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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. J Allergy Clin Immunol Glob 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] [What about the content of this article? (0)] [Affiliation(s)] [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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Bognanni A, Fiocchi A, Arasi S, Chu DK, Ansotegui I, Assa'ad AH, Bahna SL, Berni Canani R, Bozzola M, Dahdah L, Dupont C, Dziechciarz P, Ebisawa M, Firmino RT, Chu A, Galli E, Horvath A, Kamenwa R, Lack G, Li H, Martelli A, Nowak-Węgrzyn A, Papadopoulos NG, Pawankar R, Roldan Y, Said M, Sánchez-Borges M, Shamir R, Spergel JM, Szajewska H, Terracciano L, Vandenplas Y, Venter C, Waffenschmidt S, Waserman S, Warner A, Wong GW, Schünemann HJ, Brozek JL. World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) guideline update - XII - Recommendations on milk formula supplements with and without probiotics for infants and toddlers with CMA. World Allergy Organ J 2024; 17:100888. [PMID: 38706757 PMCID: PMC11068951 DOI: 10.1016/j.waojou.2024.100888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 02/13/2024] [Accepted: 02/21/2024] [Indexed: 05/07/2024] Open
Abstract
Background Cow's milk allergy (CMA) is the most common food allergy in infants. The replacement with specialized formulas is an established clinical approach to ensure adequate growth and minimize the risk of severe allergic reactions when breastfeeding is not possible. Still, given the availability of multiple options, such as extensively hydrolyzed cow's milk protein formula (eHF-CM), amino acid formula (AAF), hydrolyzed rice formula (HRF) and soy formulas (SF), there is some uncertainty as to the most suitable choice with respect to health outcomes. Furthermore, the addition of probiotics to a formula has been proposed as a potential approach to maximize benefit. Objective These evidence-based guidelines from the World Allergy Organization (WAO) intend to support patients, clinicians, and others in decisions about the use of milk specialized formulas, with and without probiotics, for individuals with CMA. Methods WAO formed a multidisciplinary guideline panel balanced to include the views of all stakeholders and to minimize potential biases from competing interests. The McMaster University GRADE Centre supported the guideline-development process, including updating or performing systematic evidence reviews. The panel prioritized clinical questions and outcomes according to their importance for clinicians and patients. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used, including GRADE Evidence-to-Decision frameworks, which were subject to review by stakeholders. Results After reviewing the summarized evidence and thoroughly discussing the different management options, the WAO guideline panel suggests: a) using an extensively hydrolyzed (cow's milk) formula or a hydrolyzed rice formula as the first option for managing infants with immunoglobulin E (IgE) and non-IgE-mediated CMA who are not being breastfed. An amino-acid formula or a soy formula could be regarded as second and third options respectively; b) using either a formula without a probiotic or a casein-based extensively hydrolyzed formula containing Lacticaseibacillus rhamnosus GG (LGG) for infants with either IgE or non-IgE-mediated CMA.The issued recommendations are labeled as "conditional" following the GRADE approach due to the very low certainty about the health effects based on the available evidence. Conclusions If breastfeeding is not available, clinicians, patients, and their family members might want to discuss all the potential desirable and undesirable consequences of each formula in infants with CMA, integrating them with the patients' and caregivers' values and preferences, local availability, and cost, before deciding on a treatment option. We also suggest what research is needed to determine with greater certainty which formulas are likely to be the most beneficial, cost-effective, and equitable.
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Affiliation(s)
- Antonio Bognanni
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, Evidence in Allergy Group, McMaster University, Hamilton, Ontario, Canada
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Alessandro Fiocchi
- Translational Research in Pediatric Specialties Area, Division of Allergy, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio, 4, Rome 00165, Italy
| | - Stefania Arasi
- Translational Research in Pediatric Specialties Area, Division of Allergy, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio, 4, Rome 00165, Italy
| | - Derek K. Chu
- Department of Medicine, Evidence in Allergy Group, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, Division of Clinical Immunology and Allergy, McMaster University, Hamilton, Ontario, Canada
| | | | - Amal H. Assa'ad
- Division of Allergy and Immunology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Sami L. Bahna
- Allergy and Immunology Section, Louisiana State University Health Sciences Center, Shreveport, LA, USA
| | - Roberto Berni Canani
- Pediatric Allergy Program at the Department of Translational Medical Science, and ImmunoNutritionLab at Ceinge Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Martin Bozzola
- Department of Medicine, Division of Clinical Immunology and Allergy, McMaster University, Hamilton, Ontario, Canada
- Department of Pediatrics, British Hospital-Perdriel, Buenos Aires, Argentina
| | - Lamia Dahdah
