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Hu W, Xiong Z, Meng X, Wu Y, Tong P, Gao J, Li X, Chen H. Lipid matrix-specific pretreatment method for enhancing the extractability and allergenicity maintenance of bovine milk allergens in ELISA detection. Food Chem 2024; 452:139462. [PMID: 38723563 DOI: 10.1016/j.foodchem.2024.139462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/21/2024] [Accepted: 04/21/2024] [Indexed: 06/01/2024]
Abstract
The presence of various components in the food matrix makes allergen detection difficult and inaccurate, and pretreatment is an innovative breakthrough point. Food matrices were categorised based on their composition. Subsequently, a pretreatment method was established using a combination of ultrasound-assisted n-hexane degreasing and weakly alkaline extraction systems to enhance the detection accuracy of bovine milk allergens. Results showed that more allergens were obtained with less structural destruction, as demonstrated using immunological quantification and spectral analysis. Concurrently, allergenicity preservation was confirmed through liquid chromatography-tandem mass spectrometry (LC-MS/MS) analysis, a KU812 cell degranulation model, and western blotting. The method exhibited good accuracy (bias, 8.47%), repeatability (RSDr, 1.52%), and stability (RSDR, 5.65%). In foods with high lipid content, such as chocolate, the allergen content was 2.29-fold higher than that of commercial kits. Laser confocal scanning microscopy (LCSM) and scanning electron microscopy (SEM) analyses revealed a significant decrease in fat content after post-pretreatment using our method. In addition, colloidal stability surpassed that achieved using commercial kits, as indicated through the PSA and zeta potential results. The results demonstrated the superiority of the extractability and allergenicity maintenance of lipid matrix-specific pretreatment methods for improving the accuracy of ELISA based allergen detection in real food.
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Affiliation(s)
- Wei Hu
- State Key Laboratory of Food Science and Resource, Nanchang University, Nanchang 330047, China; School of Food Science and Technology, Nanchang University, Nanchang 330031, China; Jiangxi Province Key Laboratory of Food Allergy, Nanchang 330047, China
| | - Ziyi Xiong
- State Key Laboratory of Food Science and Resource, Nanchang University, Nanchang 330047, China; School of Food Science and Technology, Nanchang University, Nanchang 330031, China; Jiangxi Province Key Laboratory of Food Allergy, Nanchang 330047, China
| | - Xuanyi Meng
- State Key Laboratory of Food Science and Resource, Nanchang University, Nanchang 330047, China; Jiangxi Province Key Laboratory of Food Allergy, Nanchang 330047, China; Sino-German Joint Research Institute, Nanchang University, Nanchang 330047, China
| | - Yong Wu
- State Key Laboratory of Food Science and Resource, Nanchang University, Nanchang 330047, China; Jiangxi Province Key Laboratory of Food Allergy, Nanchang 330047, China; Sino-German Joint Research Institute, Nanchang University, Nanchang 330047, China
| | - Ping Tong
- State Key Laboratory of Food Science and Resource, Nanchang University, Nanchang 330047, China; School of Food Science and Technology, Nanchang University, Nanchang 330031, China; Jiangxi Province Key Laboratory of Food Allergy, Nanchang 330047, China
| | - Jinyan Gao
- School of Food Science and Technology, Nanchang University, Nanchang 330031, China; Jiangxi Province Key Laboratory of Food Allergy, Nanchang 330047, China
| | - Xin Li
- State Key Laboratory of Food Science and Resource, Nanchang University, Nanchang 330047, China; School of Food Science and Technology, Nanchang University, Nanchang 330031, China; Jiangxi Province Key Laboratory of Food Allergy, Nanchang 330047, China.
| | - Hongbing Chen
- State Key Laboratory of Food Science and Resource, Nanchang University, Nanchang 330047, China; Jiangxi Province Key Laboratory of Food Allergy, Nanchang 330047, China; Sino-German Joint Research Institute, Nanchang University, Nanchang 330047, China
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2
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Nocerino R, Carucci L, Coppola S, Cecere G, Micillo M, Castaldo T, Russo S, Sandomenico M, Marino A, Gualano R, Ercolini P, Capasso A, Bedogni G, Berni Canani R. Epidemiology of Paediatric Italian Food Allergy: Results of the EPIFA study. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2024; 3:100246. [PMID: 38655562 PMCID: PMC11035069 DOI: 10.1016/j.jacig.2024.100246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 01/14/2024] [Accepted: 01/27/2024] [Indexed: 04/26/2024]
Abstract
Background Updated epidemiologic data are important for defining effective public health strategies for pediatric food allergy (FA). Objective The Epidemiology of Paediatric Italian Food Allergy (EPIFA) study was designed to investigate the epidemiology of pediatric FA in one of the most heavily populated Italian regions. Methods A retrospective cohort study was performed in collaboration with family pediatricians aimed at investigating the epidemiology of Italian pediatric FA during 2009 to 2021. Family pediatricians in the Campania region were invited to use the Google Forms platform for online compilation of data forms. Data forms were reviewed by experienced pediatric allergists at the coordinating center. Results A total population of 105,151 subjects (aged 0-14 years) was screened during the study period. Data from 752 FA patients were evaluated. A progressive increase in FA incidence and prevalence was observed from 2009 to 2021, with a relative increase up to 34% and 113.6%, respectively, at the end of study period. The relative increase in FA prevalence was higher in the 0-3-year-old age group in the same study period (+120.8%). The most frequent allergens were cow's milk, hen's egg, and nuts. Conclusion The results of the EPIFA study showed an increase in pediatric FA incidence and prevalence from 2009 to 2021 in Italy. These results underline the necessity of new effective strategies for preventing and managing these conditions.
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Affiliation(s)
- Rita Nocerino
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Laura Carucci
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Serena Coppola
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Gaetano Cecere
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Maria Micillo
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Tina Castaldo
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Stefania Russo
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Marialuisa Sandomenico
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Antonio Marino
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Renato Gualano
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Paola Ercolini
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Antonella Capasso
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Giorgio Bedogni
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
- Department of Internal Medicine, S Maria delle Croci Hospital, AUSL Romagna, Ravenna, Italy
| | - Roberto Berni Canani
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
- European Laboratory for the Investigation of Food-Induced Diseases, University of Naples Federico II, Naples, Italy
- Task Force for Microbiome Studies, University of Naples Federico II, Naples, Italy
| | - Italian Society of Pediatric Gastroenterology and Nutrition (SIGENP)
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
- European Laboratory for the Investigation of Food-Induced Diseases, University of Naples Federico II, Naples, Italy
- Task Force for Microbiome Studies, University of Naples Federico II, Naples, Italy
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
- Department of Internal Medicine, S Maria delle Croci Hospital, AUSL Romagna, Ravenna, Italy
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Randhawa I, Marsteller N. Long-term efficacy and safety of cow's milk anaphylaxis specific immunotherapy: Allergen unresponsiveness via the Tolerance Induction Program. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2024; 3:100285. [PMID: 38983112 PMCID: PMC11231699 DOI: 10.1016/j.jacig.2024.100285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/19/2024] [Accepted: 04/05/2024] [Indexed: 07/11/2024]
Abstract
Background Tolerance Induction Program (TIP) immunotherapy applies machine learning contextualized on immunologic and food protein data sets. TIP has established efficacy toward peanut allergy. This form of treatment demonstrates equal efficacy toward cow's milk anaphylaxis. TIP maintains remission outcomes defined as a minimum of 7 days of allergen unresponsiveness to high-dose protein exposures. Furthermore, remission patients openly consume unrestricted amounts of dairy protein. Objective We sought to assess the rate of decline in specific IgE specific whole and component-resolved diagnostics following 1 year of TIP milk immunotherapy. Methods The study comprised 214 cow milk anaphylactic children who underwent TIP at the Translational Pulmonary & Immunology Research Center/Food Allergy Institute. Postintervention changes in cow milk specific IgE, component-resolved diagnostics, and specific IgG4 were assessed. Results After 1 year of 10-g dairy protein weekly sustained unresponsiveness, eosinophil count decreased from 558.38 to 409.26 cells/μL, the mean cow milk IgE decreased from 16.91 to 9.10 kU/L, the mean boiled cow milk IgE decreased from 12.89 to 6.03 kU/L, the mean Bos D4 decreased from 7.38 to 3.52 kU/L, the mean Bos D5 decreased from 6.79 to 3.16 kU/L, and the mean Bos D8 decreased from 13.55 to 6.62 kU/L. Adverse events were rare. Conclusions TIP cow milk immunotherapy significantly reduced cow milk specific IgE and component-resolved diagnostics while increasing specific IgG4 in cow milk anaphylactic children. TIP demonstrates safety and clinical efficacy in cow milk anaphylaxis treatment.
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Affiliation(s)
| | - Nathan Marsteller
- Translational Pulmonary & Immunology Research Center, Long Beach, Calif
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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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Maryniak NZ, Mancino M, Sztuk TKS, Gao Y, Sancho AI, Hansen EB, Bøgh KL. Impact of processing on the sensitising capacity and cross-reactivity of cow's and camel milk proteins in a Brown Norway rat study. Food Chem Toxicol 2024; 189:114761. [PMID: 38796088 DOI: 10.1016/j.fct.2024.114761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Revised: 05/14/2024] [Accepted: 05/21/2024] [Indexed: 05/28/2024]
Abstract
Infant formulas based on hydrolysed cow's milk proteins are used when breastfeeding is not feasible in cow's milk allergic infants. Camel milk has been shown to be well-tolerated by the majority of children with cow's milk allergy (CMA) and may be a substitute in management of CMA. Here we aimed to evaluate the impact of processing on immunogenicity, sensitising, antibody-binding and cross-reactive capacity of cow's and camel milk. Cow's and camel milk were processed by means of enzyme hydrolysis or heat treatment. Brown Norway rats were immunised with PBS, non-processed, enzyme hydrolysed or heat-treated cow's or camel milk. In vivo tests were performed for evaluation of clinical signs. Blood and faecal samples were analysed for levels and specificity of antibody responses. Cow's and camel milk showed similar sensitising capacity. Processing decreased the sensitising capacity of cow's milk, yet only enzyme hydrolysis but not heat treatment decreased the sensitising capacity of camel milk. Processing affected the specificity of antibodies raised in the rats, though the effect differed between cow's and camel milk. The study showed a low cross-reactivity between cow's and camel milk, which was decreased with processing, suggesting that processing of camel milk may improve its usefulness in CMA management.
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Affiliation(s)
| | - Matteo Mancino
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | | | - Yumei Gao
- Ausnutria Dairy (China) Co., Ltd., Changsha, China
| | - Ana Isabel Sancho
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Egon Bech Hansen
- National Food Institute, Technical University of Denmark, Kgs. Lyngby, Denmark
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Yazici D, Suer H, Bulbuloglu CN, Guzar E, Koçak E, Nemutlu E, Buyuktiryaki B, Sackesen C. Development of a low allergenic product for patients with milk allergy and assessment of its specific IgE reactivity. Pediatr Allergy Immunol 2024; 35:e14174. [PMID: 38899602 DOI: 10.1111/pai.14174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 05/10/2024] [Accepted: 05/29/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Milk oral immunotherapy is the riskiest and most unpredictable form of oral immunotherapy. We aimed to produce a low allergenic product than conventional once baked-cake/muffin, to develop indirect in-house ELISA to check the tolerance status with milk products and evaluate IgE reactivity of patients' sera via western blotting (WB) and indirect in-house ELISA. METHOD A low allergenic product named biscotti-twice baked-cake was developed, and the total protein concentration was determined. The protein content was studied by SDS-PAGE and proteomics. Milk-specific IgE (sIgE) binding assays were performed by WB and indirect in-house ELISA by using patients' sera. RESULTS Casein band intensity was observed to be lower in the biscotti-twice baked-cake than in the once baked-cake (p = .014). Proteomics analysis and αS1-casein measurement showed that the lowest intensity of casein was found in biscotti. The low binding capacity of milk sIgE to biscotti compared with once baked-cake was shown by WB (p = .0012) and by indirect in-house ELISA (p = .0001). In the ROC analysis, the area under the curve (AUC) of the in-house ELISA IgE was comparable with Uni-CAP milk and casein sIgE. The AUC of the in-house ELISA IgE for cake (0.96) and biscotti (1) was slightly better than Uni-CAP milk sIgE (0.94; 0.97) and casein sIgE (0.96; 0.97), respectively. CONCLUSION The low allergenicity of the newly developed low allergenic product "biscotti-twice baked-cake" has been demonstrated by in vitro experiments. Biscotti could be a safe treatment option than once baked-cake/muffin in patients who are reactive to once baked-milk products.
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Affiliation(s)
- Duygu Yazici
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
- Research Center for Translational Medicine (KUTTAM), Koç University School of Medicine, Istanbul, Turkey
| | - Hande Suer
- Research Center for Translational Medicine (KUTTAM), Koç University School of Medicine, Istanbul, Turkey
- Graduate School of Health Sciences, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Cemre Naz Bulbuloglu
- Research Center for Translational Medicine (KUTTAM), Koç University School of Medicine, Istanbul, Turkey
| | - Elif Guzar
- Research Center for Translational Medicine (KUTTAM), Koç University School of Medicine, Istanbul, Turkey
| | - Engin Koçak
- Department of Analytical Chemistry, Faculty of Gulhane Pharmacy, Health Sciences University, Ankara, Turkey
| | - Emirhan Nemutlu
- Department of Analytical Chemistry, Faculty of Pharmacy, Hacettepe University, Ankara, Turkey
| | - Betul Buyuktiryaki
- Research Center for Translational Medicine (KUTTAM), Koç University School of Medicine, Istanbul, Turkey
- Division of Pediatric Allergy, School of Medicine, Koc University, Istanbul, Turkey
| | - Cansin Sackesen
- Research Center for Translational Medicine (KUTTAM), Koç University School of Medicine, Istanbul, Turkey
- Division of Pediatric Allergy, School of Medicine, Koc University, Istanbul, Turkey
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Bosco A, Altea V, Beretta P, Cacace R, Fanos V, Dessì A. Metabolomics in Children Cow's Milk Protein Allergy: Possible Contribution from a System Biology Approach? CHILDREN (BASEL, SWITZERLAND) 2024; 11:562. [PMID: 38790557 PMCID: PMC11120097 DOI: 10.3390/children11050562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 05/03/2024] [Accepted: 05/05/2024] [Indexed: 05/26/2024]
Abstract
One of the most frequent triggers of food anaphylaxis in pediatric age but also among the most common, early, and complex causes of childhood food allergy is cow's milk protein allergy (CMPA). The diagnostic course and management of this allergy is defined in a complex clinical picture due to several factors. First of all, the epidemiological data are not uniform, mainly as a consequence of the diagnostic methodology used in the various studies and the different age ranges covered. In addition, there is the complexity of terminology, since although CMPA traditionally refers to immune-mediated reactions to cow's milk, it is a term encompassing numerous clinical features with different symptoms and the requirement for specific treatments. Moreover, the differential diagnosis with other very frequent diseases, especially in the first year of life, such as gastro-esophageal reflux disease or colic, is still complex. This can result in misdiagnosis and incorrect treatment, with harmful health consequences and significant economic repercussions. In this context, the combination of several omics sciences together, which have already proved useful in clarifying the allergenicity of cow's milk proteins with greater precision, could improve the diagnostic tests currently in use through the identification of new, more specific, and precise biomarkers that make it possible to improve diagnostic accuracy and predict the patient's response to the various available treatments for the recovery of tolerance.
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Affiliation(s)
| | | | | | | | - Vassilios Fanos
- Department of Surgical Sciences, University of Cagliari and Neonatal Intensive Care Unit, AOU Cagliari, 09124 Cagliari, Italy; (A.B.); (V.A.); (P.B.); (R.C.); (A.D.)
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8
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Hirai S, Yamamoto-Hanada K, Pak K, Saito-Abe M, Fukuie T, Ohya Y. Predictive modeling for cow's milk allergy remission by low-dose oral immunotherapy in young children. World Allergy Organ J 2024; 17:100910. [PMID: 38800497 PMCID: PMC11126529 DOI: 10.1016/j.waojou.2024.100910] [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] [Received: 09/11/2023] [Revised: 01/09/2024] [Accepted: 04/27/2024] [Indexed: 05/29/2024] Open
Abstract
Background The effectiveness of slow low-dose oral immunotherapy (SLOIT) for cow's milk (CM) allergy has been reported. Most OIT studies have discussed the target populations over 4 years old. Furthermore, no predicting modeling is reported for CM allergy remission by CM-SLOIT under 4 years of age. Objective We sought to develop a predictive model for CM allergy remission by SLOIT after 3 years in young children who started CM-SLOIT under 4 years of age. Methods We included young children with cow's milk allergy or cow's milk sensitization (development modeling set with 120 children and validation modeling set with 71 children). We did logistic regression analysis to develop the models. We calculated the area under the receiver operating curves (ROC-AUCs) to evaluate the predictive modeling performance. Results The model (CM-sIgE before SLOIT + age at beginning SLOIT + serum TARC before starting SLOIT + CM-sIgE titer one year after OIT) showed good discrimination with the ROC-AUC of 0.83 (95% CI:0.76-0.91) on internal validation. Applying the model to the validation set gave good discrimination (ROC-AUC = 0.89, 95% CI:0.80-0.97) and a reasonable calibration (intraclass correlation coefficient = 0.88, 95% CI:0.62-0.97). Conclusion We developed and validated predictive modeling for determining the remission rate of CM allergy at 3 years after SLOIT under 4 years of age in children with CM allergy. This predictive model is highly accurate and can support CM allergy management. (226 words).
