, 10126 Turin, Italy;
| | - Monica Asteggiano
- Department of Public Health and Pediatrics, School of Pediatrics, University of Turin, 10126 Turin, Italy;
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Percival E, Bhatia R, Preece K, McEvoy M, Collison A, Mattes J. Change in exhaled nitric oxide during peanut challenge is related to severity of reaction. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2020; 16:64. [PMID: 32834829 PMCID: PMC7386245 DOI: 10.1186/s13223-020-00464-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 07/10/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Peanut allergy affects 3% of Australian children and has a higher risk of anaphylaxis than most food allergies. Predicting who is likely to develop anaphylaxis is still an inexact science. The fraction of exhaled nitric oxide (FeNO) shows promise as a biomarker involved in peanut allergy, as nitric oxide plays a role in inhibiting mast cell degranulation which is relevant in anaphylaxis, where mast cell degranulation plays a mediator role. The aim of this study was to assess the change in FeNO in children during peanut challenge. METHODS Thirty-six children aged from 5 to 17 years were recruited for open-labelled peanut challenge. Participants had skin prick test to peanut performed, and serum collected for Ara h2 specific IgE and peanut specific IgE. FeNO was measured by portable device (NIOX VERO) prior to and throughout the peanut challenge. RESULTS When grouped according to reaction type at peanut challenge (anaphylaxis, clinical allergy not anaphylaxis and tolerant), there were significant differences in the mean change in FeNO measurement between the anaphylaxis group and the clinical allergy, not anaphylaxis group (p = 0.005), and between the anaphylaxis group and tolerant group (p < 0.0001). CONCLUSIONS FeNO decreased more significantly in those who subsequently developed anaphylaxis than in those with clinical allergy, not anaphylaxis or negative peanut challenge (tolerance). As a bedside test that can be used in children, it has potential for further research into mechanisms of anaphylaxis in food allergy and potentially assists in predicting an imminent anaphylactic reaction in some patients.Trial registration ClinicalTrials.gov: PEAnut Anaphylaxis Predictors (PEAAP) NCT02424136.
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Affiliation(s)
- Elizabeth Percival
- GrowUpWell Priority Research Centre, Hunter Medical Research Institute, University of Newcastle, Lot 1 Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305 Australia
- Department of Paediatric Medicine, John Hunter Children’s Hospital, Newcastle, NSW Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW Australia
| | - Rani Bhatia
- Department of Paediatric Allergy & Immunology, John Hunter Children’s Hospital, Newcastle, NSW Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW Australia
| | - Kahn Preece
- Department of Paediatric Allergy & Immunology, John Hunter Children’s Hospital, Newcastle, NSW Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW Australia
| | - Mark McEvoy
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW Australia
| | - Adam Collison
- GrowUpWell Priority Research Centre, Hunter Medical Research Institute, University of Newcastle, Lot 1 Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305 Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW Australia
| | - Joerg Mattes
- GrowUpWell Priority Research Centre, Hunter Medical Research Institute, University of Newcastle, Lot 1 Kookaburra Circuit, New Lambton Heights, Newcastle, NSW 2305 Australia
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW Australia
- Department of Paediatric Respiratory & Sleep Medicine, John Hunter Children’s Hospital, Newcastle, NSW Australia
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Production of Liquid Milk Protein Concentrate with Antioxidant Capacity, Angiotensin Converting Enzyme Inhibitory Activity, Antibacterial Activity, and Hypoallergenic Property by Membrane Filtration and Enzymatic Modification of Proteins. Processes (Basel) 2020. [DOI: 10.3390/pr8070871] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Liquid milk protein concentrate with different beneficial values was prepared by membrane filtration and enzymatic modification of proteins in a sequential way. In the first step, milk protein concentrate was produced from ultra-heat-treated skimmed milk by removing milk serum as permeate. A tubular ceramic-made membrane with filtration area 5 × 10−3 m2 and pore size 5 nm, placed in a cross-flow membrane house, was adopted. Superior operational strategy in filtration process was herein: trans-membrane pressure 3 bar, retention flow rate 100 L·h−1, and implementation of a static turbulence promoter within the tubular membrane. Milk with concentrated proteins from retentate side was treated with the different concentrations of trypsin, ranging from 0.008–0.064 g·L−1 in individual batch-mode operations at temperature 40 °C for 10 min. Subsequently, inactivation of trypsin in reaction was done at a temperature of 70 °C for 30 min of incubation. Antioxidant capacity in enzyme-treated liquid milk protein concentrate was measured with the Ferric reducing ability of plasma assay. The reduction of angiotensin converting enzyme activity by enzyme-treated liquid milk protein concentrate was measured with substrate (Abz-FRK(Dnp)-P) and recombinant angiotensin converting enzyme. The antibacterial activity of enzyme-treated liquid milk protein concentrate towards Bacillus cereus and Staphylococcus aureus was tested. Antioxidant capacity, anti-angiotensin converting enzyme activity, and antibacterial activity were increased with the increase of trypsin concentration in proteolytic reaction. Immune-reactive proteins in enzyme-treated liquid milk protein concentrate were identified with clinically proved milk positive pooled human serum and peroxidase-labelled anti-human Immunoglobulin E. The reduction of allergenicity in milk protein concentrate was enzyme dose-dependent.