- Translational Research in Pediatric Specialties Area, Division of Allergy, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio, 4, Rome 00165, Italy
| | - Christophe Dupont
- Paris Descartes University, Pediatric Gastroenterology, Necker Hospital, Paris, France
- Clinique Marcel Sembat, Boulogne-Billancourt, France
| | - Piotr Dziechciarz
- Department of Paediatrics, Medical University of Warsaw, Warsaw, Poland
| | - Motohiro Ebisawa
- Clinical Research Center for Allergy and Rheumatology, National Hospital Organization, Sagamihara National Hospital, Kanagawa, Japan
| | - Ramon T. Firmino
- Faculty of Medical Sciences of Campina Grande, UNIFACISA University Centre, Campina Grande, Paraiba, Brazil
| | - Alexandro Chu
- Department of Medicine, Evidence in Allergy Group, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, Division of Clinical Immunology and Allergy, McMaster University, Hamilton, Ontario, Canada
| | - Elena Galli
- Pediatric Allergy Unit, San Pietro Hospital - Fatebenefratelli, Rome, Italy
| | - Andrea Horvath
- Department of Paediatrics, Medical University of Warsaw, Warsaw, Poland
| | - Rose Kamenwa
- Department of Paediatrics and Child Health, Aga Khan University Hospital, Nairobi, Kenya
| | - Gideon Lack
- King's College London, Asthma-UK Centre in Allergic Mechanisms of Asthma, Department of Pediatric Allergy, St Thomas' Hospital, London, UK
| | - Haiqi Li
- Department of Primary Child Care, Children's Hospital, Chongqing Medical University, China
| | - Alberto Martelli
- Member of Italian Society of Allergy and Pediatric Immunology (SIAIP), Italy
| | - Anna Nowak-Węgrzyn
- Department of Pediatrics, NYU Grossman School of Medicine, Hassenfeld Children's Hospital, New York, NY, USA
- Department of Pediatrics, Gastroenterology and Nutrition, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
| | - Nikolaos G. Papadopoulos
- Division of Infection, Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester, UK
- Allergy Department, 2nd Paediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece
| | - Ruby Pawankar
- Division of Allergy, Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - Yetiani Roldan
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
| | - Maria Said
- Allergy & Anaphylaxis Australia, Castle Hill, New South Wales, Australia
| | - Mario Sánchez-Borges
- Allergy and Clinical Immunology Department, Centro Médico Docente La Trinidad and Clínica El Avila, Caracas, Venezuela
| | - Raanan Shamir
- Institute for Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jonathan M. Spergel
- Division of Allergy and Immunology, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Hania Szajewska
- Department of Paediatrics, Medical University of Warsaw, Warsaw, Poland
| | - Luigi Terracciano
- Pediatric Primary Care, National Pediatric Health Care System, Milan, Italy
| | - Yvan Vandenplas
- Department of Pediatric Gastroenterology, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - Carina Venter
- Section of Allergy and Immunology, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, USA
| | - Siw Waffenschmidt
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
- Institute for Quality and Efficiency in Health Care, Cologne, Germany
| | - Susan Waserman
- Department of Medicine, Division of Clinical Immunology and Allergy, McMaster University, Hamilton, Ontario, Canada
| | | | - Gary W.K. Wong
- Department of Paediatrics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, Hong Kong
| | - Holger J. Schünemann
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- Department of Medicine, Division of Internal Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Jan L. Brozek
- Department of Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, Division of Clinical Immunology and Allergy, McMaster University, Hamilton, Ontario, Canada
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Nocerino R, Coppola S, Carucci L, Oglio F, Cozzolino M, Masino A, Ozen G, Farnetano M, Berni Canani R. Growth pattern of paediatric patients affected by cow milk protein allergy fed with rice hydrolyzed formula. J Pediatr Gastroenterol Nutr 2024; 78:909-917. [PMID: 38374730 DOI: 10.1002/jpn3.12161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 01/11/2024] [Accepted: 01/22/2024] [Indexed: 02/21/2024]
Abstract
OBJECTIVES Formulas made from hydrolyzed rice proteins (HRPF) are well-tolerated plant-based alternatives to cow's milk protein (CMP)-based formulas for the dietary management of paediatric patients with CMP allergy (CMPA). Growth in patients with CMPA fed with HRPF has been evaluated in several studies with conflicting results. The aim was to evaluate the growth pattern of children with CMPA over a 12-month follow-up period. METHODS Prospective cohort study evaluating growth patterns in challenge proven CMPA paediatric patients receiving HRPF for 12 months. Outcomes were anthropometry (body weight, body length, head circumference), adherence to the study formula and occurrence of adverse events (AEs). RESULTS Sixty-six children were included and completed the 12-month study. At baseline, all CMPA patients were weaned. For the entire CMPA pediatric patients' cohort, from baseline to the end of the study period, the growth pattern resulted within the normal range of World Health Organization (WHO) growth references. The formula was well tolerated. Adherence was optimal and no AEs related to HRPF use were reported. CONCLUSIONS HRPF is well tolerated and can help support healthy growth and development in infants and young children with CMPA. These type of formula can be given with complementary foods in the dietary management of CMPA.