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Affiliation(s)
- Seiko Hirai
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | | | - Kyongsun Pak
- Division of Biostatistics, Clinical Research Center, National Center for Child Health and Development, Tokyo, Japan
| | - Masako Saito-Abe
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Tatsuki Fukuie
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
| | - Yukihiro Ohya
- Allergy Center, National Center for Child Health and Development, Tokyo, Japan
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Salama M, Tebben PJ, Al Nofal A. An infant developing hypercalcemia and hypophosphatemia due to the use of exclusively almond milk. J Pediatr Endocrinol Metab 2024; 37:375-379. [PMID: 38414167 DOI: 10.1515/jpem-2023-0494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 02/12/2024] [Indexed: 02/29/2024]
Abstract
OBJECTIVES Plant-based milk alternatives are increasingly utilized in children with cow milk allergy, lactose intolerance, and personal preference. However, notable differences exist in mineral content between cow milk and plant-based alternatives. Almond milk, in particular, varies in mineral and caloric content across different brands. This case report highlights a toddler who developed hypercalcemia and hypophosphatemia attributed to almond milk consumption. CASE PRESENTATION A fourteen-month-old girl with a history of biliary atresia underwent liver transplant at seven months of age. She was exclusively consuming almond milk for two months prior to presentation. She was admitted to the hospital for severe hypercalcemia (14.6 mg/dL) and hypophosphatemia (1.6 mg/dL). She had elevated random urine calcium to creatinine ratio (2.56 mg/g) and low urine phosphorus to creatinine ratio (<0.44 mg/g) were noted. Parathyroid hormone (PTH) level was appropriately suppressed (<6 pg/mL), while 1,25 dihydroxyvitamin D level was slightly elevated at 88 pg/mL. Initial management included intravenous fluids, followed by a switch to a formula with higher phosphorus and lower calcium concentrations. The patient was discharged after six days with normalized calcium and phosphorus levels, which remained within the normal range. CONCLUSIONS Although plant-derived milk serves as a viable alternative to cow milk, careful consideration of mineral content, particularly in infants and toddlers, is imperative. Sole reliance on almond milk for nutritional needs in this population is not recommended. Caregivers should be informed about the potential risks associated with almond milk consumption in infants and toddlers.
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Affiliation(s)
- Mostafa Salama
- Department of Pediatrics, Division of Pediatric Endocrinology and Metabolism, 4352 Mayo Clinic , Rochester, MN, USA
| | - Peter J Tebben
- Department of Pediatrics, Division of Pediatric Endocrinology and Metabolism, 4352 Mayo Clinic , Rochester, MN, USA
- Department of Medicine, Division of Endocrinology, Diabetes, Metabolism and Nutrition, 123305 Mayo Clinic , Rochester, MN, USA
| | - Alaa Al Nofal
- Department of Pediatrics, Division of Pediatric Endocrinology and Metabolism, 4352 Mayo Clinic , Rochester, MN, USA
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10
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De Paepe E, Plekhova V, Vangeenderhuysen P, Baeck N, Bullens D, Claeys T, De Graeve M, Kamoen K, Notebaert A, Van de Wiele T, Van Den Broeck W, Vanlede K, Van Winckel M, Vereecke L, Elliott C, Cox E, Vanhaecke L. Integrated gut metabolome and microbiome fingerprinting reveals that dysbiosis precedes allergic inflammation in IgE-mediated pediatric cow's milk allergy. Allergy 2024; 79:949-963. [PMID: 38193259 DOI: 10.1111/all.16005] [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: 07/08/2023] [Revised: 11/29/2023] [Accepted: 12/01/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND IgE-mediated cow's milk allergy (IgE-CMA) is one of the first allergies to arise in early childhood and may result from exposure to various milk allergens, of which β-lactoglobulin (BLG) and casein are the most important. Understanding the underlying mechanisms behind IgE-CMA is imperative for the discovery of novel biomarkers and the design of innovative treatment and prevention strategies. METHODS We report a longitudinal in vivo murine model, in which two mice strains (BALB/c and C57Bl/6) were sensitized to BLG using either cholera toxin or an oil emulsion (n = 6 per group). After sensitization, mice were challenged orally, their clinical signs monitored, antibody (IgE and IgG1) and cytokine levels (IL-4 and IFN-γ) measured, and fecal samples subjected to metabolomics. The results of the murine models were further extrapolated to fecal microbiome-metabolome data from our population of IgE-CMA (n = 22) and healthy (n = 23) children (Trial: NCT04249973), on which polar metabolomics, lipidomics and 16S rRNA metasequencing were performed. In vitro gastrointestinal digestions and multi-omics corroborated the microbial origin of proposed metabolic changes. RESULTS During mice sensitization, we observed multiple microbially derived metabolic alterations, most importantly bile acid, energy and tryptophan metabolites, that preceded allergic inflammation. We confirmed microbial dysbiosis, and its associated effect on metabolic alterations in our patient cohort, through in vitro digestions and multi-omics, which was accompanied by metabolic signatures of low-grade inflammation. CONCLUSION Our results indicate that gut dysbiosis precedes allergic inflammation and nurtures a chronic low-grade inflammation in children on elimination diets, opening important new opportunities for future prevention and treatment strategies.
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Affiliation(s)
- Ellen De Paepe
- Faculty of Veterinary Medicine, Department of Translational Physiology, Infectiology and Public Health, Laboratory of Integrative Metabolomics (LIMET), Ghent University, Merelbeke, Belgium
| | - Vera Plekhova
- Faculty of Veterinary Medicine, Department of Translational Physiology, Infectiology and Public Health, Laboratory of Integrative Metabolomics (LIMET), Ghent University, Merelbeke, Belgium
| | - Pablo Vangeenderhuysen
- Faculty of Veterinary Medicine, Department of Translational Physiology, Infectiology and Public Health, Laboratory of Integrative Metabolomics (LIMET), Ghent University, Merelbeke, Belgium
| | - Nele Baeck
- Department of Pediatrics, Pediatric Gastroenterology, AZ Jan Palfijn Ghent, Ghent, Belgium
| | - Dominique Bullens
- Department of Microbiology, Immunology and Transplantation, Allergy and Immunology Research Group, KU Leuven, Leuven, Belgium
- Clinical Division of Pediatrics, UZ Leuven, Leuven, Belgium
| | - Tania Claeys
- Department of Pediatrics, Pediatric Gastroenterology and Nutrition & General Pediatric Medicine, AZ Sint-Jan Bruges, Bruges, Belgium
| | - Marilyn De Graeve
- Faculty of Veterinary Medicine, Department of Translational Physiology, Infectiology and Public Health, Laboratory of Integrative Metabolomics (LIMET), Ghent University, Merelbeke, Belgium
| | - Kristien Kamoen
- Department of Pediatrics, Maria Middelares Ghent, Ghent, Belgium
| | - Anneleen Notebaert
- Department of Pediatrics, Sint-Vincentius Hospital Deinze, Deinze, Belgium
| | - Tom Van de Wiele
- Faculty of Bioscience Engineering, Center for Microbial Ecology and Technology (CMET), Ghent University, Ghent, 9000, Belgium
| | - Wim Van Den Broeck
- Faculty of Veterinary Medicine, Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Ghent University, Merelbeke, Belgium
| | - Koen Vanlede
- Department of General Pediatrics, VITAZ, Sint-Niklaas, Belgium
| | - Myriam Van Winckel
- Faculty of Medicine and Health Sciences, Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
| | - Lars Vereecke
- Faculty of Medicine and Health Sciences, Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
- VIB-UGent Center for Inflammation Research, Ghent, Belgium
- Ghent Gut Inflammation Group (GGIG), Ghent, Belgium
| | - Chris Elliott
- School of Biological Sciences, Institute for Global Food Security, Queen's University Belfast, Belfast, United Kingdom
| | - Eric Cox
- Faculty of Veterinary Medicine, Department of Translational Physiology, Infectiology and Public Health, Laboratory of Immunology, Ghent University, Merelbeke, Belgium
| | - Lynn Vanhaecke
- Faculty of Veterinary Medicine, Department of Translational Physiology, Infectiology and Public Health, Laboratory of Integrative Metabolomics (LIMET), Ghent University, Merelbeke, Belgium
- School of Biological Sciences, Institute for Global Food Security, Queen's University Belfast, Belfast, United Kingdom
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11
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Petroni D, Bégin P, Bird JA, Brown-Whitehorn T, Chong HJ, Fleischer DM, Gagnon R, Jones SM, Leonard S, Makhija MM, Oriel RC, Shreffler WG, Sindher SB, Sussman GL, Yang WH, Bee KJ, Bois T, Campbell DE, Green TD, Rutault K, Sampson HA, Wood RA. Varying Doses of Epicutaneous Immunotherapy With Viaskin Milk vs Placebo in Children With Cow's Milk Allergy: A Randomized Clinical Trial. JAMA Pediatr 2024; 178:345-353. [PMID: 38407859 PMCID: PMC10897821 DOI: 10.1001/jamapediatrics.2023.6630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/08/2023] [Indexed: 02/27/2024]
Abstract
Importance No approved treatment exists for allergen-specific immunoglobulin E (IgE)-mediated cow's milk allergy (CMA), a common childhood food allergy. Objective To assess dose, efficacy, and safety of epicutaneous immunotherapy with Viaskin milk in children with IgE-mediated CMA. Design, Setting, and Participants A phase 1/2, 2-part, randomized, double-blind, placebo-controlled dose-ranging clinical trial in children aged 2 to 17 years with IgE-mediated CMA was conducted between November 2014 through December 2017. It took place at 17 trial sites in the US and Canada. Current CMA was confirmed by double-blind, placebo-controlled food challenge at study entry. Part A assessed the short-term safety of 150 μg, 300 μg, or 500 μg of Viaskin milk; part B evaluated the efficacy and safety of the 3 doses vs placebo over 12 months of treatment. Of the 308 screened participants with physician-diagnosed CMA, 198 met eligibility criteria (including an eliciting dose 300 mg or less) and were randomized. Intervention Safety of Viaskin milk (150-μg, 300-μg, or 500-μg doses) was evaluated over a 3-week period (part A). In part B, 180 additional participants were randomized to receive Viaskin milk at doses of 150 μg, 300 μg, or 500 μg or placebo (1:1:1:1) for 12 months. Main Outcomes and Measures The primary outcome was the proportion of treatment responders, defined as a 10-fold or more increase in the cumulative reactive dose of cow's milk protein (reaching at least 144 mg) or a cumulative reactive dose of cow's milk protein at 1444 mg or more at the month 12 double-blind, placebo-controlled food challenge. Results A total of 95.5% of the randomized participants (mean [SD] age, 8 [4.17] years; 124 of 198 were male [62.6%]) completed treatment. The highest response rate was observed in participants who received Viaskin milk at the 300-μg dose with 24 of 49 responders (49.0%) overall vs 16 of 53 responders (30.2%) in the placebo group (odds ratio, 2.19; 95% CI, 0.91-5.41; P = .09), highest in the 2 to 11 years age group (22 of 38 [57.9%] vs 13 of 40 [32.5%]; P = .04). Most treatment-emergent adverse events were mild or moderate application-site reactions. One participant in the 500-μg Viaskin milk dose group experienced treatment-related anaphylaxis. Conclusions and Relevance In this randomized clinical trial, 12 months of daily epicutaneous immunotherapy with a dose of Viaskin milk at 300 μg was associated with a statistically significant treatment response in 2- to 11-year-old children with IgE-mediated CMA. Treatment-related anaphylaxis and treatment-related discontinuation rates were low. Further research is needed to explore Viaskin milk as a viable treatment option for children with IgE-mediated CMA. Trial Registration ClinicalTrials.gov Identifier: NCT02223182.
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Affiliation(s)
- Daniel Petroni
- Seattle Allergy and Asthma Research Institute, Seattle, Washington
| | - Philippe Bégin
- Section of Allergy, Immunology and Rheumatology, Department of Pediatrics, CHU Sainte-Justine, Montréal, Quebec, Canada
| | | | - Terri Brown-Whitehorn
- Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Hey J. Chong
- UPMC Children’s Hospital of Pittsburgh and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - David M. Fleischer
- Children’s Hospital Colorado, University of Colorado Denver School of Medicine, Aurora
| | - Rémi Gagnon
- Clinique Spécialisée en Allergie de la Capitale, Québec, Québec, Canada
| | - Stacie M. Jones
- Department of Pediatrics, Arkansas Children’s Hospital, University of Arkansas for Medical Sciences, Little Rock
| | - Stephanie Leonard
- Department of Pediatrics, Rady Children’s Hospital, University of California, San Diego
| | - Melanie M. Makhija
- Division of Allergy and Immunology, Ann and Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Roxanne C. Oriel
- The Elliot and Roslyn Jaffe Food Allergy Institute, Division of Allergy and Immunology, Department of Pediatrics, Kravis Children’s Hospital, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | | | | | - William H. Yang
- Department of Medicine, Ottawa Allergy Research Corporation, University of Ottawa Medical School, Ottawa, Ontario, Canada
| | | | | | - Dianne E. Campbell
- DBV Technologies SA, Montrouge, France
- Westmead Children’s Hospital, Westmead, New South Wales, Australia
| | - Todd D. Green
- UPMC Children’s Hospital of Pittsburgh and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- DBV Technologies SA, Montrouge, France
| | | | - Hugh A. Sampson
- DBV Technologies SA, Montrouge, France
- Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Robert A. Wood
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
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12
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Baran JV, Brown JM, Farrar AA, Oliveros LV, Beacker J, Lamos L, Florio J, Fabbrini AL, Wilsey MJ. Impact of the 2022 national formula shortage on clinical decision-making of healthcare providers in switching amino acid formulas for infants with cow's milk protein allergy: a survey-based study. Front Pediatr 2024; 12:1328506. [PMID: 38560398 PMCID: PMC10978596 DOI: 10.3389/fped.2024.1328506] [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: 10/26/2023] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
Background In 2022, the United States experienced a national shortage of infant formula due to a global supply chain crisis and a large-scale domestic formula recall. The existing literature on healthcare providers' (HCPs) clinical decision-making during formula shortages is limited. This study aims to analyze the factors influencing pediatric HCP clinical decision-making when switching between amino acid formulas (AAF) for managing cow's milk protein allergy (CMPA) in infants under 24 months of age during an unprecedented national formula shortage. Methods The study included pediatric HCPs with experience managing CMPA in infants and toddlers under 24 months during the formula shortage from January 2022 to November 2022. A de-identified survey comprising 26 questions examining driving factors used in clinical decision-making was administered to pediatric HCPs using a real-time mobile data collection tool. Results Among the surveyed pediatric HCPs (n = 75), the factors most frequently considered as "extremely important" when switching to another AAF included safety (85%), tolerability (73%), and efficacy (83%). No statistically significant differences were found in HCP ratings among the listed examined factors of the four AAFs. The availability of specific formulas was the only factor that exhibited a statistically significant difference in perceived performance among pediatric HCPs when comparing the four AAFs (p < 0.05). Discussion This study elucidates the crucial aspects that influenced pediatric HCPs' selection of AAFs for CMPA management during the 2022 formula shortage. The findings highlight the significance of safety, tolerability, efficacy, and availability in the pediatric HCP decision-making processes.