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Kehinde BA, Panghal A, Garg MK, Sharma P, Chhikara N. Vegetable milk as probiotic and prebiotic foods. ADVANCES IN FOOD AND NUTRITION RESEARCH 2020; 94:115-160. [PMID: 32892832 DOI: 10.1016/bs.afnr.2020.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Vegetable milks are fast gaining attention on the global scale as the possible alternatives due to concerns associated with milk consumption. In particular, issues varying from allergenic constituents and lactose intolerance to social and religious beliefs among consumers have induced an increase in the market demand for vegetable milks. Their concomitant nutritional and bioactive components appraise them of the suitable profile for the food-based carriage and delivery of probiotics. More so, the presence of prebiotics in their natural configuration makes them serviceable for the assurance of the needed probiotic viability, subsequent to their exposure to digestive conditions. On another note, their availability, ease of processing, and cost-effectiveness have been established as other possible rationales behind their adoption. This chapter comprehensively delineates the probiotic and prebiotic food-usage of vegetable milks. Captions related with consumer concerns, processing operations, nutritional and prebiotic constitutions, metabolic interactions during probiotic fermentation, and associated health benefits of vegetable milks are discoursed.
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Affiliation(s)
- Bababode Adesegun Kehinde
- Department of Biosystems and Agricultural Engineering, University of Kentucky, Lexington, KY, United States
| | - Anil Panghal
- Department of Processing and Food Engineering, AICRP-PHET, Chaudhary Charan Singh Haryana Agricultural University, Hisar, India
| | - M K Garg
- Department of Processing and Food Engineering, AICRP-PHET, Chaudhary Charan Singh Haryana Agricultural University, Hisar, India
| | - Poorva Sharma
- Department of Food Technology and Nutrition, Lovely Professional University, Phagwara, Punjab, India
| | - Navnidhi Chhikara
- Department of Food Technology, Guru Jambheshwar University of Science and Technology, Hisar, India.
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TAVŞANLI H, GÖKMEN M, ÖNEN A. Chemical and microbiological quality of donkey milk. ANKARA ÜNIVERSITESI VETERINER FAKÜLTESI DERGISI 2020. [DOI: 10.33988/auvfd.592950] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Nutten S, Schuh S, Dutter T, Heine RG, Kuslys M. Design, quality, safety and efficacy of extensively hydrolyzed formula for management of cow's milk protein allergy: What are the challenges? ADVANCES IN FOOD AND NUTRITION RESEARCH 2020; 93:147-204. [PMID: 32711862 DOI: 10.1016/bs.afnr.2020.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Cow's milk protein allergy (CMPA) is one of the most common food allergies in infancy. Clinical food allergy guidelines recommend an extensively hydrolyzed formula (EHF) as the first-line treatment in nonbreastfed infants with CMPA. Designing and commercializing EHF poses both technical and regulatory challenges. Each manufacturing step, from sourcing of raw materials to release of the final product, needs to be managed in accordance with comprehensive quality systems. To avoid cross-contamination via externally sourced ingredients, suppliers should be carefully selected based on quality requirements. Strict zoning of the manufacturing areas according to contamination risk and air flow control are effective strategies to prevent accidental allergen contamination. Furthermore, dedicated manufacturing lines for hypoallergenic products are used to prevent potential cross-contamination from other products produced on the same line. The enzymatic hydrolysis, heat treatment and ultrafiltration used are specific to each manufacturer. Consequently, EHF are a heterogenous group of products with differences in the molecular weight profile of peptides, content of residual immunogenic cow's milk allergens, and residual in-vitro allergenicity. These differences are likely to affect clinical efficacy and safety. As not all commercialized EHF products have undergone formal testing in the laboratory and clinical trials, there is a need to develop guidelines for minimum technical and regulatory requirements for EHF products, including validated assays for ongoing quality control. Clinical trials assessing new EHF products for their hypoallergenicity and ability to support normal growth remain the definitive proof of efficacy and safety in infants and young children with CMPA.
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Affiliation(s)
| | - Susanne Schuh
- Nestlé Research and Development, Konolfingen, Switzerland
| | - Thibaut Dutter
- Nestlé Research and Development, Konolfingen, Switzerland
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Nawaz MA, Tan M, Øiseth S, Buckow R. An Emerging Segment of Functional Legume-Based Beverages: A Review. FOOD REVIEWS INTERNATIONAL 2020. [DOI: 10.1080/87559129.2020.1762641] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Malik Adil Nawaz
- Commonwealth Scientific and Industrial Research Organisation (CSIRO), Agriculture and Food, Werribee, Australia
| | - Melvin Tan
- Commonwealth Scientific and Industrial Research Organisation (CSIRO), Agriculture and Food, Werribee, Australia
| | - Sofia Øiseth
- Commonwealth Scientific and Industrial Research Organisation (CSIRO), Agriculture and Food, Werribee, Australia
| | - Roman Buckow
- Commonwealth Scientific and Industrial Research Organisation (CSIRO), Agriculture and Food, Werribee, Australia
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