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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
| | - 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
| | - Marica Cozzolino
- 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
| | - Gulsum Ozen
- Department of Pediatrics, Ankara Ataturk Sanatoryum Training and Research Hospital, Ankara, Turkey
| | - Margherita Farnetano
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, 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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Berni Canani R, Caminati M, Carucci L, Eguiluz-Gracia I. Skin, gut, and lung barrier: Physiological interface and target of intervention for preventing and treating allergic diseases. Allergy 2024. [PMID: 38439599 DOI: 10.1111/all.16092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 02/21/2024] [Accepted: 02/23/2024] [Indexed: 03/06/2024]
Abstract
The epithelial barriers of the skin, gut, and respiratory tract are critical interfaces between the environment and the host, and they orchestrate both homeostatic and pathogenic immune responses. The mechanisms underlying epithelial barrier dysfunction in allergic and inflammatory conditions, such as atopic dermatitis, food allergy, eosinophilic oesophagitis, allergic rhinitis, chronic rhinosinusitis, and asthma, are complex and influenced by the exposome, microbiome, individual genetics, and epigenetics. Here, we review the role of the epithelial barriers of the skin, digestive tract, and airways in maintaining homeostasis, how they influence the occurrence and progression of allergic and inflammatory conditions, how current treatments target the epithelium to improve symptoms of these disorders, and what the unmet needs are in the identification and treatment of epithelial disorders.
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Affiliation(s)
- Roberto Berni Canani
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Marco Caminati
- Allergy Unit and Asthma Centre, Verona Integrated University Hospital and Department of Medicine, University of Verona, Verona, Italy
| | - Laura Carucci
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Ibon Eguiluz-Gracia
- Allergy Unit, Hospital Regional Universitario de Malága, Malaga, Spain
- Allergy Group, Biomedical Research Institute of Malaga (IBIMA)-BIONAND Platform, RICORS Inflammatory Diseases, Malaga, Spain
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Paparo L, Coppola S, Nocerino R, Pisapia L, Picariello G, Cortese M, Voto L, Maglio M, Miele E, Carucci L, Oglio F, Trinchese G, Mollica MP, Bruno C, De Vita S, Tarallo A, Damiano C, Cerulo M, Esposito C, Fogliano V, Parenti G, Troncone R, Berni Canani R. How dietary advanced glycation end products could facilitate the occurrence of food allergy. J Allergy Clin Immunol 2024; 153:742-758. [PMID: 38042501 DOI: 10.1016/j.jaci.2023.11.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/04/2023] [Accepted: 11/02/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUND Food allergy (FA) is one of the most common chronic conditions in children with an increasing prevalence facilitated by the exposure to environmental factors in predisposed individuals. It has been hypothesized that the increased consumption of ultra-processed foods, containing high levels of dietary advanced glycation end products (AGEs), could facilitate the occurrence of FA. OBJECTIVE We sought to provide preclinical and clinical evidence on the potential role of AGEs in facilitating the occurrence of FA. METHODS Human enterocytes, human small intestine organ culture, and PBMCs from children at risk for allergy were used to investigate the direct effect of AGEs on gut barrier, inflammation, TH2 cytokine response, and mitochondrial function. Intake of the 3 most common glycation products in Western diet foods, Nε-(carboxymethyl) lysine, Nε-(1-carboxyethyl) lysin, and Nδ-(5-hydro-5- methyl-4-imidazolone-2-yl)-ornithine (MG-H1), and the accumulation of AGEs in the skin were comparatively investigated in children with FA and in age-matched healthy controls. RESULTS Human enterocytes exposed to AGEs showed alteration in gut barrier, AGE receptor expression, reactive oxygen species production, and autophagy, with increased transepithelial passage of food antigens. Small intestine organ cultures exposed to AGEs showed an increase of CD25+ cells and proliferating crypt enterocytes. PBMCs exposed to AGEs showed alteration in proliferation rate, AGE receptor activation, release of inflammatory and TH2 cytokines, and mitochondrial metabolism. Significant higher dietary AGE intake and skin accumulation were observed children with FA (n = 42) compared with age-matched healthy controls (n = 66). CONCLUSIONS These data, supporting a potential role for dietary AGEs in facilitating the occurrence of FA, suggest the importance of limiting exposure to AGEs children as a potential preventive strategy against this common condition.
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Affiliation(s)
- Lorella Paparo
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | - Serena Coppola
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | - Rita Nocerino
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | - Laura Pisapia
- Institute of Genetics and Biophysics, National Research Council, Naples, Italy
| | | | - Maddalena Cortese
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | - Luana Voto
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | - Mariantonia Maglio
- Department of Translational Medical Science, University Federico II, Naples, Italy; European Laboratory for the Investigation of Food-Induced Diseases, University Federico II, Naples, Italy
| | - Erasmo Miele
- Department of Translational Medical Science, University Federico II, Naples, Italy
| | - Laura Carucci
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | - Franca Oglio
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | | | | | - Cristina Bruno
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | - Simone De Vita
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | - Antonietta Tarallo
- Department of Translational Medical Science, University Federico II, Naples, Italy; Telethon Institute of Genetics and Medicine, Pozzuoli, Italy
| | - Carla Damiano
- Department of Translational Medical Science, University Federico II, Naples, Italy; Telethon Institute of Genetics and Medicine, Pozzuoli, Italy
| | - Mariapina Cerulo
- Department of Translational Medical Science, University Federico II, Naples, Italy
| | - Ciro Esposito
- Department of Translational Medical Science, University Federico II, Naples, Italy
| | - Vincenzo Fogliano
- Food Quality and Design Group, Wageningen University and Research, Wageningen, The Netherlands
| | - Giancarlo Parenti
- Department of Translational Medical Science, University Federico II, Naples, Italy; Telethon Institute of Genetics and Medicine, Pozzuoli, Italy
| | - Riccardo Troncone
- Department of Translational Medical Science, University Federico II, Naples, Italy; European Laboratory for the Investigation of Food-Induced Diseases, University Federico II, Naples, Italy
| | - Roberto Berni Canani
- Department of Translational Medical Science, University Federico II, Naples, Italy; ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy; European Laboratory for the Investigation of Food-Induced Diseases, University Federico II, Naples, Italy; Task Force for Microbiome Studies, University Federico II, Naples, Italy; Task Force for Nutraceuticals and Functional Foods, University Federico II, Naples, Italy.