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Affiliation(s)
- Jessica V. Baran
- Office of Medical Education, Florida Atlantic University Charles E. Schmid College of Medicine, Boca Raton, FL, United States
| | - Jerry M. Brown
- Office of Medical Education, Florida Atlantic University Charles E. Schmid College of Medicine, Boca Raton, FL, United States
| | - Andrew A. Farrar
- Office of Medical Education, Kansas City University College of Osteopathic Medicine, Kansas City, MO, United States
| | - Lea V. Oliveros
- Office of Medical Education, Alabama College of Osteopathic Medicine, Dothan, AL, United States
| | - Jesse Beacker
- Office of Medical Education, Florida Atlantic University Charles E. Schmid College of Medicine, Boca Raton, FL, United States
| | - Luke Lamos
- Office of Medical Education, Florida Atlantic University Charles E. Schmid College of Medicine, Boca Raton, FL, United States
| | - Jared Florio
- Office of Medical Education, Florida Atlantic University Charles E. Schmid College of Medicine, Boca Raton, FL, United States
| | - Abigail L. Fabbrini
- Office of Medical Education, Kansas City University College of Osteopathic Medicine, Kansas City, MO, United States
| | - Michael J. Wilsey
- Department of Pediatrics, University of South Florida Morsani College of Medicine, Tampa, FL, United States
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13
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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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14
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Lee ECK, Trogen B, Brady K, Ford LS, Wang J. The Natural History and Risk Factors for the Development of Food Allergies in Children and Adults. Curr Allergy Asthma Rep 2024; 24:121-131. [PMID: 38416390 PMCID: PMC10960768 DOI: 10.1007/s11882-024-01131-3] [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] [Accepted: 01/31/2024] [Indexed: 02/29/2024]
Abstract
PURPOSE OF REVIEW This narrative review explores food allergy prevalence and natural history stratified by life stages, especially in context of evolving knowledge over the last few decades. RECENT FINDINGS The prevalence of food allergy remains highest in early childhood with common food triggers being cow's milk, soy, hen's egg, wheat, peanut, tree nuts, sesame, fish, and shellfish. This correlates with certain risk factors especially pertinent in the postnatal period which appear to predispose an individual to developing a food allergy. Some allergies (such as milk and egg) were previously thought to be easily outgrown in early life; however, recent studies suggest increasing rates of persistence of these allergies into young adulthood; the reason behind this is unknown. Despite this, there is also evidence demonstrating that food allergies can be outgrown in adolescents and adults. An understanding of the paradigm shifts in the natural history of food allergy allows clinicians to provide updated, age-appropriate, and tailored advice for patients on the management and prognosis of food allergy.
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Affiliation(s)
- Eric C K Lee
- The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145, Australia
| | - Brit Trogen
- Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Kathryn Brady
- Department of Pediatrics, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, USA
| | - Lara S Ford
- The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145, Australia.
- Sydney Medical School, The University of Sydney, The University of Sydney, NSW, 2006, Australia.
| | - Julie Wang
- Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, USA
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15
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Patel PK, Tanpowpong P, Sriaroon P, Lockey RF. Nonallergic Diseases Associated With Foods. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:607-619. [PMID: 37783385 DOI: 10.1016/j.jaip.2023.09.027] [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: 01/31/2023] [Revised: 09/14/2023] [Accepted: 09/14/2023] [Indexed: 10/04/2023]
Abstract
Clinicians are faced with evaluating real and alleged reactions to foods that may be allergic or nonallergic. Pathogenesis, diagnosis, and treatment of various non-IgE-mediated diseases are discussed in this review. These food-related conditions range from mild to severe. Referral for an allergy workup may be pursued despite the lack of IgE-mediated symptoms. Diagnostic testing is available for defined non-IgE-mediated food diseases that are either immunologic or nonimmunologic. These include celiac disease and related disorders, carbohydrate maldigestion, pancreatic insufficiency, and histamine intolerance. In contrast, there is a paucity of definitive studies to prove food intolerance diseases. There are no definitive diagnostic criteria or testing for nonceliac gluten sensitivity. Functional gastrointestinal disorders, such as irritable bowel syndrome, are better stratified diagnostically but still lack reliable testing. Both nonceliac gluten sensitivity and irritable bowel syndrome are linked to dietary triggers including fermentable oligosaccharides, disaccharides, monosaccharides, and polyols. Therefore, dietary alteration alone may be diagnostic and therapeutic when all other conditions are ruled out. These conditions are important considerations when evaluating a patient with history of a food reaction. There is little evidence that foods are causative in other ailments such as acne, migraines, and nasal congestion and hypersecretion.
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Affiliation(s)
- Priya K Patel
- Department of Pediatric Medicine, Johns Hopkins All Children's Hospital, St Petersburg, Fla; Division of Allergy and Immunology, Department of Pediatrics, University of South Florida Morsani College of Medicine, Tampa, Fla
| | - Pornthep Tanpowpong
- Division of Gastroenterology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Panida Sriaroon
- Department of Pediatric Medicine, Johns Hopkins All Children's Hospital, St Petersburg, Fla; Division of Allergy and Immunology, Department of Pediatrics, University of South Florida Morsani College of Medicine, Tampa, Fla
| | - Richard F Lockey
- Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, Fla.
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16
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Lauwers E, Sabino J, Hoffman I, van Hoeve K. Faecal microbiota transplantation in children: A systematic review. Acta Paediatr 2024. [PMID: 38391047 DOI: 10.1111/apa.17167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 01/25/2024] [Accepted: 02/13/2024] [Indexed: 02/24/2024]
Abstract
AIM Novel technologies offer insights into the potential role of the intestinal microbiota in human health and disease. Dysbiosis has been associated with several diseases, and it is thought to play a role in the pathogenesis of different gastrointestinal diseases. Faecal microbiota transplantation (FMT) is emerging as a method to modulate the gastrointestinal microbial ecosystem. While recurrent Clostridioides difficile infection is the recognised FMT indication, exploration of other therapeutic uses is ongoing. METHODS Following PRISMA guidelines, we conducted a systematic review, extracting 583 articles from Embase and PubMed (index date to October 2022). RESULTS The search yielded 58 studies for full review, with 50 included in the systematic review. Articles were categorised by FMT indication, study design, efficacy, adverse events, donor selection and administration route. FMT appears safe and effective for recurrent Clostridioides difficile infection, although severe adverse events are reported in children. However, there are currently insufficient data to support the use of FMT for other potential therapeutic indications (such as irritable or inflammatory bowel disease or obesity), beside the potential to decolonise multi-drug resistant organisms. CONCLUSION This underscores the need for randomised, controlled, prospective cohort studies in children to assess FMT effectiveness in diverse conditions and counteract publication bias.
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Affiliation(s)
- Ella Lauwers
- Department of Paediatric Gastroenterology & Hepatology & Nutrition, University Hospitals Leuven, Leuven, Belgium
| | - João Sabino
- TARGID, Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, Leuven, Belgium
- Department of Gastroenterology & Hepatology, University Hospitals Leuven, Leuven, Belgium
| | - Ilse Hoffman
- Department of Paediatric Gastroenterology & Hepatology & Nutrition, University Hospitals Leuven, Leuven, Belgium
| | - Karen van Hoeve
- Department of Paediatric Gastroenterology & Hepatology & Nutrition, University Hospitals Leuven, Leuven, Belgium
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17
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李 洋, 侯 林, 马 紫, 黄山 雅, 刘 捷, 曾 超, 秦 炯. [Association of pregnancy factors with cow's milk protein allergy in infants]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2024; 56:144-149. [PMID: 38318909 PMCID: PMC10845187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Indexed: 02/07/2024]
Abstract
OBJECTIVE To preliminarily explore the association of pregnancy factors with cow's milk protein allergy in infants. METHODS This study was based on data from a subcohort of a study called genetic susceptibility to cow's milk allergy in Chinese children, including infants born in Peking University People's Hospital between March 1, 2020, and December 31, 2020. The infants were divided into a cow's milk protein allergy (CMPA) group and a control group according to whether they had developed cow's milk protein allergy at the age of 1 year. We retrospectively collected the clinical data of infants and their mothers before and during pregnancy, and analyzed the association of multiple factors during pregnancy with cow's milk protein allergy in infants. RESULTS A total of 278 infants were enrolled in this study, including 52 infants with CMPA and 226 infants without CMPA. Among them, there were 143 boys and 135 girls. The proportion of male infants in the CMPA group (69.2%) was higher than that in the control group (47.3%), and the difference was statistically significant (P=0.004). There were no significant differences in the distribution of birth weight, gestational age at birth, low-birth-weight infants, premature, umbilical cord entangle neck, and neonatal asphyxia between the CMPA group and the control group (P>0.05). The proportion of mothers complicated with autoimmune diseases, anemia or antibiotics exposure during pregnancy in the CMPA group was higher than that in the control group, and there were statistical differences between the two groups (P < 0.05). There was no significant difference in the distribution of other pregnancy complications between the two groups (P>0.05), such as eclampsia/preeclampsia, chronic hypertension/gestational hypertension, diabetes/gestational diabetes, thyroid diseases, and so on. There was no significant difference in the overall distribution of some blood routine indexes during pregnancy between the CMPA group and the control group (P>0.05). Multivariate Logistic regression analysis showed that male infant, mothers complicated with autoimmune diseases or anemia, antibiotic exposure during pregnancy were independent risk factors for cow's milk protein allergy. CONCLUSION Male infant, mothers complicated with autoimmune diseases or anemia, antibiotic exposure during pregnancy were independent risk factors for cow's milk protein allergy.
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Affiliation(s)
- 洋洋 李
- />北京大学人民医院儿科,北京 100044Department of Pediatrics, Peking University People's Hospital, Beijing 100044, China
| | - 林 侯
- />北京大学人民医院儿科,北京 100044Department of Pediatrics, Peking University People's Hospital, Beijing 100044, China
| | - 紫君 马
- />北京大学人民医院儿科,北京 100044Department of Pediatrics, Peking University People's Hospital, Beijing 100044, China
| | - 雅美 黄山
- />北京大学人民医院儿科,北京 100044Department of Pediatrics, Peking University People's Hospital, Beijing 100044, China
| | - 捷 刘
- />北京大学人民医院儿科,北京 100044Department of Pediatrics, Peking University People's Hospital, Beijing 100044, China
| | - 超美 曾
- />北京大学人民医院儿科,北京 100044Department of Pediatrics, Peking University People's Hospital, Beijing 100044, China
| | - 炯 秦
- />北京大学人民医院儿科,北京 100044Department of Pediatrics, Peking University People's Hospital, Beijing 100044, China
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18
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Issa M, Michaudel C, Guinot M, Grauso-Culetto M, Guillon B, Lecardonnel J, Jouneau L, Chapuis C, Bernard H, Hazebrouck S, Castelli F, Fenaille F, Gaultier E, Rivière G, Houdeau E, Adel-Patient K. Long-term exposure from perinatal life to food-grade TiO 2 alters intestinal homeostasis and predisposes to food allergy in young mice. Allergy 2024; 79:471-484. [PMID: 38010857 DOI: 10.1111/all.15960] [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: 08/18/2023] [Revised: 10/24/2023] [Accepted: 10/31/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Food allergy (FA) is an inappropriate immunological response to food proteins resulting from an impaired induction of oral tolerance. Various early environmental factors can affect the establishment of intestinal homeostasis, predisposing to FA in early life. In this context, we aimed to assess the effect of chronic perinatal exposure to food-grade titanium dioxide (fg-TiO2 ), a common food additive. METHODS Dams were fed a control versus fg-TiO2 -enriched diet from preconception to weaning, and their progeny received the same diet at weaning. A comprehensive analysis of baseline intestinal and systemic homeostasis was performed in offspring 1 week after weaning by assessing gut barrier maturation and microbiota composition, and local and systemic immune system and metabolome. The effect of fg-TiO2 on the susceptibility of progeny to develop oral tolerance versus FA to cow's milk proteins (CMP) was performed starting at the same baseline time-point, using established models. Sensitization to CMP was investigated by measuring β-lactoglobulin and casein-specific IgG1 and IgE antibodies, and elicitation of the allergic reaction by measuring mouse mast cell protease (mMCP1) in plasma collected after an oral food challenge. RESULTS Perinatal exposure to fg-TiO2 at realistic human doses led to an increased propensity to develop FA and an impaired induction of oral tolerance only in young males, which could be related to global baseline alterations in intestinal barrier, gut microbiota composition, local and systemic immunity, and metabolism. CONCLUSIONS Long-term perinatal exposure to fg-TiO2 alters intestinal homeostasis establishment and predisposes to food allergy, with a clear gender effect.
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Affiliation(s)
- Mohammad Issa
- Université Paris-Saclay, CEA, INRAE, Département Médicaments et Technologies pour la Santé (DMTS), SPI/Laboratoire d'Immuno-Allergie Alimentaire, Gif-sur-Yvette, France
| | - Chloé Michaudel
- Université Paris-Saclay, CEA, INRAE, Département Médicaments et Technologies pour la Santé (DMTS), SPI/Laboratoire d'Immuno-Allergie Alimentaire, Gif-sur-Yvette, France
| | - Marine Guinot
- Université Paris-Saclay, CEA, INRAE, Département Médicaments et Technologies pour la Santé (DMTS), SPI/Laboratoire d'Immuno-Allergie Alimentaire, Gif-sur-Yvette, France
| | - Marta Grauso-Culetto
- Université Paris-Saclay, CEA, INRAE, Département Médicaments et Technologies pour la Santé (DMTS), SPI/Laboratoire d'Immuno-Allergie Alimentaire, Gif-sur-Yvette, France
| | - Blanche Guillon
- Université Paris-Saclay, CEA, INRAE, Département Médicaments et Technologies pour la Santé (DMTS), SPI/Laboratoire d'Immuno-Allergie Alimentaire, Gif-sur-Yvette, France
| | - Jérôme Lecardonnel
- Université Paris-Saclay, INRAE, AgroParisTech, GABI, Jouy-en-Josas, France
| | - Luc Jouneau
- Université Paris-Saclay, INRAE, UVSQ, VIM, Jouy-en-Josas, France
| | - Céline Chapuis
- Université Paris-Saclay, CEA, INRAE, Département Médicaments et Technologies pour la Santé (DMTS), SPI/Laboratoire d'Immuno-Allergie Alimentaire, Gif-sur-Yvette, France
| | - Hervé Bernard
- Université Paris-Saclay, CEA, INRAE, Département Médicaments et Technologies pour la Santé (DMTS), SPI/Laboratoire d'Immuno-Allergie Alimentaire, Gif-sur-Yvette, France
| | - Stephane Hazebrouck
- Université Paris-Saclay, CEA, INRAE, Département Médicaments et Technologies pour la Santé (DMTS), SPI/Laboratoire d'Immuno-Allergie Alimentaire, Gif-sur-Yvette, France
| | - Florence Castelli
- Université Paris-Saclay, CEA, INRAE - UMR Médicaments et Technologies pour la Santé (DMTS), Laboratoire d'Innovation en Spectrométrie de Masse, Saclay, France
| | - François Fenaille
- Université Paris-Saclay, CEA, INRAE - UMR Médicaments et Technologies pour la Santé (DMTS), Laboratoire d'Innovation en Spectrométrie de Masse, Saclay, France
| | - Eric Gaultier
- Toxalim UMR1331 (Research Centre in Food Toxicology), Toulouse University, INRAE, ENVT, INP-Purpan, UPS, Toulouse, France
| | - Gilles Rivière
- Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail (ANSES), Direction de l'Evaluation des Risques, Maisons-Alfort, France
| | - Eric Houdeau
- Toxalim UMR1331 (Research Centre in Food Toxicology), Toulouse University, INRAE, ENVT, INP-Purpan, UPS, Toulouse, France
| | - Karine Adel-Patient
- Université Paris-Saclay, CEA, INRAE, Département Médicaments et Technologies pour la Santé (DMTS), SPI/Laboratoire d'Immuno-Allergie Alimentaire, Gif-sur-Yvette, France
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19
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Savova MV, Zhu P, Harms AC, van der Molen RG, Belzer C, Hendrickx DM. Current insights into cow's milk allergy in children: Microbiome, metabolome, and immune response-A systematic review. Pediatr Allergy Immunol 2024; 35:e14084. [PMID: 38363041 DOI: 10.1111/pai.14084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 02/17/2024]
Abstract
The increasing prevalence of IgE-mediated cow's milk allergy (CMA) in childhood is a worldwide health concern. There is a growing awareness that the gut microbiome (GM) might play an important role in CMA development. Therefore, treatment with probiotics and prebiotics has gained popularity. This systematic review provides an overview of the alterations of the GM, metabolome, and immune response in CMA children and animal models, including post-treatment modifications. MEDLINE, PubMed, Scopus, and Web of Science were searched for studies on GM in CMA-diagnosed children, published before 1 March 2023. A total of 21 articles (13 on children and 8 on animal models) were included. The studies suggest that the GM, characterized by an enrichment of the Clostridia class and reductions in the Lactobacillales order and Bifidobacterium genus, is associated with CMA in early life. Additionally, reduced levels of short-chain fatty acids (SCFAs) and altered amino acid metabolism were reported in CMA children. Commonly used probiotic strains belong to the Bifidobacterium and Lactobacillus genera. However, only Bifidobacterium levels were consistently upregulated after the intervention, while alterations of other bacteria taxa remain inconclusive. These interventions appear to contribute to the restoration of SCFAs and amino acid metabolism balance. Mouse models indicate that these interventions tend to restore the Th 2/Th 1 balance, increase the Treg response, and/or silence the overall pro- and anti-inflammatory cytokine response. Overall, this systematic review highlights the need for multi-omics-related research in CMA children to gain a mechanistic understanding of this disease and to develop effective treatments and preventive strategies.
