Effect of terfenadine on TNFα release from peripheral blood mononuclear cells during cow's milk allergy

Proinflammatory and regulatory cytokine production associated with innate and adaptive immune responses in children with autism spectrum disorders and developmental regression

We determined innate and adaptive immune responses in children with developmental regression and autism spectrum disorders (ASD, N=71), developmentally normal siblings (N=23), and controls (N=17). With lipopolysaccharide (LPS), a stimulant for innate immunity, peripheral blood mononuclear cells (PBMCs) from 59/71 (83.1%) ASD patients produced >2 SD above the control mean (CM) values of TNF-alpha, IL-1beta, and/or IL-6 produced by control PBMCs. ASD PBMCs produced higher levels of proinflammatory/counter-regulatory cytokines without stimuli than controls. With stimulants of phytohemagglutinin (PHA), tetanus, IL-12p70, and IL-18, PBMCs from 47.9% to 60% of ASD patients produced >2 SD above the CM values of TNF-alpha depending on stimulants. Our results indicate excessive innate immune responses in a number of ASD children that may be most evident in TNF-alpha production.

The time-course of milk antigen-induced TNF-alpha secretion differs according to the clinical symptoms in children with cow's milk allergy

BACKGROUND

TNF-alpha secretion by blood mononuclear cells stimulated with cow's milk proteins is significantly higher in infants with active cow's milk allergy (CMA) manifested by digestive symptoms than in children who have recovered from CMA.

OBJECTIVE

The current study was undertaken to analyze the kinetics of TNF-alpha secretion and to evaluate the usefulness of the measurement of TNF-alpha release in whole blood cultures in the prediction of clinical outcome after milk challenge.

METHODS

Blood samples were obtained from 83 children maintained on a cow's milk-free diet and examined just before a cow's milk provocation. Children were divided into 4 groups according to clinical outcome: group I (active CMA with cutaneous symptoms), group II (active CMA with predominantly digestive symptoms), group III (children recovered from CMA), and group IV (control). The kinetics of TNF-alpha secretion was measured in blood cultured for 1 to 5 days at different cow's milk protein concentrations.

RESULTS

On day 1 TNF-alpha secretion was significantly higher in group I (485 [453] pg/mL, mean [SD], P <.005) and in group II (269 [102] pg/mL, P <. 005) than that observed in groups III and IV (149 [95] and 87 [71] pg/mL, respectively). Then TNF-alpha was rapidly degraded and a second peak of secretion was observed on day 5 but only in group II (278 [221] pg/mL), whereas in groups I, III, and IV a low secretion was observed (70 [61], 45 [40], and 11 [12] pg/mL, respectively, P <. 02).

CONCLUSION

These results show that the pattern of TNF-alpha secretion in response to cow's milk proteins is different in CMA infants with cutaneous or digestive symptoms and suggest that TNF-alpha release might predict clinical relapse on challenge.