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Indrio F, Dinleyici EC, Berni Canani R, Domellöf M, Francavilla R, Guarino A, Gutierrez Castrellon P, Orel R, Salvatore S, Van den Akker CHP, Weizman Z. Prebiotics in the management of pediatric gastrointestinal disorders: Position paper of the ESPGHAN special interest group on gut microbiota and modifications. J Pediatr Gastroenterol Nutr 2024; 78:728-742. [PMID: 38270255 DOI: 10.1002/jpn3.12134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 12/28/2023] [Accepted: 01/11/2024] [Indexed: 01/26/2024]
Abstract
Prebiotics are substrates that are selectively utilized by host microorganisms conferring a health benefit. Compared to probiotics there are few studies with prebiotics in children. Most studies have been performed using infant formula supplemented with prebiotics, while add-on prebiotic supplementation as prevention or treatment of childhood gastrointestinal disorders has rarely been reported. The aim of this position paper was to summarize evidence and make recommendations for prebiotic supplementation in children with gastrointestinal diseases. Recommendations made are based on publications up to January 1, 2023. Within the scope of the European Society for Paediatric Gastroenterology Hepatology and Nutrition Special Interest Group on Gut Microbiota and Modifications, as in our previous biotic recommendations, at least two randomized controlled clinical trials were required for recommendation. There are some studies showing benefits of prebiotics on selected outcomes; however, we cannot give any positive recommendations for supplementing prebiotics in children with gastrointestinal disorders.
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Affiliation(s)
- Flavia Indrio
- Department of Experimental Medicine, Pediatric Section, University of Salento, Lecce, Italy
| | - Ener Cagri Dinleyici
- Department of Pediatrics, Eskisehir Osmangazi University Faculty of Medicine, Eskisehir, Turkiye
| | - Roberto Berni Canani
- Department of Translational Medical Sciences-Section of Paediatrics, University of Naples Federico II, Naples, Italy
| | - Magnus Domellöf
- Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden
| | - Ruggiero Francavilla
- Interdisciplinary Department of Medicine, Pediatric Section, Children's Hospital 'Giovanni XXIII', University of Bari Aldo Moro, Bari, Italy
| | - Alfredo Guarino
- Department of Translational Medical Sciences-Section of Paediatrics, University of Naples Federico II, Naples, Italy
| | - Pedro Gutierrez Castrellon
- Innovación y Desarrollo de Estrategias en Salud (IDEAS), Mexico City, Mexico
- International Scientific Council for Probiotics A.C., Mexico City, Mexico
| | - Rok Orel
- Department of Gastroenterology, Hepatology and Nutrition, University Medical Centre Ljubljana, University Children's Hospital, Ljubljana, Slovenia
| | - Silvia Salvatore
- Department of Pediatrics, "F. Del Ponte" Hospital, University of Insubria, Varese, Italy
| | - Chris H P Van den Akker
- Department of Pediatrics-Neonatology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Zvi Weizman
- Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva, Israel
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7
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Campbell E, Hesser LA, Berni Canani R, Carucci L, Paparo L, Patry RT, Nagler CR. A Lipopolysaccharide-Enriched Cow's Milk Allergy Microbiome Promotes a TLR4-Dependent Proinflammatory Intestinal Immune Response. J Immunol 2024; 212:702-714. [PMID: 38169331 PMCID: PMC10872367 DOI: 10.4049/jimmunol.2300518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/12/2023] [Indexed: 01/05/2024]
Abstract
We have previously reported that the gut microbiota of healthy infants harbors allergy-protective bacteria taxa that are depleted in infants with cow's milk allergy (CMA). Few reports have investigated the role of the gut microbiota in promoting allergic responses. In this study we selected a CMA-associated microbiota with increased abundance of Gram-negative bacteria for analysis of its proinflammatory potential. LPS is the major component of the outer membrane of Gram-negative bacteria. Colonization of mice with a global or conditional mutation of the LPS receptor TLR4 with this CMA microbiota induced expression of serum amyloid A1 (Saa1) and other Th17-, B cell-, and Th2-associated genes in the ileal epithelium in a TLR4-dependent manner. In agreement with the gene expression data, mice colonized with the CMA microbiota have expanded populations of Th17 and regulatory T cells and elevated concentrations of fecal IgA. Importantly, we used both antibiotic-treated specific pathogen-free and germ-free rederived mice with a conditional mutation of TLR4 in the CD11c+ compartment to demonstrate that the induction of proinflammatory genes, fecal IgA, and Th17 cells is dependent on TLR4 signaling. Furthermore, metagenomic sequencing revealed that the CMA microbiota has an increased abundance of LPS biosynthesis genes. Taken together, our results show that a microbiota displaying a higher abundance of LPS genes is associated with TLR4-dependent proinflammatory gene expression and a mixed type 2/type 3 response in mice, which may be characteristic of a subset of infants with CMA.