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Affiliation(s)
- Mariyana V Savova
- Metabolomics and Analytics Centre, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - Pingping Zhu
- Metabolomics and Analytics Centre, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - Amy C Harms
- Metabolomics and Analytics Centre, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - Renate G van der Molen
- Laboratory of Medical Immunology, Department of Laboratory Medicine, Radboudumc, Nijmegen, The Netherlands
| | - Clara Belzer
- Laboratory of Microbiology, Wageningen University, Wageningen, The Netherlands
| | - Diana M Hendrickx
- Laboratory of Microbiology, Wageningen University, Wageningen, The Netherlands
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20
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Di Costanzo M, Vella A, Infantino C, Morini R, Bruni S, Esposito S, Biasucci G. Probiotics in Infancy and Childhood for Food Allergy Prevention and Treatment. Nutrients 2024; 16:297. [PMID: 38257190 PMCID: PMC10819136 DOI: 10.3390/nu16020297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/13/2024] [Accepted: 01/15/2024] [Indexed: 01/24/2024] Open
Abstract
Food allergy represents a failure of oral tolerance mechanisms to dietary antigens. Over the past few years, food allergies have become a growing public health problem worldwide. Gut microbiota is believed to have a significant impact on oral tolerance to food antigens and in initiation and maintenance of food allergies. Therefore, probiotics have also been proposed in this field as a possible strategy for modulating both the gut microbiota and the immune system. In recent years, results from preclinical and clinical studies suggest a promising role for probiotics in food allergy prevention and treatment. However, future studies are needed to better understand the mechanisms of action of probiotics in food allergies and to design comparable study protocols using specific probiotic strains, defined doses and exposure times, and longer follow-up periods.
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Affiliation(s)
- Margherita Di Costanzo
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy;
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Adriana Vella
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.V.); (C.I.); (R.M.); (S.B.); (S.E.)
| | - Claudia Infantino
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.V.); (C.I.); (R.M.); (S.B.); (S.E.)
| | - Riccardo Morini
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.V.); (C.I.); (R.M.); (S.B.); (S.E.)
| | - Simone Bruni
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.V.); (C.I.); (R.M.); (S.B.); (S.E.)
| | - Susanna Esposito
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy; (A.V.); (C.I.); (R.M.); (S.B.); (S.E.)
| | - Giacomo Biasucci
- Pediatrics and Neonatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy;
- Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
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21
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Ravenwood B, Coad J, Barnes MJ. A comparison of the effects of sheep's milk and cow's milk on recovery from eccentric exercise. Front Sports Act Living 2024; 5:1335434. [PMID: 38274033 PMCID: PMC10808620 DOI: 10.3389/fspor.2023.1335434] [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] [Received: 11/08/2023] [Accepted: 12/30/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction When consumed after eccentric exercise, cow's milk has been shown to improve recovery and alleviate symptoms of exercise induced muscle damage. Although currently less commercially available than cow's milk, sheep's milk may offer similar or greater benefits for recovery as it is higher in protein and energy; however, the effect of sheep's milk in any exercise context has not been explored. This study compared the effects of a sheep's milk beverage and a cow's milk beverage on recovery from strenuous eccentric exercise. Additionally, the effects of each beverage on satiety and gastrointestinal comfort were assessed. Methods Ten healthy males completed baseline measures of perceived muscle soreness and maximal voluntary concentric, eccentric, and isometric quadriceps force of one leg before completing 200 maximal eccentric knee extensions on an isokinetic dynamometer. Measures were repeated 0.5, 24, 48 and 72 h post-eccentric exercise. After 0.5 h measures, participants consumed either 450 ml of chocolate flavored sheep's milk or chocolate flavored cow's milk. Following a washout period, participants completed a second trial on the contralateral leg and consumed the other beverage. Additionally, a satiety and gastrointestinal comfort questionnaire was completed before and after each beverage was consumed. Results Eccentric exercise brought about a significant decrease in muscle function over time (all P < 0.012). No difference between treatments (all P > 0.097) was found. Measures of muscle soreness increased over time (all P < 0.002), however no difference was observed between treatments (all P > 0.072). Only sheep's milk altered perceived satiety, however, only the response to "How full do you feel" differed between treatments (P = 0.04). Discussion The results of this study suggest that consuming sheep's milk may provide similar benefits as cow's milk when recovering from exercise-induced muscle damage. While these findings provide initial support for the use of sheep's milk in a muscle recovery context, further research is warranted to confirm these findings. Given its superior nutritional profile, greater impact on satiety and lower environment impact, sheep's milk may be a more efficient post-exercise recovery beverage, compared to cow's milk.
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Affiliation(s)
- Ben Ravenwood
- School of Sport, Exercise & Nutrition, Massey University, Palmerston North, New Zealand
| | - Jane Coad
- School of Food and Advanced Technology, Massey University, Palmerston North, New Zealand
| | - Matthew J. Barnes
- School of Sport, Exercise & Nutrition, Massey University, Palmerston North, New Zealand
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22
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Xu Y, Zhang F, Mu G, Zhu X. Effect of lactic acid bacteria fermentation on cow milk allergenicity and antigenicity: A review. Compr Rev Food Sci Food Saf 2024; 23:e13257. [PMID: 38284611 DOI: 10.1111/1541-4337.13257] [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: 03/02/2023] [Revised: 09/22/2023] [Accepted: 10/02/2023] [Indexed: 01/30/2024]
Abstract
Cow milk is a major allergenic food. The potential prevention and treatment effects of lactic acid bacteria (LAB)-fermented dairy products on allergic symptoms have garnered considerable attention. Cow milk allergy (CMA) is mainly attributed to extracellular and/or cell envelope proteolytic enzymes with hydrolysis specificity. Numerous studies have demonstrated that LAB prevents the risk of allergies by modulating the development and regulation of the host immune system. Specifically, LAB and its effectors can enhance intestinal barrier function and affect immune cells by interfering with humoral and cellular immunity. Fermentation hydrolysis of allergenic epitopes is considered the main mechanism of reducing CMA. This article reviews the linear epitopes of allergens in cow milk and the effect of LAB on these allergens and provides insight into the means of predicting allergenic epitopes by conventional laboratory analysis methods combined with molecular simulation. Although LAB can reduce CMA in several ways, the mechanism of action remains partially clarified. Therefore, this review additionally attempts to summarize the main mechanism of LAB fermentation to provide guidance for establishing an effective preventive and treatment method for CMA and serve as a reference for the screening, research, and application of LAB-based intervention.
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Affiliation(s)
- Yunpeng Xu
- School of Food Science and Technology, Dalian Polytechnic University, Dalian, Liaoning, P. R. China
| | - Feifei Zhang
- Liaoning Ocean and Fisheries Science Research Institute, Dalian, Liaoning, P. R. China
| | - Guangqing Mu
- Dalian Key Laboratory of Functional Probiotics, Dalian, Liaoning, P. R. China
| | - Xuemei Zhu
- School of Food Science and Technology, Dalian Polytechnic University, Dalian, Liaoning, P. R. China
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23
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Alfonso RMJ, Rubí IAK, Manuel TME, Roberto CB, Alejandra RCM, de Jesús MVI, Gabriela AGA, Vladimir BND, Lucía CG, Antonio CBJ, Sergio DM, Esther FFL, Manuel Enrique GPM, Ileana GCJ, Elena HHR, Elena LRA, Héctor MA, Carlos MN, José Antonio OM, Iván OGC, Rubén PV, Nicolás RMJ, Del Mar SDOGM, Gerardo SM, Eugenia URM, Liliana WD, Hideo WKG, Yvan V. Mexican consensus on cow's milk protein allergy. Allergol Immunopathol (Madr) 2024; 52:24-37. [PMID: 38186191 DOI: 10.15586/aei.v52i1.958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 10/04/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND The aim of this study is to present the current views of a diverse group of experts on the diagnosis and treatment of Cow's Milk Protein Allergy (CMPA) in children under 2 years of age in Mexico. MATERIAL AND METHODS The study, led by a scientific committee of five experts in CMPA, was divided into six phases, including a modified Delphi process. A total of 20 panelists, all of whom were pediatric specialists, participated in administering a comprehensive 38-item questionnaire. The questionnaire was divided into two blocks: Diagnosis and Treatment (20 items each). RESULTS Consensus was reached on all the proposed items, with an agreement rate of over 70% for each of them. As a result, a diagnostic and treatment algorithm was developed that emphasized the reduction of unnecessary diagnostic studies and encouraged breastfeeding whenever possible. In cases where breast milk is not available, appropriate use of hypoallergenic formulas was recommended. In addition, recommendations on treatment duration and gradual reintroduction of cow's milk protein were provided. CONCLUSIONS The recommendations endorsed by 20 Mexican pediatricians through this study are applicable to everyday clinical practice, thereby enhancing the diagnosis and treatment of children under 2 years of age with CMPA. This, in turn, will foster improved health outcomes and optimize the utilization of healthcare resources.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Casas Guzik Lucía
- Pediatric Gastroenterology, Hospital Infantil de Morelia Eva Sámano de López Mateos, Morelia, México
| | | | | | | | | | | | | | | | | | - Méndez Nieto Carlos
- Pediatric Gastroenterology, Hospital Infantil de Especialidades, Ciudad Juárez, Mexico
| | | | | | - Peña Vélez Rubén
- Pediatric Gastroenterology, Hospital General de Puebla Dr. Eduardo Vázquez N., Puebla, Mexico
| | | | | | | | | | | | | | - Vandenplas Yvan
- Pediatric Gastroenterology, KidZ Health Castle, UZ Brussel; Vrije Universiteit Brussel, Brussels, Belgium
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24
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Vasconcelos PDSP, Andrade ALMB, Sandy NS, Barreto JCC, Gomez GS, Riccetto AGL, Lomazi EA, Bellomo-Brandão MÂ. Outcomes and factors associated with tolerance in infants with non-IgE-mediated cow's milk allergy with gastrointestinal manifestations. J Pediatr (Rio J) 2024; 100:40-45. [PMID: 37696495 PMCID: PMC10751709 DOI: 10.1016/j.jped.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 08/06/2023] [Accepted: 08/08/2023] [Indexed: 09/13/2023] Open
Abstract
OBJECTIVES To evaluate outcomes of oral food challenge (OFC) test to assess tolerance in infants with non-IgE-mediated cow's milk allergy (CMA) with gastrointestinal manifestations and explore clinical data predictive of these outcomes. METHODS Single-center retrospective study including infants (age < 12 months) who were referred for CMA between 2000 and 2018 and underwent OFC on follow-up. A univariate logistic regression test was performed to evaluate variables associated with the outcomes of the follow-up OFC test. RESULTS Eighty-two patients were included, 50% were male. Eighteen patients had a positive OFC test (22%). Most patients had presented with hematochezia (77%). The median age of symptom onset was 30 days. Two-thirds of the patients were on appropriate infant formula (extensively hydrolyzed or amino acid-based formula), exclusively or in association with breastfeeding. The median time on an elimination diet before the OFC test was 8 months (Q1 6 - Q3 11 months). All cases with positive follow-up OFC tests (n = 18) had been exposed to cow's milk-based formula before the first clinical manifestation of CMA. Five out of eight cases with Food Protein-Induced Enterocolitis Syndrome (FPIES) had positive OFC tests. Exposure to cow's milk-based formula before diagnosis, a history of other food allergies, hematochezia and diarrhea were predictors of a positive OFC test. CONCLUSIONS In infants with non-IgE-mediated CMPA with gastrointestinal manifestations, the use of cow's milk-based formula, a history of other food allergies, and hematochezia and diarrhea upon initial presentation were associated factors for the later achievement of tolerance.
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Affiliation(s)
- Príscila da Silva Pereira Vasconcelos
- Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Departamento de Pediatria, Campinas, SP, Brazil; Centro de Investigação em Pediatria da Faculdade de Ciências Médicas de Campinas (CIPED), Campinas, SP, Brazil; Programa de Pós-graduação em Saúde da Criança e do Adolescente (PPG-SCA), São Paulo, SP, Brazil; Laboratório de Investigação Diagnóstica de Gastroenterologia e Hepatologia Pediátrica, Campinas, SP, Brazil
| | | | - Natascha Silva Sandy
- Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Departamento de Pediatria, Campinas, SP, Brazil; Laboratório de Investigação Diagnóstica de Gastroenterologia e Hepatologia Pediátrica, Campinas, SP, Brazil
| | - Juliana Corrêa Campos Barreto
- Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Departamento de Pediatria, Campinas, SP, Brazil; Laboratório de Investigação Diagnóstica de Gastroenterologia e Hepatologia Pediátrica, Campinas, SP, Brazil
| | - Gabriela Souza Gomez
- Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Departamento de Pediatria, Campinas, SP, Brazil; Laboratório de Investigação Diagnóstica de Gastroenterologia e Hepatologia Pediátrica, Campinas, SP, Brazil
| | - Adriana Gut Lopes Riccetto
- Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Departamento de Pediatria, Campinas, SP, Brazil; Centro de Investigação em Pediatria da Faculdade de Ciências Médicas de Campinas (CIPED), Campinas, SP, Brazil; Programa de Pós-graduação em Saúde da Criança e do Adolescente (PPG-SCA), São Paulo, SP, Brazil
| | - Elizete Aparecida Lomazi
- Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Departamento de Pediatria, Campinas, SP, Brazil; Centro de Investigação em Pediatria da Faculdade de Ciências Médicas de Campinas (CIPED), Campinas, SP, Brazil; Programa de Pós-graduação em Saúde da Criança e do Adolescente (PPG-SCA), São Paulo, SP, Brazil
| | - Maria Ângela Bellomo-Brandão
- Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Departamento de Pediatria, Campinas, SP, Brazil; Centro de Investigação em Pediatria da Faculdade de Ciências Médicas de Campinas (CIPED), Campinas, SP, Brazil; Programa de Pós-graduação em Saúde da Criança e do Adolescente (PPG-SCA), São Paulo, SP, Brazil; Laboratório de Investigação Diagnóstica de Gastroenterologia e Hepatologia Pediátrica, Campinas, SP, Brazil.
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25
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van Eijnatten EJM, Camps G, Guerville M, Fogliano V, Hettinga K, Smeets PAM. Milk coagulation and gastric emptying in women experiencing gastrointestinal symptoms after ingestion of cow's milk. Neurogastroenterol Motil 2024; 36:e14696. [PMID: 37877465 DOI: 10.1111/nmo.14696] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 09/13/2023] [Accepted: 10/10/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND Gastrointestinal symptoms after drinking milk are often attributed to lactose intolerance or cow's milk allergy. However, some individuals without either condition still report gastrointestinal symptoms after drinking milk. This may be caused by gastric emptying (GE) rate or gastric protein coagulation. This study aimed to compare GE rate and protein coagulation after milk consumption between individuals reporting gastrointestinal symptoms and those without symptoms using a novel gastric MRI approach. METHODS Thirty women were included in this case-control study, of whom 15 reported gastrointestinal symptoms after drinking milk and 15 were controls. Participants underwent gastric MRI before and up to 90 min after consumption of 250 mL cow's milk. Gastric content volume and image texture of the stomach contents were used to determine GE and changes in the degree of coagulation. KEY RESULTS GE half-time did not differ between the groups (gastrointestinal symptom group 66 ± 18 min; control group 61 ± 14 min, p = 0.845). The gastrointestinal symptom group reported symptoms from 30 min onwards and rated pain highest at 90 min. The control group reported no symptoms. Image texture analyses showed a significantly higher percentage of coagulum and lower percentage of liquid in the group in the GI symptom group (MD 11%, 95% CI [3.9, 17], p = 0.003). In vitro data suggests that pH and proteolytic enzyme activity influence the coagulum structure. CONCLUSIONS AND INFERENCES Gastric milk coagulation and emptied fraction of stomach content may differ between individuals experiencing symptoms after milk consumption, possibly due to differences in pH and proteolytic enzyme activity.
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Affiliation(s)
| | - Guido Camps
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Mathilde Guerville
- Nutrition Department, Lactalis Research and Development, Retiers, France
| | - Vincenzo Fogliano
- Food Quality & Design Group, Wageningen University, Wageningen, The Netherlands
| | - Kasper Hettinga
- Food Quality & Design Group, Wageningen University, Wageningen, The Netherlands
| | - Paul A M Smeets
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
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26
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Jardim-Botelho A, Martins TG, Motta-Franco J, Meyer R, Fontes Vieira SC, Protásio BF, Santos Silva ML, Pontes RS, de Oliveira MBB, de Carvalho Barreto ID, Gurgel RQ. Growth and Nutritional Biomarkers in Brazilian Infants with Cow's Milk Allergy at Diagnosis and 18-Month Follow-Up: A Prospective Cohort Study. Pediatr Gastroenterol Hepatol Nutr 2023; 26:355-369. [PMID: 38025488 PMCID: PMC10651362 DOI: 10.5223/pghn.2023.26.6.355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/14/2023] [Accepted: 08/03/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose This study aimed to describe the growth, body protein status, and micronutrient biomarkers of Brazilian infants with cow's milk allergy (CMPA) at baseline and at 18 months of follow-up in comparison with their healthy peers. Methods Thirty infants with CMPA younger than six months of age were included in this longitudinal study, and their nutritional status was compared with that of 24 non-allergic age-matched children. Anthropometric measurements were used to assess growth, and blood and urine samples were analyzed for protein and micronutrient status. Mixed linear models adjusted for birth weight, socioeconomic status, infant feeding at baseline, weight-for-age, C-reactive protein, serum albumin, micronutrient dietary supplementation, and salt consumption were employed to evaluate the evolution of nutritional parameters throughout the follow-up period. Results Overall, the mean age of the children at enrolment was 2.9 (standard deviation 1.7) months, and 29 children (53.7%) were male. Infants with CMPA showed a higher prevalence of functional iron depletion (transferrin saturation <20) (p=0.027), lower serum ferritin (p=0.009), and lower urinary iodine (p=0.034) levels than non-allergic children at baseline. Patients with CMPA showed a higher increment in weight-for-age and length-for-age over time than those in the control group (p<0.01). Mixed linear analyses showed a significantly lower increase in serum vitamin B12 (s-B12) (p=0.001) and urinary iodine (p<0.001) concentrations over time compared to the control group. Conclusion Infants with CMPA on a cow's milk elimination diet had a higher weight and length at 18 months of follow-up but showed signs of inadequate iron, iodine, and B-12 vitamin status.
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Affiliation(s)
- Anne Jardim-Botelho
- Reference Center for Food Allergy of Sergipe (RCFAS), Federal University of Sergipe, Aracaju, Brazil
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, Brazil
| | - Tatiane Graça Martins
- Reference Center for Food Allergy of Sergipe (RCFAS), Federal University of Sergipe, Aracaju, Brazil
- Graduate Program in Health Sciences, Federal University of Sergipe, Aracaju, Brazil
| | - Jackeline Motta-Franco
- Reference Center for Food Allergy of Sergipe (RCFAS), Federal University of Sergipe, Aracaju, Brazil
| | - Rosan Meyer
- Department of Pediatrics, Imperial College, London, Winchester, UK
- Department Dietetics, Winchester University, Winchester, UK
- Department Medicine, Catholic University of Leuven, Leuven, Belgium
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27
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Lewis SA, Sutherland A, Soldevila F, Westernberg L, Aoki M, Frazier A, Maiche S, Erlewyn-Lajeunesse M, Arshad H, Leonard S, Laubach S, Dantzer JA, Wood RA, Sette A, Seumois G, Vijayanand P, Peters B. Identification of cow milk epitopes to characterize and quantify disease-specific T cells in allergic children. J Allergy Clin Immunol 2023; 152:1196-1209. [PMID: 37604312 PMCID: PMC10846667 DOI: 10.1016/j.jaci.2023.07.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/12/2023] [Accepted: 07/31/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Cow milk (CM) allergy is the most prevalent food allergy in young children in the United States and Great Britain. Current diagnostic tests are either unreliable (IgE test and skin prick test) or resource-intensive with risks (food challenges). OBJECTIVE We sought to determine whether allergen-specific T cells in CM-allergic (CMA) patients have a distinct quality and/or quantity that could potentially be used as a diagnostic marker. METHODS Using PBMCs from 147 food-allergic pediatric subjects, we mapped T-cell responses to a set of reactive epitopes in CM that we compiled in a peptide pool. This pool induced cytokine responses in in vitro cultured cells distinguishing subjects with CMA from subjects without CMA. We further used the pool to isolate and characterize antigen-specific CD4 memory T cells using flow cytometry and single-cell RNA/TCR sequencing assays. RESULTS We detected significant changes in the transcriptional program and clonality of CM antigen-specific (CM+) T cells elicited by the pool in subjects with CMA versus subjects without CMA ex vivo. CM+ T cells from subjects with CMA had increased percentages of FOXP3+ cells over FOXP3- cells. FOXP3+ cells are often equated with regulatory T cells that have suppressive activity, but CM+ FOXP3+ cells from subjects with CMA showed significant expression of interferon-responsive genes and dysregulated chemokine receptor expression compared with subjects without CMA, suggesting that these are not conventional regulatory T cells. The CM+ FOXP3+ cells were also more clonally expanded than the FOXP3- population. We were further able to use surface markers (CD25, CD127, and CCR7) in combination with our peptide pool stimulation to quantify these CM+ FOXP3+ cells by a simple flow-cytometry assay. We show increased percentages of CM+ CD127-CD25+ cells from subjects with CMA in an independent cohort, which could be used for diagnostic purposes. Looking specifically for TH2 cells normally associated with allergic diseases, we found a small population of clonally expanded CM+ cells that were significantly increased in subjects with CMA and that had high expression of TH2 cytokines and pathogenic TH2/T follicular helper markers. CONCLUSIONS Overall, these findings suggest that there are several differences in the phenotypes of CM+ T cells with CM allergy and that the increase in CM+ FOXP3+ cells is a potential diagnostic marker of an allergic state. Such markers have promising applications in monitoring natural disease outgrowth and/or the efficacy of immunotherapy that will need to be validated in future studies.
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Affiliation(s)
| | | | | | | | - Minori Aoki
- La Jolla Institute for Immunology, San Diego, Calif
| | | | | | - Mich Erlewyn-Lajeunesse
- University Hospital Southampton, Southampton, United Kingdom; Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Hasan Arshad
- University Hospital Southampton, Southampton, United Kingdom; Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Stephanie Leonard
- Division of Allergy and Immunology, Department of Pediatrics, University of California San Diego, Rady Children's Hospital, San Diego, Calif
| | - Susan Laubach
- Division of Allergy and Immunology, Department of Pediatrics, University of California San Diego, Rady Children's Hospital, San Diego, Calif
| | - Jennifer A Dantzer
- Division of Allergy and Immunology, Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, Md
| | - Robert A Wood
- Division of Allergy and Immunology, Department of Pediatrics, The Johns Hopkins University School of Medicine, Baltimore, Md
| | - Alessandro Sette
- La Jolla Institute for Immunology, San Diego, Calif; Department of Medicine, University of California San Diego, San Diego, Calif
| | | | - Pandurangan Vijayanand
- La Jolla Institute for Immunology, San Diego, Calif; Department of Medicine, University of California San Diego, San Diego, Calif
| | - Bjoern Peters
- La Jolla Institute for Immunology, San Diego, Calif; Department of Medicine, University of California San Diego, San Diego, Calif.
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28
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Pérez-Rodríguez ML, Serrano-Carretero A, García-Herrera P, Cámara-Hurtado M, Sánchez-Mata MC. Plant-based beverages as milk alternatives? Nutritional and functional approach through food labelling. Food Res Int 2023; 173:113244. [PMID: 37803557 DOI: 10.1016/j.foodres.2023.113244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 10/08/2023]
Abstract
Plant-based beverages (PBB) market is largely growing. In this study, 136 beverages made of soy, oat, almond, rice, tigernut, and others (mixtures of various plant materials), from the Spanish market were evaluated through labelling information. Energy value and fat content were intermediate between skimmed and whole cow milk; while fatty acids profile was quite different. Carbohydrate content was usually higher than cow milk, and highly dependent on the addition of sugars. All products provided some dietary fibre. With the exception of soy-based drinks, samples presented lower protein and calcium content than milk (1/3 samples studied were Ca-fortified), and 23% were vitamin D enriched. The claim "No added sugars" was in more than 50% samples. A right labelling and nutritional education of consumers is essential to make adequate choices, since the appearing of many claims is not always indicative of a better-quality product. Plant-based beverages cannot be considered as an alternative to milk, but as a different product, with their own nutritional and functional entity. Their inclusion in a diversified balanced diet can provide interesting functional components, such as soluble fibre or unsaturated fatty acids (mainly soybean and almond drink), which can help improve the health status of the population.
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Affiliation(s)
- M L Pérez-Rodríguez
- Departamento Nutrición y Ciencia de los Alimentos, Facultad de Farmacia, Universidad Complutense de Madrid (UCM), Pza. Ramón y Cajal, s/n, E-28040 Madrid, Spain
| | - A Serrano-Carretero
- Departamento Nutrición y Ciencia de los Alimentos, Facultad de Farmacia, Universidad Complutense de Madrid (UCM), Pza. Ramón y Cajal, s/n, E-28040 Madrid, Spain
| | - P García-Herrera
- Departamento Nutrición y Ciencia de los Alimentos, Facultad de Farmacia, Universidad Complutense de Madrid (UCM), Pza. Ramón y Cajal, s/n, E-28040 Madrid, Spain.
| | - M Cámara-Hurtado
- Departamento Nutrición y Ciencia de los Alimentos, Facultad de Farmacia, Universidad Complutense de Madrid (UCM), Pza. Ramón y Cajal, s/n, E-28040 Madrid, Spain
| | - M C Sánchez-Mata
- Departamento Nutrición y Ciencia de los Alimentos, Facultad de Farmacia, Universidad Complutense de Madrid (UCM), Pza. Ramón y Cajal, s/n, E-28040 Madrid, Spain
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29
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He S, Xiong M, Li L, Yan Y, Li J, Feng Z, Li Y, Zhao J, Dong Y, Li X, Chen H, Long C. One-Step Purification of IgE Epitope-Specific Antibody Using Immunomagnetic Beads and Highly Sensitive Detection of Bovine β-Lactoglobulin for the Prediction of Milk Allergenicity in Foods. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2023; 71:14068-14078. [PMID: 37679308 DOI: 10.1021/acs.jafc.3c03461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
Bovine β-lactoglobulin (BLG) is a common allergen found in milk, and the immunoglobulin E (IgE) epitope plays a crucial role in cow milk allergy. Therefore, targeting the IgE epitope could be useful in accurately detecting BLG and assessing its allergenicity. However, producing an IgE epitope-specific antibody (IgE-EsAb) through traditional methods requires complex and time-consuming procedures. Here, IgE-EsAb was purified from rabbit anti-BLG sera by immunomagnetic beads in one step. Then, a sandwich ELISA (sELISA) based on the IgE-EsAb was developed to detect BLG and predict the potential milk allergenicity in foods. The obtained IgE-EsAb could specifically recognize the target IgE epitope of BLG and exhibited high affinity and specificity. The developed IgE-EsAb-based sELISA demonstrated an ultra-wide linear range of 3.9-1.28 × 105 ng/mL, with a limit of detection of 0.49 ng/mL for BLG. Additionally, the proposed immunoassay showed high specificity and recoveries (91.24-109.61%). The ability of the IgE-EsAb-based sELISA to evaluate the potential milk allergenicity in foods was validated using sera from cow milk allergy patients. These results suggest that immunomagnetic beads are an effective tool for rapidly obtaining the IgE-EsAb, and our proposed sELISA could be a reliable and user-friendly method for monitoring trace amounts of BLG and predicting the potential milk allergenicity of food samples.
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Affiliation(s)
- Shengfa He
- School of Public Health and Health Management, Gannan Medical University, Ganzhou 341000, China
| | - Meng Xiong
- School of Public Health and Health Management, Gannan Medical University, Ganzhou 341000, China
| | - Liming Li
- First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China
| | - Yan Yan
- School of Public Health and Health Management, Gannan Medical University, Ganzhou 341000, China
| | - Jinyu Li
- First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China
| | - Ziling Feng
- School of Public Health and Health Management, Gannan Medical University, Ganzhou 341000, China
| | - Yang Li
- School of Public Health and Health Management, Gannan Medical University, Ganzhou 341000, China
| | - Jiangqiang Zhao
- School of Public Health and Health Management, Gannan Medical University, Ganzhou 341000, China
| | - Yaping Dong
- School of Public Health and Health Management, Gannan Medical University, Ganzhou 341000, China
| | - Xin Li
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, China
| | - Hongbing Chen
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, China
| | - Caiyun Long
- Ganzhou Center for Disease Control and Prevention, Ganzhou 341000, China
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30
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Balogh-Hartmann F, Páger C, Bufa A, Madarászné Horváth I, Verzár Z, Marosvölgyi T, Makszin L. Microfluidic Analysis for the Determination of Protein Content in Different Types of Plant-Based Drinks. Molecules 2023; 28:6684. [PMID: 37764460 PMCID: PMC10535950 DOI: 10.3390/molecules28186684] [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: 08/28/2023] [Revised: 09/14/2023] [Accepted: 09/18/2023] [Indexed: 09/29/2023] Open
Abstract
The widespread consumption of plant-based drinks, driven by health and dietary reasons (including cow's milk allergy, lactose intolerance, milk protein intolerance, following a vegetarian or vegan diet) necessitates automated and accurate test methods. Our study demonstrates the simultaneous determination of protein components and total protein concentrations in plant-based milk alternatives using a rapid and reproducible microchip gel electrophoretic method. As expected, the electrophoretic profiles of each plant-based drink differed. Based on our analyses and statistical evaluation, it can be determined that the protein profiles of different plant-based beverages do not differ significantly between different manufacturers or different expiry dates. The measured total protein content was compared with the nominal values, i.e., the values stated on the beverage labels. As the number of consumers of functional and specialized plant-based milk alternatives continues to rise, it is important to prioritize methods that provide qualitative and quantitative information on protein composition and other nutrients.
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Affiliation(s)
- Fruzsina Balogh-Hartmann
- Institute of Bioanalysis, Medical School, Szentágothai Research Center, University of Pécs, 7622 Pécs, Hungary; (F.B.-H.); (C.P.); (A.B.); (I.M.H.); (T.M.)
| | - Csilla Páger
- Institute of Bioanalysis, Medical School, Szentágothai Research Center, University of Pécs, 7622 Pécs, Hungary; (F.B.-H.); (C.P.); (A.B.); (I.M.H.); (T.M.)
| | - Anita Bufa
- Institute of Bioanalysis, Medical School, Szentágothai Research Center, University of Pécs, 7622 Pécs, Hungary; (F.B.-H.); (C.P.); (A.B.); (I.M.H.); (T.M.)
| | - Ibolya Madarászné Horváth
- Institute of Bioanalysis, Medical School, Szentágothai Research Center, University of Pécs, 7622 Pécs, Hungary; (F.B.-H.); (C.P.); (A.B.); (I.M.H.); (T.M.)
| | - Zsófia Verzár
- Institute of Nutritional Sciences and Dietetics, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary;
| | - Tamás Marosvölgyi
- Institute of Bioanalysis, Medical School, Szentágothai Research Center, University of Pécs, 7622 Pécs, Hungary; (F.B.-H.); (C.P.); (A.B.); (I.M.H.); (T.M.)
| | - Lilla Makszin
- Institute of Bioanalysis, Medical School, Szentágothai Research Center, University of Pécs, 7622 Pécs, Hungary; (F.B.-H.); (C.P.); (A.B.); (I.M.H.); (T.M.)
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31
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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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32
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Nocerino R, Coppola S, Carucci L, de Giovanni di Santa Severina AF, Oglio F, de Michele R, di Sessa I, Masino A, Bedogni G, Berni Canani R. The step-down approach in children with cow's milk allergy: Results of a randomized controlled trial. Allergy 2023; 78:2477-2486. [PMID: 37087638 DOI: 10.1111/all.15750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/20/2023] [Accepted: 04/03/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND The Step-Down Approach for Cow's Milk Allergy (SDACMA) trial evaluated the tolerability and the rate of immune tolerance acquisition in CMA children starting dietary treatment with amino acid-based formula (AAF) and then switching to EHCF containing the probiotic Lacticaseibacillus rhamnosus GG (EHCF + LGG). METHODS Randomized controlled trial involving IgE-mediated CMA children receiving AAF from at least 4 weeks. EHCF + LGG tolerance was evaluated by the results of double-blind placebo-controlled food challenge (DBPCFC). Subjects tolerating EHCF + LGG were randomly allocated to remain on AAF, or to switch to EHCF + LGG. Immune tolerance acquisition to cow's milk proteins was evaluated with DBPCFC after 12 months of treatment. Allergy screening tests and body growth were also monitored. RESULTS Sixty IgE-mediated CMA children were enrolled. The proportion of children treated with AAF who resulted tolerant to the first exposure of EHCF + LGG was 0.98 (exact 95% CI 0.91-0.99). The rate of the immune tolerance acquisition to cow milk proteins after 12 months treatment was higher in the EHCF + LGG (0.48, 95% exact CI 0.29-0.67, n/N = 14/29) than in the AAF group (0.03, 95% exact CI 0.001-0.17, n/N = 1/30). There was an absolute benefit increase (ABI) of tolerance rate equal to 0.45 (95% CI 0.23-0.63, Newcombe method 10) for EHCF + LGG versus AAF, corresponding to a NNT of 2 (2-4, Bender's method). A normal body growth pattern was observed in the two study groups. CONCLUSION In IgE-mediated CMA children the step-down from AAF to EHCF + LGG is well tolerated and could facilitate the immune tolerance acquisition.