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Affiliation(s)
- Evelyn Campbell
- Committee on Microbiology, The University of Chicago, Chicago, IL. U.S.A
| | - Lauren A. Hesser
- Department of Pathology, The University of Chicago, Chicago, IL. U.S.A
- Pritzker School of Molecular Engineering, The University of Chicago, Chicago, IL. U.S.A
| | - Roberto Berni Canani
- Department of Translational Medical Science and ImmunoNutrition Lab at CEINGE Advanced Biotechnologies Research Center and Task Force for Microbiome Studies, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Laura Carucci
- Department of Translational Medical Science and ImmunoNutrition Lab at CEINGE Advanced Biotechnologies Research Center and Task Force for Microbiome Studies, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Lorella Paparo
- Department of Translational Medical Science and ImmunoNutrition Lab at CEINGE Advanced Biotechnologies Research Center and Task Force for Microbiome Studies, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Robert T. Patry
- Department of Pathology, The University of Chicago, Chicago, IL. U.S.A
| | - Cathryn R. Nagler
- Department of Pathology, The University of Chicago, Chicago, IL. U.S.A
- Pritzker School of Molecular Engineering, The University of Chicago, Chicago, IL. U.S.A
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8
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Roth-Walter F, Berni Canani R, O'Mahony L, Peroni D, Sokolowska M, Vassilopoulou E, Venter C. Nutrition in chronic inflammatory conditions: Bypassing the mucosal block for micronutrients. Allergy 2024; 79:353-383. [PMID: 38084827 DOI: 10.1111/all.15972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/14/2023] [Accepted: 11/27/2023] [Indexed: 02/01/2024]
Abstract
Nutritional Immunity is one of the most ancient innate immune responses, during which the body can restrict nutrients availability to pathogens and restricts their uptake by the gut mucosa (mucosal block). Though this can be a beneficial strategy during infection, it also is associated with non-communicable diseases-where the pathogen is missing; leading to increased morbidity and mortality as micronutritional uptake and distribution in the body is hindered. Here, we discuss the acute immune response in respect to nutrients, the opposing nutritional demands of regulatory and inflammatory cells and particularly focus on some nutrients linked with inflammation such as iron, vitamins A, Bs, C, and other antioxidants. We propose that while the absorption of certain micronutrients is hindered during inflammation, the dietary lymph path remains available. As such, several clinical trials investigated the role of the lymphatic system during protein absorption, following a ketogenic diet and an increased intake of antioxidants, vitamins, and minerals, in reducing inflammation and ameliorating disease.
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Affiliation(s)
- Franziska Roth-Walter
- Comparative Medicine, The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, Vienna, Austria
- Institute of Pathophysiology and Allergy Research, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - Roberto Berni Canani
- Department of Translational Medical Science and ImmunoNutritionLab at CEINGE-Advanced Biotechnologies, University of Naples "Federico II", Naples, Italy
| | - Liam O'Mahony
- Department of Medicine, School of Microbiology, APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Diego Peroni
- Section of Paediatrics, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - 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
| | - Emilia Vassilopoulou
- Pediatric Area, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
- Department of Nutritional Sciences and Dietetics, International Hellenic University, Thessaloniki, Greece
| | - Carina Venter
- Children's Hospital Colorado, University of Colorado, Aurora, Colorado, USA
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9
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Carucci L, Berni Canani R. Derived cholesterol metabolites and sIgA production: A novel intriguing link. Allergy 2024; 79:260-262. [PMID: 37746772 DOI: 10.1111/all.15896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/07/2023] [Accepted: 09/14/2023] [Indexed: 09/26/2023]
Affiliation(s)
- Laura Carucci
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy
| | - Roberto Berni Canani
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy
- Task Force on Microbiome Studies, University of Naples Federico II, Naples, Italy
- European Laboratory for the Investigation of Food-Induced Diseases, University of Naples Federico II, Naples, Italy
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10
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Cuomo M, Coretti L, Costabile D, Della Monica R, De Riso G, Buonaiuto M, Trio F, Bravaccio C, Visconti R, Berni Canani R, Chiariotti L, Lembo F. Host fecal DNA specific methylation signatures mark gut dysbiosis and inflammation in children affected by autism spectrum disorder. Sci Rep 2023; 13:18197. [PMID: 37875530 PMCID: PMC10598023 DOI: 10.1038/s41598-023-45132-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/16/2023] [Indexed: 10/26/2023] Open
Abstract
The gut-brain axis involves several bidirectional pathway communications including microbiome, bacterial metabolites, neurotransmitters as well as immune system and is perturbed both in brain and in gastrointestinal disorders. Consistently, microbiota-gut-brain axis has been found altered in autism spectrum disorder (ASD). We reasoned that such alterations occurring in ASD may impact both on methylation signatures of human host fecal DNA (HFD) and possibly on the types of human cells shed in the stools from intestinal tract giving origin to HFD. To test this hypothesis, we have performed whole genome methylation analysis of HFD from an age-restricted cohort of young children with ASD (N = 8) and healthy controls (N = 7). In the same cohort we have previously investigated the fecal microbiota composition and here we refined such analysis and searched for eventual associations with data derived from HFD methylome analysis. Our results showed that specific epigenetic signatures in human fecal DNA, especially at genes related to inflammation, associated with the disease. By applying methylation-based deconvolution algorithm, we found that the HFD derived mainly from immune cells and the relative abundance of those differed between patients and controls. Consistently, most of differentially methylated regions fitted with genes involved in inflammatory response. Interestingly, using Horvath epigenetic clock, we found that ASD affected children showed both epigenetic and microbiota age accelerated. We believe that the present unprecedented approach may be useful for the identification of the ASD associated HFD epigenetic signatures and may be potentially extended to other brain disorders and intestinal inflammatory diseases.
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Affiliation(s)
- Mariella Cuomo
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, Italy
- CEINGE Advanced Biotechnologies "Franco Salvatore", Via G. Salvatore 482, 80145, Naples, Italy
| | - Lorena Coretti
- Department of Pharmacy, University of Naples "Federico II", Via Domenico Montesano 49, 80131, Naples, Italy
| | - Davide Costabile
- CEINGE Advanced Biotechnologies "Franco Salvatore", Via G. Salvatore 482, 80145, Naples, Italy
- SEMM-European School of Molecular Medicine, University of Naples "Federico II", Naples, Italy
| | - Rosa Della Monica
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, Italy
- CEINGE Advanced Biotechnologies "Franco Salvatore", Via G. Salvatore 482, 80145, Naples, Italy
| | - Giulia De Riso
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, Italy
| | - Michela Buonaiuto
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, Italy
- CEINGE Advanced Biotechnologies "Franco Salvatore", Via G. Salvatore 482, 80145, Naples, Italy
| | - Federica Trio
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, Italy
- CEINGE Advanced Biotechnologies "Franco Salvatore", Via G. Salvatore 482, 80145, Naples, Italy
| | - Carmela Bravaccio
- Department of Translational Medical Science - Pediatric Section, University of Naples Federico II, Naples, Italy
| | - Roberta Visconti
- Institute for the Experimental Endocrinology and Oncology "G. Salvatore", Italian National Council of Research, Via S. Pansini 5, 80131, Naples, Italy
| | - Roberto Berni Canani
- Department of Translational Medical Science - Pediatric Section, University of Naples Federico II, Naples, Italy
| | - Lorenzo Chiariotti
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples "Federico II", Via S. Pansini 5, 80131, Naples, Italy.
- CEINGE Advanced Biotechnologies "Franco Salvatore", Via G. Salvatore 482, 80145, Naples, Italy.
- SEMM-European School of Molecular Medicine, University of Naples "Federico II", Naples, Italy.
| | - Francesca Lembo
- Department of Pharmacy, University of Naples "Federico II", Via Domenico Montesano 49, 80131, Naples, Italy.
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Di Lorenzo F, Paparo L, Pisapia L, Oglio F, Pither MD, Cirella R, Nocerino R, Carucci L, Silipo A, de Filippis F, Ercolini D, Molinaro A, Berni Canani R. The chemistry of gut microbiome-derived lipopolysaccharides impacts on the occurrence of food allergy in the pediatric age. Front Mol Biosci 2023; 10:1266293. [PMID: 37900913 PMCID: PMC10606559 DOI: 10.3389/fmolb.2023.1266293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/27/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction: Food allergy (FA) in children is a major health concern. A better definition of the pathogenesis of the disease could facilitate effective preventive and therapeutic measures. Gut microbiome alterations could modulate the occurrence of FA, although the mechanisms involved in this phenomenon are poorly characterized. Gut bacteria release signaling byproducts from their cell wall, such as lipopolysaccharides (LPSs), which can act locally and systemically, modulating the immune system function. Methods: In the current study gut microbiome-derived LPS isolated from fecal samples of FA and healthy children was chemically characterized providing insights into the carbohydrate and lipid composition as well as into the LPS macromolecular nature. In addition, by means of a chemical/MALDI-TOF MS and MS/MS approach we elucidated the gut microbiome-derived lipid A mass spectral profile directly on fecal samples. Finally, we evaluated the pro-allergic and pro-tolerogenic potential of these fecal LPS and lipid A by harnessing peripheral blood mononuclear cells from healthy donors. Results: By analyzing fecal samples, we have identified different gut microbiome-derived LPS chemical features comparing FA children and healthy controls. We also have provided evidence on a different immunoregulatory action elicited by LPS on peripheral blood mononuclear cells collected from healthy donors suggesting that LPS from healthy individuals could be able to protect against the occurrence of FA, while LPS from children affected by FA could promote the allergic response. Discussion: Altogether these data highlight the relevance of gut microbiome-derived LPSs as potential biomarkers for FA and as a target of intervention to limit the disease burden.