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Affiliation(s)
- Rita Nocerino
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Serena Coppola
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Laura Carucci
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Anna Fiorenza de Giovanni di Santa Severina
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Franca Oglio
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Roberta de Michele
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Ilaria di Sessa
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Antonio Masino
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Giorgio Bedogni
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
- Department of Primary Health Care, Internal Medicine Unit addressed to Frailty and Aging, S. Maria delle Croci Hospital, AUSL Romagna, Ravenna, Italy
| | - Roberto Berni Canani
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
- European Laboratory for the Investigation of Food-Induced Diseases, University of Naples Federico II, Naples, Italy
- Task Force on Microbiome Studies, University of Naples Federico II, Naples, Italy
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Ulusoy Severcan E, Ertugrul A, Ozmen S. Evaluation of Children with Cow's Milk Allergy Who Received Measles or Measles, Mumps, and Rubella Vaccines Containing Alpha-Lactalbumin. PEDIATRIC ALLERGY, IMMUNOLOGY, AND PULMONOLOGY 2023; 36:90-93. [PMID: 37433203 DOI: 10.1089/ped.2023.0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
Objective: Cases of cow's milk allergy (CMA) who reacted to measles or measles, mumps, and rubella (MMR) vaccines containing alpha-lactalbumin have been reported. The purpose of this study was to assess patients with CMA who received measles or MMR vaccines containing alpha-lactalbumin, as well as the characteristics of those who developed reactions to these vaccines. Study Design: Patients followed up in the allergy clinic for CMA and who received measles or MMR vaccines containing alpha-lactalbumin at 9 or 12 months of age were included in the study, and their characteristics were analyzed retrospectively from the hospital registry system. Results: Forty-nine patients were included in the study. Six patients received the measles vaccine, whereas 43 patients received the MMR vaccine containing alpha-lactalbumin. Vaccine skin tests were performed on these 6 patients. One patient had a positive intradermal test, so an alternative vaccine not containing alpha-lactalbumin was administered. The other 5 patients were vaccinated, and no reaction was observed. Anaphylaxis was observed in 3 of 43 patients who received the MMR vaccine containing alpha-lactalbumin. In all of these patients, the first reaction to dairy products was anaphylaxis. In 2 of those patients, cow's milk-specific IgE (spIgE) levels were >100 kU/L, and alpha-lactalbumin-spIgE levels were also high at 97 and 90 kU/L. The third patient's cow's milk-spIgE level was 15.9 kU/L, whereas the alpha-lactalbumin-spIgE level was 0.04 kU/L. Conclusion: Especially in patients with an initial reaction of anaphylaxis to dairy products and high cow's milk-spIgE levels, the risk of reaction is high with the MMR vaccine.
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Affiliation(s)
- Ezgi Ulusoy Severcan
- Division of Immunology and Allergy, Department of Pediatrics, Dr. Sami Ulus Maternity and Children Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Aysegul Ertugrul
- Division of Immunology and Allergy, Department of Pediatrics, Dr. Sami Ulus Maternity and Children Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | - Serap Ozmen
- Division of Immunology and Allergy, Department of Pediatrics, Dr. Sami Ulus Maternity and Children Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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Gil MV, Fernández-Rivera N, Pastor-Vargas C, Cintas P. Food Allergens: When Friends Become Foes-Caveats and Opportunities for Oral Immunotherapy Based on Deactivation Methods. Nutrients 2023; 15:3650. [PMID: 37630840 PMCID: PMC10458749 DOI: 10.3390/nu15163650] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/12/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023] Open
Abstract
Food allergies represent a serious health concern and, since the 1990s, they have risen gradually in high-income countries. Unfortunately, the problem is complex because genetic, epigenetic, and environmental factors may be collectively involved. Prevention and diagnoses have not yet evolved into efficacious therapies. Identification and control of allergens present in edible substances hold promise for multi-purpose biomedical approaches, including oral immunotherapy. This review highlights recent studies and methods to modify the otherwise innocuous native proteins in most subjects, and how oral treatments targeting immune responses could help cancel out the potential risks in hypersensitive individuals, especially children. We have focused on some physical methods that can easily be conducted, along with chemo-enzymatic modifications of allergens by means of peptides and phytochemicals in particular. The latter, accessible from naturally-occurring substances, provide an added value to hypoallergenic matrices employing vegetal wastes, a point where food chemistry meets sustainable goals as well.
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Affiliation(s)
- M. Victoria Gil
- Departamento de Química Orgánica e Inorgánica, Facultad de Ciencias, IACYS-Unidad de Química Verde y Desarrollo Sostenible, Universidad de Extremadura, 06006 Badajoz, Spain
| | - Nuria Fernández-Rivera
- Departamento de Química Orgánica e Inorgánica, Facultad de Ciencias, IACYS-Unidad de Química Verde y Desarrollo Sostenible, Universidad de Extremadura, 06006 Badajoz, Spain
| | - Carlos Pastor-Vargas
- Departamento de Bioquímica y Biología Molecular, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Pedro Cintas
- Departamento de Química Orgánica e Inorgánica, Facultad de Ciencias, IACYS-Unidad de Química Verde y Desarrollo Sostenible, Universidad de Extremadura, 06006 Badajoz, Spain
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35
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Xiong Z, Wang W, Ma X, Zhang X, Wu Z, Yang A, Wu Y, Meng X, Chen H, Li X. Development of a Two-Step Hydrolysis Hypoallergenic Cow's Milk Formula and Evaluation of Residue Allergenicity by Peptidomics and Immunoreactivity Analysis. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2023; 71:12237-12249. [PMID: 37531557 DOI: 10.1021/acs.jafc.3c01221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
Cow's milk allergy (CMA) is an abnormal immune response that severely affects the nutritional supplementation of allergic infants. Currently, only a limited number of hypoallergenic formulas are available on the market, and these are only categorized according to their degree of hydrolysis, which still poses an allergy risk and cannot be consumed by CMA patients, especially infants. To address this issue, we developed a two-step hydrolysis hypoallergenic formula targeting destruction of allergen epitope from whey protein. Then, a comprehensive evaluation system was constructed, including peptidomics analysis, in vivo and in vitro allergenicity assessments, revealing allergic changes in the product from the epitope structure level to the immunological level. The results showed that 97.14% of hydrolyzed peptides from α-lactalbumin and β-lactoglobulin did not contain allergenic epitopes after treatment with trypsin and flavourzyme. In vitro and in vivo allergenicity assessment results confirmed that the two-step hydrolysis method effectively reduced the allergenicity of whey protein. Compared with the common milk powder, the hypoallergenic formula induced lower levels of basophil degranulation and relieved the body's anaphylactic symptoms caused by cow milk. This study provides a promising solution to the limited hypoallergenic formula problem and may benefit allergic infants who require nutritional supplements.
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Affiliation(s)
- Ziyi Xiong
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, Jiangxi 330047, P. R. China
- School of Food Science and Technology, Nanchang University, Nanchang, Jiangxi 330047, P. R. China
- Jiangxi Province Key Laboratory of Food Allergy, Nanchang University, Nanchang, Jiangxi 330047, China
| | - Wenjie Wang
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, Jiangxi 330047, P. R. China
- School of Food Science and Technology, Nanchang University, Nanchang, Jiangxi 330047, P. R. China
- Jiangxi Province Key Laboratory of Food Allergy, Nanchang University, Nanchang, Jiangxi 330047, China
| | - Xin Ma
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, Jiangxi 330047, P. R. China
- School of Food Science and Technology, Nanchang University, Nanchang, Jiangxi 330047, P. R. China
- Jiangxi Province Key Laboratory of Food Allergy, Nanchang University, Nanchang, Jiangxi 330047, China
| | - Xing Zhang
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, Jiangxi 330047, P. R. China
- School of Food Science and Technology, Nanchang University, Nanchang, Jiangxi 330047, P. R. China
- Jiangxi Province Key Laboratory of Food Allergy, Nanchang University, Nanchang, Jiangxi 330047, China
| | - Zhihua Wu
- School of Food Science and Technology, Nanchang University, Nanchang, Jiangxi 330047, P. R. China
- Sino-German Joint Research Institute, Nanchang University, Nanchang, Jiangxi 330047, P. R. China
- Jiangxi Province Key Laboratory of Food Allergy, Nanchang University, Nanchang, Jiangxi 330047, China
| | - Anshu Yang
- School of Food Science and Technology, Nanchang University, Nanchang, Jiangxi 330047, P. R. China
- Sino-German Joint Research Institute, Nanchang University, Nanchang, Jiangxi 330047, P. R. China
- Jiangxi Province Key Laboratory of Food Allergy, Nanchang University, Nanchang, Jiangxi 330047, China
| | - Yong Wu
- School of Food Science and Technology, Nanchang University, Nanchang, Jiangxi 330047, P. R. China
- Sino-German Joint Research Institute, Nanchang University, Nanchang, Jiangxi 330047, P. R. China
- Jiangxi Province Key Laboratory of Food Allergy, Nanchang University, Nanchang, Jiangxi 330047, China
| | - Xuanyi Meng
- School of Food Science and Technology, Nanchang University, Nanchang, Jiangxi 330047, P. R. China
- Sino-German Joint Research Institute, Nanchang University, Nanchang, Jiangxi 330047, P. R. China
- Jiangxi Province Key Laboratory of Food Allergy, Nanchang University, Nanchang, Jiangxi 330047, China
| | - Hongbing Chen
- School of Food Science and Technology, Nanchang University, Nanchang, Jiangxi 330047, P. R. China
- Sino-German Joint Research Institute, Nanchang University, Nanchang, Jiangxi 330047, P. R. China
- Jiangxi Province Key Laboratory of Food Allergy, Nanchang University, Nanchang, Jiangxi 330047, China
| | - Xin Li
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, Jiangxi 330047, P. R. China
- School of Food Science and Technology, Nanchang University, Nanchang, Jiangxi 330047, P. R. China
- Jiangxi Province Key Laboratory of Food Allergy, Nanchang University, Nanchang, Jiangxi 330047, China
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Lampousi AM, Carlsson S, Löfvenborg JE, Cabrera-Castro N, Chirlaque MD, Fagherazzi G, Franks PW, Hampe CS, Jakszyn P, Koulman A, Kyrø C, Moreno-Iribas C, Nilsson PM, Panico S, Papier K, van der Schouw YT, Schulze MB, Weiderpass E, Zamora-Ros R, Forouhi NG, Sharp SJ, Rolandsson O, Wareham NJ. Interaction between plasma phospholipid odd-chain fatty acids and GAD65 autoantibodies on the incidence of adult-onset diabetes: the EPIC-InterAct case-cohort study. Diabetologia 2023; 66:1460-1471. [PMID: 37301794 PMCID: PMC10317878 DOI: 10.1007/s00125-023-05948-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 04/25/2023] [Indexed: 06/12/2023]
Abstract
AIMS/HYPOTHESIS Islet autoimmunity may progress to adult-onset diabetes. We investigated whether circulating odd-chain fatty acids (OCFA) 15:0 and 17:0, which are inversely associated with type 2 diabetes, interact with autoantibodies against GAD65 (GAD65Ab) on the incidence of adult-onset diabetes. METHODS We used the European EPIC-InterAct case-cohort study including 11,124 incident adult-onset diabetes cases and a subcohort of 14,866 randomly selected individuals. Adjusted Prentice-weighted Cox regression estimated HRs and 95% CIs of diabetes in relation to 1 SD lower plasma phospholipid 15:0 and/or 17:0 concentrations or their main contributor, dairy intake, among GAD65Ab-negative and -positive individuals. Interactions between tertiles of OCFA and GAD65Ab status were estimated by proportion attributable to interaction (AP). RESULTS Low concentrations of OCFA, particularly 17:0, were associated with a higher incidence of adult-onset diabetes in both GAD65Ab-negative (HR 1.55 [95% CI 1.48, 1.64]) and GAD65Ab-positive (HR 1.69 [95% CI 1.34, 2.13]) individuals. The combination of low 17:0 and high GAD65Ab positivity vs high 17:0 and GAD65Ab negativity conferred an HR of 7.51 (95% CI 4.83, 11.69), with evidence of additive interaction (AP 0.25 [95% CI 0.05, 0.45]). Low dairy intake was not associated with diabetes incidence in either GAD65Ab-negative (HR 0.98 [95% CI 0.94, 1.02]) or GAD65Ab-positive individuals (HR 0.97 [95% CI 0.79, 1.18]). CONCLUSIONS/INTERPRETATION Low plasma phospholipid 17:0 concentrations may promote the progression from GAD65Ab positivity to adult-onset diabetes.
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Affiliation(s)
- Anna-Maria Lampousi
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Sofia Carlsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Josefin E Löfvenborg
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Risk and Benefit Assessment, Swedish Food Agency, Uppsala, Sweden
| | | | - María-Dolores Chirlaque
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Health and Social Sciences, Murcia University, Murcia, Spain
| | - Guy Fagherazzi
- Deep Digital Phenotyping Research Unit, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Paul W Franks
- Department of Clinical Sciences, Clinical Research Center, Skåne University Hospital, Lund University, Malmö, Sweden
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
| | - Christiane S Hampe
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Paula Jakszyn
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
- Blanquerna School of Health Sciences, Ramon Llull University, Barcelona, Spain
| | - Albert Koulman
- Medical Research Council Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK
- National Institute for Health Research Biomedical Research Centre Core Nutritional Biomarker Laboratory, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Cecilie Kyrø
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Conchi Moreno-Iribas
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Navarra Public Health Institute, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Peter M Nilsson
- Department of Clinical Sciences, Clinical Research Center, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy
| | - Keren Papier
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yvonne T van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
- Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany
| | - Elisabete Weiderpass
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Raul Zamora-Ros
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain
| | - Nita G Forouhi
- Medical Research Council Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Stephen J Sharp
- Medical Research Council Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Olov Rolandsson
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
| | - Nicholas J Wareham
- Medical Research Council Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, UK
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Pérez-Codesido S, Grifol-Clar E, Petrone MB, Malumbres MG, Garban PA, Tejedor-Alonso MA. "Frequency of fatal and recurrent anaphylaxis due to COW'S milk: A systematic review and meta-analysis of observational studies". Pediatr Allergy Immunol 2023; 34:e13977. [PMID: 37492910 DOI: 10.1111/pai.13977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 05/20/2023] [Accepted: 05/31/2023] [Indexed: 07/27/2023]
Abstract
Cow's milk allergy can result in anaphylactic reactions. The estimated prevalence of cow's milk allergy in developed countries ranges from 0.5% to 3% at age 1 year. Our objective was to perform a systematic review and, if possible, a meta-analysis to assess the frequency of fatal and recurrent anaphylaxis induced by cow's milk. We searched PubMed/MEDLINE, EMBASE, and the Web of Science for studies that had assessed fatal and recurrent anaphylaxis induced by cow's milk for the population of a country or at least an administrative region. Our review included cohort, cross-sectional, and registry studies that had assessed the incidence or prevalence of recurrent anaphylaxis or the incidence of fatal anaphylaxis due to cow's milk. The pooled prevalence of recurrence (PR) for at least an episode of anaphylaxis was 26.98% (3.85-189.1). Teymourpour et al (Iran) reported the highest PR (53.10%); the two studies with the lowest PR were from France (5.2 and 0.42, respectively) (p < .01). Nine studies on fatal anaphylaxis were selected (41 deaths) and found to be highly heterogeneous (I2 = 75.9%). Levy et al and Bassagio et al reported the highest incidence rate (IR 0.15 and 0.6 deaths per million persons-year). The PR of anaphylaxis was approximately one quarter of patients with anaphylaxis due to cow's milk, while deaths from anaphylaxis caused by cow's milk were very rare, although some studies report rates as high as 15 times the lowest IR.