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Affiliation(s)
- Flaviana Di Lorenzo
- Department of Chemical Sciences, University Federico II, Naples, Italy
- Task Force on Microbiome Studies, University Federico II, Naples, Italy
| | - Lorella Paparo
- Department of Translational Medical Science, University Federico II, Naples, Italy
- ImmunoNutritionLab at CEINGE Biotechnologies Research Center, University Federico II, Naples, Italy
- European Laboratory for Investigation of Food Induced Diseases, University Federico II, Naples, Italy
| | - Laura Pisapia
- Institute of Genetics and Biophysics, National Research Council, Naples, Italy
| | - Franca Oglio
- Department of Translational Medical Science, University Federico II, Naples, Italy
- ImmunoNutritionLab at CEINGE Biotechnologies Research Center, University Federico II, Naples, Italy
| | | | - Roberta Cirella
- Department of Chemical Sciences, University Federico II, Naples, Italy
| | - Rita Nocerino
- Department of Translational Medical Science, University Federico II, Naples, Italy
- ImmunoNutritionLab at CEINGE Biotechnologies Research Center, University Federico II, Naples, Italy
| | - Laura Carucci
- Department of Translational Medical Science, University Federico II, Naples, Italy
- ImmunoNutritionLab at CEINGE Biotechnologies Research Center, University Federico II, Naples, Italy
| | - Alba Silipo
- Department of Chemical Sciences, University Federico II, Naples, Italy
- Task Force on Microbiome Studies, University Federico II, Naples, Italy
| | - Francesca de Filippis
- Task Force on Microbiome Studies, University Federico II, Naples, Italy
- Department of Agriculture, University Federico II, Naples, Italy
| | - Danilo Ercolini
- Task Force on Microbiome Studies, University Federico II, Naples, Italy
- Department of Agriculture, University Federico II, Naples, Italy
| | - Antonio Molinaro
- Department of Chemical Sciences, University Federico II, Naples, Italy
- Task Force on Microbiome Studies, University Federico II, Naples, Italy
- Department of Chemistry, School of Science, Osaka University, Toyonaka, Osaka, Japan
| | - Roberto Berni Canani
- Task Force on Microbiome Studies, University Federico II, Naples, Italy
- Department of Translational Medical Science, University Federico II, Naples, Italy
- ImmunoNutritionLab at CEINGE Biotechnologies Research Center, University Federico II, Naples, Italy
- European Laboratory for Investigation of Food Induced Diseases, University Federico II, Naples, Italy
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12
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Coppola S, Paparo L, Trinchese G, Rivieri AM, Masino A, De Giovanni Di Santa Severina AF, Cerulo M, Escolino M, Turco A, Esposito C, Mollica MP, Berni Canani R. Increased dietary intake of ultraprocessed foods and mitochondrial metabolism alterations in pediatric obesity. Sci Rep 2023; 13:12609. [PMID: 37537205 PMCID: PMC10400566 DOI: 10.1038/s41598-023-39566-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 07/26/2023] [Indexed: 08/05/2023] Open
Abstract
The increased intake of ultraprocessed foods (UPFs) in the pediatric age paralleled with the risen prevalence of childhood obesity. The Ultraprocessed Foods in Obesity (UFO) Project aimed at investigating the potential mechanisms for the effects of UPFs in facilitating pediatric obesity, focusing on the direct role of advanced glycation end-products (AGEs) on mitochondrial function, the key regulator of obesity pathophysiology. We comparatively investigated the daily dietary intake of UPFs, energy, nutrients, dietary AGEs [Nε -(carboxymethyl)lysine (CML), Nε -(1-carboxyethyl)lysine (CEL), and Nδ -(5-hydro-5- methyl-4-imidazolon-2-yl)-ornithine (MG-H1)] in 53 obese patients and in 100 healthy controls visiting the Tertiary Center for Pediatric Nutrition of the Department of Translational Medical Science at the University of Naples "Federico II". AGEs skin accumulation and mitochondrial function in peripheral blood mononuclear cells (PBMCs) were also assessed. A higher intake of UPFs and AGEs, energy, protein, fat, and saturated fatty acids was observed in obese patients. Obese children presented significantly higher skin AGEs accumulation and alterations in mitochondrial metabolism. PBMCs from healthy controls exposed to AGEs showed the same mitochondrial alterations observed in patients. These findings support the UPFs role in pediatric obesity, and the need for dietary strategies limiting UPFs exposure for obesity prevention and treatment.