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Affiliation(s)
- Sabela Pérez-Codesido
- Hospital Universitario Fundación Alcorcón, Alcorcón, Spain
- International Doctoral School, Facultad Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Spain
- Division of immunology and Allergology, University Hospitals and Medical Faculty of Geneva, Genève, Switzerland
| | | | | | | | | | - Miguel A Tejedor-Alonso
- Hospital Universitario Fundación Alcorcón, Alcorcón, Spain
- Facultad Ciencias de la Salud, Department of Medical Specialties and Public Health, Universidad Rey Juan Carlos, Alcorcón, Spain
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Bakshi S, Paswan VK, Yadav SP, Bhinchhar BK, Kharkwal S, Rose H, Kanetkar P, Kumar V, Al-Zamani ZAS, Bunkar DS. A comprehensive review on infant formula: nutritional and functional constituents, recent trends in processing and its impact on infants' gut microbiota. Front Nutr 2023; 10:1194679. [PMID: 37415910 PMCID: PMC10320619 DOI: 10.3389/fnut.2023.1194679] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/30/2023] [Indexed: 07/08/2023] Open
Abstract
Human milk is considered the most valuable form of nutrition for infants for their growth, development and function. So far, there are still some cases where feeding human milk is not feasible. As a result, the market for infant formula is widely increasing, and formula feeding become an alternative or substitute for breastfeeding. The nutritional value of the formula can be improved by adding functional bioactive compounds like probiotics, prebiotics, human milk oligosaccharides, vitamins, minerals, taurine, inositol, osteopontin, lactoferrin, gangliosides, carnitine etc. For processing of infant formula, diverse thermal and non-thermal technologies have been employed. Infant formula can be either in powdered form, which requires reconstitution with water or in ready-to-feed liquid form, among which powder form is readily available, shelf-stable and vastly marketed. Infants' gut microbiota is a complex ecosystem and the nutrient composition of infant formula is recognized to have a lasting effect on it. Likewise, the gut microbiota establishment closely parallels with host immune development and growth. Therefore, it must be contemplated as an important factor for consideration while developing formulas. In this review, we have focused on the formulation and manufacturing of safe and nutritious infant formula equivalent to human milk or aligning with the infant's needs and its ultimate impact on infants' gut microbiota.
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Affiliation(s)
- Shiva Bakshi
- Department of Dairy Science and Food Technology, Institute of Agricultural Sciences, Banaras Hindu University, Varanasi, India
| | - Vinod Kumar Paswan
- Department of Dairy Science and Food Technology, Institute of Agricultural Sciences, Banaras Hindu University, Varanasi, India
| | - Satya Prakash Yadav
- Department of Dairy Science and Food Technology, Institute of Agricultural Sciences, Banaras Hindu University, Varanasi, India
| | - Basant Kumar Bhinchhar
- Department of Livestock Production Management, Sri Karan Narendra Agriculture University, Jobner, India
| | - Sheela Kharkwal
- Department of Agriculture Economics, Sri Karan Narendra Agriculture University, Jobner, India
| | - Hency Rose
- Division of Dairy Technology, ICAR—National Dairy Research Institute, Karnal, India
| | - Prajasattak Kanetkar
- Department of Dairy Science and Food Technology, Institute of Agricultural Sciences, Banaras Hindu University, Varanasi, India
| | - Vishal Kumar
- Department of Dairy Science and Food Technology, Institute of Agricultural Sciences, Banaras Hindu University, Varanasi, India
| | - Zakarya Ali Saleh Al-Zamani
- Department of Dairy Science and Food Technology, Institute of Agricultural Sciences, Banaras Hindu University, Varanasi, India
- Department of Food Technology and Science, Faculty of Agriculture and Veterinary Medicine, Ibb University, Ibb, Yemen
| | - Durga Shankar Bunkar
- Department of Dairy Science and Food Technology, Institute of Agricultural Sciences, Banaras Hindu University, Varanasi, India
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Boutsikou T, Sekkidou M, Karaglani E, Krepi A, Moschonis G, Nicolaou N, Iacovidou N, Pancheva R, Marinova-Achkar M, Popova S, Kapetanaki A, Iliodromiti Z, Papaevangelou V, Sardeli O, Papathoma E, Schaafsma A, Bos R, Manios Y, Xepapadaki P. The Impact of Infant Feeding Regimen on Cow's Milk Protein Allergy, Atopic Dermatitis and Growth in High-Risk Infants during the First 6 Months of Life: The Allergy Reduction Trial. Nutrients 2023; 15:nu15112622. [PMID: 37299585 DOI: 10.3390/nu15112622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/24/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
The development of early-onset cow's milk protein allergy and atopic dermatitis during the first months of life is multifactorial, including both genetic and nutritional aspects. This study aims to assess the impact of different feeding patterns on the incidence of cow's milk protein allergy, atopic dermatitis, and growth among infants with a family history of allergy. A total of 551 high-risk infants were randomly recruited from 3 European countries in three feeding regimens: exclusive breastfeeding, partially hydrolyzed formula, or standard formula with intact protein either exclusively or supplementary to breastfeeding. During the first 6 months of intervention, amongst infants with a family history of atopic dermatitis, 6.5% of partially hydrolyzed formula-fed infants and 22.7% of exclusively breastfed infants (p = 0.007) presented with atopic dermatitis respectively. Growth as assessed by weight increase did not differ between the aforementioned groups. Although cow's milk protein allergy was not related to the different milk feeding regimens in the whole cohort, when adjusting for high breast milk intake, the respective incident was significantly lower in the infants consuming partially hydrolyzed formula (p < 0.001). This data indicates that a specific partially hydrolyzed formula could serve as a more appropriate complement to breast milk compared to a standard intact protein formula in high-risk infants, to reduce the incidence of atopic dermatitis.
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Affiliation(s)
- Theodora Boutsikou
- Neonatal Department, Medical School, National and Kapodistrian University of Athens, Aretaieio Hospital, 11528 Athens, Greece
| | - Mikaela Sekkidou
- Asthma and Allergy Center, 3025 Limassol, Cyprus
- University of Nicosia Medical School, 2408 Nicosia, Cyprus
| | - Eva Karaglani
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El. Venizelou Ave., 17671 Athens, Greece
| | - Adamantia Krepi
- Neonatal Department, Medical School, National and Kapodistrian University of Athens, Aretaieio Hospital, 11528 Athens, Greece
| | - George Moschonis
- Department of Food, Nutrition and Dietetics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3086, Australia
| | - Nicolaos Nicolaou
- Asthma and Allergy Center, 3025 Limassol, Cyprus
- University of Nicosia Medical School, 2408 Nicosia, Cyprus
| | - Nicoletta Iacovidou
- Neonatal Department, Medical School, National and Kapodistrian University of Athens, Aretaieio Hospital, 11528 Athens, Greece
| | - Rouzha Pancheva
- Department of Hygiene and Epidemiology, Faculty of Public Health, Medical University of Varna, 9000 Varna, Bulgaria
| | - Miglena Marinova-Achkar
- Department of Hygiene and Epidemiology, Faculty of Public Health, Medical University of Varna, 9000 Varna, Bulgaria
| | - Simoneta Popova
- Department of Hygiene and Epidemiology, Faculty of Public Health, Medical University of Varna, 9000 Varna, Bulgaria
| | - Anastasia Kapetanaki
- Neonatal Intensive Care Unit, General and Maternity Hospital Elena Venizelou, 11521 Athens, Greece
| | - Zoi Iliodromiti
- Neonatal Department, Medical School, National and Kapodistrian University of Athens, Aretaieio Hospital, 11528 Athens, Greece
| | - Vassiliki Papaevangelou
- Third Department of Pediatrics, National and Kapodistrian University of Athens, ATTIKON General University Hospital, 12462 Athens, Greece
| | - Olympia Sardeli
- Third Department of Pediatrics, National and Kapodistrian University of Athens, ATTIKON General University Hospital, 12462 Athens, Greece
| | - Evangelia Papathoma
- Neonatal Intensive Care Unit, Alexandra General Hospital, 11528 Athens, Greece
| | | | - Rolf Bos
- FrieslandCampina, 3818 LE Amersfoort, The Netherlands
| | - Yannis Manios
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, 70 El. Venizelou Ave., 17671 Athens, Greece
- Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre, 71410 Heraklion, Greece
| | - Paraskevi Xepapadaki
- Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, 15771 Athens, Greece
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Wang X, Wang H, Ye Y, Yang P, Liu G, Hu Y, Tu Z. Ultrasound-assisted glycation and the allergenicity of α-lactalbumin. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2023; 103:3830-3839. [PMID: 36303537 DOI: 10.1002/jsfa.12293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/30/2022] [Accepted: 10/28/2022] [Indexed: 05/03/2023]
Abstract
BACKGROUND Ultrasound-assisted glycation is a promising method for decreasing the allergenicity of α-lactalbumin (ALA). However, there is a lack of in vivo studies on the allergenicity of ultrasound-assisted glycated ALA. In this study, the effects of the ultrasound-assisted glycation of ALA on the allergenicity and intestinal microflora were characterized using a BALB/c mouse model. RESULTS Increased immunoglobulin -G/ immunoglobulin-E (IgG/IgE) and interleukin-4/6 (IL-4/6) secretions, and reduced interferon-γ (IFN-γ) secretions were found in the serum of ALA sensitized and challenged, mice in comparison with a control group. However, there was no significant difference between the mice fed with ultrasound-assisted glycated ALA and the control group. Mice that were sensitized and challenged with ALA showed disrupted intestinal microflora, manifesting in significantly decreased Firmicutes and significantly increased Proteobacteria. It was found that 100ALA-gal could maintain the intestinal microflora of mice in a normal state. Pearson's rank correlation showed that Proteobacteria and Spirochaetota were correlated positively with the IL-4/IL-6 level and were correlated negatively with the expression of IFN-γ. Proteobacteria were also significantly positively correlated with IL-6 and negatively correlated with IFN-γ (P < 0.05). CONCLUSION These results suggested that ultrasound-assisted glycation on ALA can maintain the intestinal microflora in a normal state thus balancing the proportion of Th1/Th2 to decrease allergic reaction. © 2022 Society of Chemical Industry.
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Affiliation(s)
- Xumei Wang
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, China
| | - Hui Wang
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, China
| | - Yunhua Ye
- National R&D Branch Center for Conventional Freshwater Fish Processing, Jiangxi Normal University, Nanchang, China
- Engineering Research Center of Freshwater Fish High-value Utilization of Jiangxi Province, Jiangxi Normal University, Nanchang, China
| | - Ping Yang
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, China
| | - Guangxian Liu
- Institute of Food Science and Technology, Jiangxi Academy of Agricultural Sciences, Nanchang, China
| | - Yueming Hu
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, China
| | - Zongcai Tu
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang, China
- National R&D Branch Center for Conventional Freshwater Fish Processing, Jiangxi Normal University, Nanchang, China
- Engineering Research Center of Freshwater Fish High-value Utilization of Jiangxi Province, Jiangxi Normal University, Nanchang, China
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Hussain M, Gantumur MA, Manzoor MF, Hussain K, Xu J, Aadil RM, Qayum A, Ahmad I, Zhong H, Guan R. Sustainable emerging high-intensity sonication processing to enhance the protein bioactivity and bioavailability: An updated review. ULTRASONICS SONOCHEMISTRY 2023; 97:106464. [PMID: 37271028 DOI: 10.1016/j.ultsonch.2023.106464] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/19/2023] [Accepted: 05/28/2023] [Indexed: 06/06/2023]
Abstract
High-intensity ultrasound (HIU) is considered one of the promising non-chemical eco-friendly techniques used in food processing. Recently (HIU) is known to enhance food quality, extraction of bioactive compounds and formulation of emulsions. Various foods are treated with ultrasound, including fats, bioactive compounds, and proteins. Regarding proteins, HIU induces acoustic cavitation and bubble formation, causing the unfolding and exposure of hydrophobic regions, resulting in functional, bioactive, and structural enhancement. This review briefly portrays the impact of HIU on the bioavailability and bioactive properties of proteins; the effect of HIU on protein allergenicity and anti-nutritional factors has also been discussed. HIU can enhance bioavailability and bioactive attributes in plants and animal-based proteins, such as antioxidant activity, antimicrobial activity, and peptide release. Moreover, numerous studies revealed that HIU treatment could enhance functional properties, increase the release of short-chain peptides, and decrease allergenicity. HIU could replace the chemical and heat treatments used to enhance protein bioactivity and digestibility; however, its applications are still on research and small scale, and its usage in industries is yet to be implemented.
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Affiliation(s)
- Muhammad Hussain
- College of Food Science and Technology, Zhejiang University of Technology, Hangzhou 310014, China; Key Laboratory of Marine Fishery Resources Exploitment & Utilization of Zhejiang Province, China
| | - Munkh-Amgalan Gantumur
- Food College, Northeast Agricultural University, No. 600 Changjiang St. Xian fang Dist, 150030 Harbin, China
| | - Muhammad Faisal Manzoor
- Guangdong Provincial Key Laboratory of Intelligent Food Manufacturing, Foshan University, Foshan 528225, China; School of Food Science and Engineering, South China University of Technology, Guangzhou 510641, China
| | - Kifayat Hussain
- Departments of Animal Nutrition, Institute of Animal and Dairy Sciences, University of Agriculture Faisalabad, Pakistan
| | - Jie Xu
- College of Food Science and Technology, Zhejiang University of Technology, Hangzhou 310014, China; Key Laboratory of Marine Fishery Resources Exploitment & Utilization of Zhejiang Province, China
| | - Rana Muhammad Aadil
- National Institute of Food Science and Technology, University of Agriculture, Faisalabad 38000, Pakistan
| | - Abdul Qayum
- School of Food and Biological Engineering, Jiangsu University, 301 Xuefu Road, Zhenjiang, Jiangsu 212013, China
| | - Ishtiaq Ahmad
- College of Food Science and Technology, Zhejiang University of Technology, Hangzhou 310014, China
| | - Hao Zhong
- College of Food Science and Technology, Zhejiang University of Technology, Hangzhou 310014, China; Key Laboratory of Marine Fishery Resources Exploitment & Utilization of Zhejiang Province, China.
| | - Rongfa Guan
- College of Food Science and Technology, Zhejiang University of Technology, Hangzhou 310014, China; Key Laboratory of Marine Fishery Resources Exploitment & Utilization of Zhejiang Province, China.
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Giugliano R, Musolino N, Ciccotelli V, Ferraris C, Savio V, Vivaldi B, Ercolini C, Bianchi DM, Decastelli L. Soy, Rice and Oat Drinks: Investigating Chemical and Biological Safety in Plant-Based Milk Alternatives. Nutrients 2023; 15:nu15102258. [PMID: 37242141 DOI: 10.3390/nu15102258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/06/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
During the last decades, plant-based milk has become very appreciated by consumers, becoming a staple ingredient, especially for alternative breakfasts. Milk contains lactose, which is a sugar hydrolysed by the lactase enzyme. Lactose intolerance and lactose malabsorption are very common food intolerances among individuals. However, a lot of consumers consider themselves as lactose intolerant on the basis of self-reported intolerance and start to avoid dairy products, ignoring that plant-based milk alternatives are not nutritionally comparable to animal milk, especially in terms of protein intake. The aim of this study is to grow folder knowledge of the security of plant-based drinks, helping competent authorities to issue a risk assessment and to apply national plans about consumer safety. Results show that proper sanitary practices, such as pasteurization, are necessary in plant-based milk alternatives as well as in dairy milk. Chemical analysis has highlighted that there are no pesticide risks for consumers.
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Affiliation(s)
- Roberta Giugliano
- National Reference Laboratory of Pesticides in Cereals and Feed (NRL), Istituto Zooprofilattico Sperimentale del Piemonte, Liguria E Valle D'Aosta, Piazza Borgo Pila 39/24, 16129 Genoa, Italy
| | - Noemi Musolino
- National Reference Centre for the Detection of Substances and Products Causing Allergies or Intolerances in Food (CReNaRiA), Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle D'Aosta, Via Bologna 148, 10154 Turin, Italy
| | - Valentina Ciccotelli
- National Reference Laboratory of Pesticides in Cereals and Feed (NRL), Istituto Zooprofilattico Sperimentale del Piemonte, Liguria E Valle D'Aosta, Piazza Borgo Pila 39/24, 16129 Genoa, Italy
| | - Carla Ferraris
- National Reference Centre for the Detection of Substances and Products Causing Allergies or Intolerances in Food (CReNaRiA), Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle D'Aosta, Via Bologna 148, 10154 Turin, Italy
| | - Valentina Savio
- National Reference Laboratory of Pesticides in Cereals and Feed (NRL), Istituto Zooprofilattico Sperimentale del Piemonte, Liguria E Valle D'Aosta, Piazza Borgo Pila 39/24, 16129 Genoa, Italy
| | - Barbara Vivaldi
- National Reference Laboratory of Pesticides in Cereals and Feed (NRL), Istituto Zooprofilattico Sperimentale del Piemonte, Liguria E Valle D'Aosta, Piazza Borgo Pila 39/24, 16129 Genoa, Italy
| | - Carlo Ercolini
- National Reference Laboratory of Pesticides in Cereals and Feed (NRL), Istituto Zooprofilattico Sperimentale del Piemonte, Liguria E Valle D'Aosta, Piazza Borgo Pila 39/24, 16129 Genoa, Italy
| | - Daniela Manila Bianchi
- National Reference Centre for the Detection of Substances and Products Causing Allergies or Intolerances in Food (CReNaRiA), Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle D'Aosta, Via Bologna 148, 10154 Turin, Italy
| | - Lucia Decastelli
- National Reference Centre for the Detection of Substances and Products Causing Allergies or Intolerances in Food (CReNaRiA), Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle D'Aosta, Via Bologna 148, 10154 Turin, Italy
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Xu Z, Bai H, Ma X, Wu Y, Wu Z, Yang A, Mao W, Li X, Chen H. Cytological evaluation by Caco-2 and KU812 of non-allergenic peptides from simulated digestion of infant formula in vitro. FOOD SCIENCE AND HUMAN WELLNESS 2023. [DOI: 10.1016/j.fshw.2022.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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44
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Aquilante BP, Castro APBM, Yonamine GH, de Barros Dorna M, Barp MF, Martins TPDR, Pastorino AC. IgE-mediated cow's milk allergy in Brazilian children: Outcomes of oral food challenge. World Allergy Organ J 2023; 16:100781. [PMID: 37251812 PMCID: PMC10209878 DOI: 10.1016/j.waojou.2023.100781] [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: 11/16/2022] [Revised: 04/14/2023] [Accepted: 04/21/2023] [Indexed: 05/31/2023] Open
Abstract
Background Oral food challenge (OFC) is useful for diagnosing food allergies and assessing tolerance, but severe reactions may occur during the procedure. Objective To characterize the frequency and severity of reactions during cow's milk (CM) OFCs. Methods A cross-sectional study was conducted to analyze the outcome of cow's milk oral food challenges (CMOFCs) performed to confirm IgE-mediated CM allergy or to assess food tolerance. CM was given first as baked milk (BM), followed by whole CM if there was no prior reaction to BM. An OFC was considered positive if IgE-mediated symptoms developed up to 2 h after ingestion. Symptoms were described and variables including age at OFC, prior anaphylaxis, other atopic diseases, and skin test results were compared according to the OFC outcomes. Results A total of 266 CMOFCs were performed, including 159 patients with a median age of 6.3 years old. One hundred thirty-six tests were positive and 62 resulted in anaphylaxis. Thirty-nine anaphylactic reactions were observed up to 30 min after the first dose. Severe anaphylaxis (cardiovascular and/or neurological involvement) was reported in 5 tests. A second dose of epinephrine was required in 3 tests, and 1 presented a biphasic response. Younger patients had a higher risk of anaphylaxis during baked milk oral food challenge (BMOFC) (p = 0.009). The frequency of anaphylaxis was higher in patients submitted to BM (p = 0.009). Conclusions Anaphylaxis is a known complication of CMOFCs even when there is no prior anaphylaxis or when conducted with baked products. This study reinforces the importance of conducting OFC in appropriate settings with a well-trained team.
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Affiliation(s)
- Bruna Pultrini Aquilante
- Corresponding author. Av. Dr. Enéas Carvalho de Aguiar, 647 - Cerqueira César, São Paulo, SP, 05403, Brazil,
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Wilsey MJ, Florio J, Beacker J, Lamos L, Baran JV, Oliveros L, Sriaroon P, Brown JM, Vanderhoof JA. Extensively Hydrolyzed Formula Improves Allergic Symptoms in the Short Term in Infants with Suspected Cow’s Milk Protein Allergy. Nutrients 2023; 15:nu15071677. [PMID: 37049517 PMCID: PMC10096968 DOI: 10.3390/nu15071677] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/24/2023] [Accepted: 03/28/2023] [Indexed: 04/01/2023] Open
Abstract
Although extensively hydrolyzed formula is widely accepted for managing cow’s milk protein allergy (CMPA) long-term, there is a lack of evidence on its short-term efficacy. This study’s objective was to investigate the short-term symptom changes (within 3–6 weeks) of infants diagnosed with CMPA and managed with extensively hydrolyzed formula containing Lactobacillus rhamnosus at their subsequent physician visit. Healthcare providers treating 202 patients diagnosed with CMPA under six months old completed de-identified surveys, which were then analyzed in this prospective study. After their first visit, the patients were started on extensively hydrolyzed formula, and their baseline symptoms were scored on a severity scale of 0–3. Patients were then reevaluated at their next follow-up visit to assess changes in symptom severity. The study found statistically significant improvements in gastrointestinal (93%), skin (83%), respiratory (73%), and uncategorized symptoms (90%). These symptom improvements were consistent across different follow-up visit durations. This study is the largest prospective analysis conducted in the United States evaluating short-term change in CMPA symptoms severity in infants under six months old using extensively hydrolyzed formula. These findings suggest that extensively hydrolyzed formula is associated with clinical symptom relief, which is often noticeable by the next follow-up visit. However, additional randomized control trials are needed to validate these results.
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46
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Strieder MM, Silva EK, Mekala S, Meireles MAA, Saldaña MDA. Barley-Based Non-dairy Alternative Milk: Stabilization Mechanism, Protein Solubility, Physicochemical Properties, and Kinetic Stability. FOOD BIOPROCESS TECH 2023. [DOI: 10.1007/s11947-023-03037-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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Yamamoto-Hanada K, Sato M, Toyokuni K, Irahara M, Hiraide-Kotaki E, Harima-Mizusawa N, Morita H, Matsumoto K, Ohya Y. Combination of heat-killed Lactiplantibacillus plantarum YIT 0132 (LP0132) and oral immunotherapy in cow's milk allergy: a randomised controlled trial. Benef Microbes 2023; 14:17-30. [PMID: 36815492 DOI: 10.3920/bm2022.0064] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
Safer and more effective cow milk (CM)-oral immunotherapy that does not induce allergic reactions has not yet been standardised. We sought to explore the efficacy and feasibility of a combination of heat-killed Lactiplantibacillus plantarum YIT 0132 (LP0132) and oral immunotherapy for treating IgE-mediated cow milk allergy (CMA). We conducted a 24-week, double-blind, randomised (1:1), two-arm, parallel-group, placebo-controlled, phase 2 trial of LP0132 intervention for treating IgE-mediated CMA in children aged 1-18 years (n=60) from January 29, 2018 to July 12, 2019 in Tokyo, Japan. Participants were randomly assigned to the LP0132 group receiving citrus juice fermented with LP0132 or to the control group receiving citrus juice without. Both groups received low-dose slow oral immunotherapy with CM. The primary outcome was improved tolerance to CM, proven by the CM challenge test at 24 weeks. Secondary outcomes were changes in serum biomarkers of serum-specific β-lactoglobulin-IgE (sIgE) and β-lactoglobulin-IgG4 (sIgG4). Exploratory outcomes included changes in serum cytokine levels and gut microbiota composition. A total of 61 participants were included. Finally, 31 children were assigned to the LP0132 group and 30 to the control group, respectively. After the intervention, 41.4 and 37.9% of the participants in the LP0132 and control groups, respectively, showed improved tolerance to CM. In serum biomarkers after the intervention, the sIgG4 level was significantly higher, and interleukin (IL)-5 and IL-9 were significantly lower, in the LP0132 group than in the control group. In the gut microbiome, the α-diversity and Lachnospiraceae increased significantly in the LP0132 group, and Lachnospiraceae after the intervention was significantly higher in the LP0132 group than in the control group. In conclusion, low-dose oral immunotherapy with modulating gut microbiota might be a safer and more effective approach for treating cow's milk allergy.
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Affiliation(s)
- K Yamamoto-Hanada
- Allergy Center, National Center for Child Health and Development, 2-10-1 Okura, 1578535 Tokyo, Japan
| | - M Sato
- Allergy Center, National Center for Child Health and Development, 2-10-1 Okura, 1578535 Tokyo, Japan
| | - K Toyokuni
- Allergy Center, National Center for Child Health and Development, 2-10-1 Okura, 1578535 Tokyo, Japan
| | - M Irahara
- Allergy Center, National Center for Child Health and Development, 2-10-1 Okura, 1578535 Tokyo, Japan
| | - E Hiraide-Kotaki
- Yakult Central Institute for Microbiological Research, 5-11 Izumi, Kunitachi, Tokyo 186-8650, Japan
| | - N Harima-Mizusawa
- Yakult Central Institute for Microbiological Research, 5-11 Izumi, Kunitachi, Tokyo 186-8650, Japan
| | - H Morita
- Department of Allergy and Clinical Immunology, National Research Institute for Child Health and Development, 2-10-1 Okura, 1578535 Tokyo, Japan
| | - K Matsumoto
- Department of Allergy and Clinical Immunology, National Research Institute for Child Health and Development, 2-10-1 Okura, 1578535 Tokyo, Japan
| | - Y Ohya
- Allergy Center, National Center for Child Health and Development, 2-10-1 Okura, 1578535 Tokyo, Japan
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‘Early Introduction’ of Cow’s Milk for Children with IgE-Mediated Cow’s Milk Protein Allergy: A Review of Current and Emerging Approaches for CMPA Management. Nutrients 2023; 15:nu15061397. [PMID: 36986127 PMCID: PMC10057913 DOI: 10.3390/nu15061397] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/09/2023] [Accepted: 03/10/2023] [Indexed: 03/16/2023] Open
Abstract
IgE-mediated cow’s milk protein allergy (CMPA) is one of the most prevalent food allergies in early childhood. Though the cornerstone of management involves the strict avoidance of milk products while awaiting natural tolerance, research increasingly shows that the rates of resolution are slowing down. Therefore, there is a need to explore alternative pathways to promote tolerance to cow’s milk in pediatric populations. This review aims to combine and appraise the scientific literature regarding the three CMPA management methods: avoidance, the milk ladder, and oral immunotherapy (OIT) and their outcomes in terms of efficacy, safety, and immunological effects. Cow’s milk (CM) avoidance virtually protects against allergic reaction until natural tolerance occurs, with hypoallergenic substitutes available in the market, but accidental ingestion represents the main issue for this strategy. Introduction to baked milk using the milk ladder was designed, with most CMPA patients successfully completing the ladder. Similar to baked milk treatment, many OIT protocols also demonstrated decreased IgE and increased IgG4 levels post protocol, as well as a reduction in wheal size diameter. Though these strategies are shown to be safe and effective in CMPA, future clinical trials should compare the safety and effectiveness of these three management strategies.
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Emmert V, Lendvai-Emmert D, Eklics K, Prémusz V, Tóth GP. Current Practice in Pediatric Cow's Milk Protein Allergy-Immunological Features and Beyond. Int J Mol Sci 2023; 24:ijms24055025. [PMID: 36902457 PMCID: PMC10003246 DOI: 10.3390/ijms24055025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/28/2023] [Accepted: 03/04/2023] [Indexed: 03/08/2023] Open
Abstract
Cow's milk protein allergy is one of the most common pediatric food allergies. It poses a significant socioeconomic burden in industrialized countries and has a profound effect on the quality of life of affected individuals and their families. Diverse immunologic pathways can lead to the clinical symptoms of cow's milk protein allergy; some of the pathomechanisms are known in detail, but others need further elucidation. A comprehensive understanding of the development of food allergies and the features of oral tolerance could have the potential to unlock more precise diagnostic tools and novel therapeutic approaches for patients with cow's milk protein allergy.
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Affiliation(s)
- Vanessza Emmert
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary
- Erzsébet Teaching Hospital and Rehabilitation Institute, 9400 Sopron, Hungary
- Correspondence:
| | - Dominika Lendvai-Emmert
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary
- Department of Neurosurgery, Medical School, University of Pécs, 7623 Pécs, Hungary
- Neurotrauma Research Group, Szentágothai Research Centre, University of Pécs, 7624 Pécs, Hungary
| | - Kata Eklics
- Department of Languages for Biomedical Purposes, Medical School, University of Pécs, 7624 Pécs, Hungary
| | - Viktória Prémusz
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary
- Institute of Physiotherapy and Sport Sciences, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary
| | - Gergely Péter Tóth
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary
- Erzsébet Teaching Hospital and Rehabilitation Institute, 9400 Sopron, Hungary
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50
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van Boven FE, Arends NJT, Sprikkelman AB, Emons JAM, Hendriks AI, van Splunter M, Schreurs MWJ, Terlouw S, Gerth van Wijk R, Wichers HJ, Savelkoul HFJ, van Neerven RJJ, Hettinga KA, de Jong NW. Tolerance Induction in Cow's Milk Allergic Children by Heated Cow's Milk Protein: The iAGE Follow-Up Study. Nutrients 2023; 15:nu15051181. [PMID: 36904179 PMCID: PMC10005260 DOI: 10.3390/nu15051181] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/10/2023] [Accepted: 02/21/2023] [Indexed: 03/03/2023] Open
Abstract
Accelerating the induction of tolerance to cow's milk (CM) reduces the burden of cow's milk allergy (CMA). In this randomised controlled intervention study, we aimed to investigate the tolerance induction of a novel heated cow milk protein, the iAGE product, in 18 children with CMA (diagnosed by a paedriatric allergist). Children who tolerated the iAGE product were included. The treatment group (TG: n = 11; mean age 12.8 months, SD = 4.7) consumed the iAGE product daily with their own diet, and the control group (CG: n = 7; mean age 17.6 months, SD = 3.2) used an eHF without any milk consumption. In each group, 2 children had multiple food allergies. The follow-up procedures consisted of a double-blind placebo-controlled food challenge (DBPCFC) with CM t = 0, t = 1 (8 months), t = 2 (16 months), and t = 3 (24 months). At t = 1, eight (73%) of 11 children in the TG had a negative DBPCFC, versus four out of seven (57%) in the CG (BayesFactor = 0.61). At t = 3, nine of the 11 (82%) children in the TG and five of seven (71%) in the CG were tolerant (BayesFactor = 0.51). SIgE for CM reduced from a mean of 3.41 kU/L (SD = 5.63) in the TG to 1.24 kU/L (SD = 2.08) at the end of intervention, respectively a mean of 2.58 (SD = 3.32) in the CG to 0.63 kU/L (SD = 1.06). Product-related AEs were not reported. CM was successfully introduced in all children with negative DBPCFC. We found a standardised, well-defined heated CM protein powder that is safe for daily OIT treatment in a selected group of children with CMA. However, the benefits of inducing tolerance were not observed.
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Affiliation(s)
- Frank E. van Boven
- Department of Internal Medicine, Section of Allergology & Clinical Immunology, Erasmus MC, University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands
| | - Nicolette J. T. Arends
- Depertment of Peadiatric Allergology, Sophia Children Hospital, Erasmus MC, University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands
| | - Aline B. Sprikkelman
- Department of Peadiatric Pulmonology & Allergology, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands
- University Medical Center Groningen, GRIAC Research Institute, University of Groningen, 9713 GZ Groningen, The Netherlands
| | - Joyce A. M. Emons
- Depertment of Peadiatric Allergology, Sophia Children Hospital, Erasmus MC, University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands
| | - Astrid I. Hendriks
- Depertment of Peadiatric Allergology, Sophia Children Hospital, Erasmus MC, University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands
| | - Marloes van Splunter
- Cell Biology & Immunology, Wageningen University & Research, 6708 PB Wageningen, The Netherlands
| | - Marco W. J. Schreurs
- Department of Immunology, Erasmus MC, University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands
| | - Severina Terlouw
- Department of Internal Medicine, Section of Allergology & Clinical Immunology, Erasmus MC, University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands
| | - Roy Gerth van Wijk
- Department of Internal Medicine, Section of Allergology & Clinical Immunology, Erasmus MC, University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands
| | - Harry J. Wichers
- Food & Biobased Research, Wageningen University & Research, 6700 AA Wageningen, The Netherlands
| | - Huub F. J. Savelkoul
- Cell Biology & Immunology, Wageningen University & Research, 6708 PB Wageningen, The Netherlands
| | - R. J. Joost van Neerven
- Cell Biology & Immunology, Wageningen University & Research, 6708 PB Wageningen, The Netherlands
- FrieslandCampina, 3811 LP Amersfoort, The Netherlands
| | - Kasper A. Hettinga
- Dairy Science and Technology, Food Quality and Design Group, Wageningen University and Research, P.O. Box 17, 6700 AA Wageningen, The Netherlands
| | - Nicolette W. de Jong
- Department of Internal Medicine, Section of Allergology & Clinical Immunology, Erasmus MC, University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands
- Depertment of Peadiatric Allergology, Sophia Children Hospital, Erasmus MC, University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands
- Correspondence: ; Tel.: +31-6-21697954
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