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Affiliation(s)
- Serena Coppola
- Department of Translational Medical Science, University Federico II, Naples, Italy
- ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | - Lorella Paparo
- Department of Translational Medical Science, University Federico II, Naples, Italy
- ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | | | | | - Antonio Masino
- Department of Translational Medical Science, University Federico II, Naples, Italy
- ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | - Anna Fiorenza De Giovanni Di Santa Severina
- Department of Translational Medical Science, University Federico II, Naples, Italy
- ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | - Mariapina Cerulo
- Department of Translational Medical Science, University Federico II, Naples, Italy
| | - Maria Escolino
- Department of Translational Medical Science, University Federico II, Naples, Italy
| | - Assunta Turco
- Department of Translational Medical Science, University Federico II, Naples, Italy
| | - Ciro Esposito
- Department of Translational Medical Science, University Federico II, Naples, Italy
| | | | - Roberto Berni Canani
- Department of Translational Medical Science, University Federico II, Naples, Italy.
- ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy.
- European Laboratory for the Investigation of Food-Induced Diseases, University Federico II, Naples, Italy.
- Task Force for Microbiome Studies, University Federico II, Naples, Italy.
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Coppola S, Carucci L, Oglio F, Di Sarra C, Ozen G, Berni Canani R. Nutritional Strategies for the Prevention and Management of Cow's Milk Allergy in the Pediatric Age. Nutrients 2023; 15:3328. [PMID: 37571266 PMCID: PMC10421120 DOI: 10.3390/nu15153328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/22/2023] [Accepted: 07/23/2023] [Indexed: 08/13/2023] Open
Abstract
Cow's milk allergy (CMA) is one of the most common pediatric food allergies. The prevalence and severity of CMA have increased dramatically in the last decades, under the pressure of environmental factors in genetically predisposed individuals. Among the environmental influences, nutritional factors play a crucial role. Diet is the most modifiable factor, representing a potential target for the prevention and treatment of CMA. In this review, we report the most scientific-based nutritional strategies for preventing and managing pediatric CMA. In addition, we propose the most complete supplement of compounds able to prevent nutrient deficiencies in CMA pediatric patients and to positively influence the disease course.
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Affiliation(s)
- Serena Coppola
- Department of Translational Medical Science, University of Naples Federico II, 80131 Naples, Italy; (S.C.); (L.C.); (F.O.); (C.D.S.); (G.O.)
- Immunonutrition Lab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, 80131 Naples, Italy
| | - Laura Carucci
- Department of Translational Medical Science, University of Naples Federico II, 80131 Naples, Italy; (S.C.); (L.C.); (F.O.); (C.D.S.); (G.O.)
- Immunonutrition Lab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, 80131 Naples, Italy
| | - Franca Oglio
- Department of Translational Medical Science, University of Naples Federico II, 80131 Naples, Italy; (S.C.); (L.C.); (F.O.); (C.D.S.); (G.O.)
- Immunonutrition Lab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, 80131 Naples, Italy
| | - Claudia Di Sarra
- Department of Translational Medical Science, University of Naples Federico II, 80131 Naples, Italy; (S.C.); (L.C.); (F.O.); (C.D.S.); (G.O.)
- Immunonutrition Lab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, 80131 Naples, Italy
| | - Gulsum Ozen
- Department of Translational Medical Science, University of Naples Federico II, 80131 Naples, Italy; (S.C.); (L.C.); (F.O.); (C.D.S.); (G.O.)
| | - Roberto Berni Canani
- Department of Translational Medical Science, University of Naples Federico II, 80131 Naples, Italy; (S.C.); (L.C.); (F.O.); (C.D.S.); (G.O.)
- Immunonutrition Lab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, 80131 Naples, Italy
- European Laboratory for the Investigation of Food-Induced Diseases, University of Naples Federico II, 80131 Naples, Italy
- Task Force for Microbiome Studies, University of Naples Federico II, 80131 Naples, Italy
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Carucci L, Votto M, Licari A, Marseglia GL, Berni Canani R. Food allergy: cause or consequence of pediatric eosinophilic esophagitis? Potential implications of ultraprocessed foods in prevention and management. Front Allergy 2023; 4:1138400. [PMID: 37456790 PMCID: PMC10344695 DOI: 10.3389/falgy.2023.1138400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 06/12/2023] [Indexed: 07/18/2023] Open
Abstract
Eosinophilic esophagitis (EoE) is a chronic, immune-mediated disease characterized by eosinophilic infiltration, leading to esophageal dysfunction, inflammation, and fibrotic remodeling. In the last few decades, there has been an increased prevalence of EoE at an alarming rate in the pediatric age. The pathogenesis of EoE is still largely undefined, and this limits the definition of effective strategies for the prevention and management of this condition. EoE is considered a multifactorial disease arising from a negative interaction between environmental factors and genetic background, causing an impaired esophageal epithelial barrier with subsequent abnormal allergen exposure activating type 2 (Th2) inflammation. Food antigens have been suggested as key players in Th2 inflammation in pediatric patients with EoE, but emerging evidence suggests a potential role of other dietary factors, including ultraprocessed foods, as possible triggers for the occurrence of EoE. In this paper, we discuss the potential role of these dietary factors in the development of the disease, and we propose a new approach for the management of pediatric patients with EoE.
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Affiliation(s)
- Laura Carucci
- Department of Translational Medical Science, University of Naples “Federico II,”Naples, Italy
- ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples “Federico II,”Naples, Italy
| | - Martina Votto
- Pediatric Unit, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Amelia Licari
- Pediatric Unit, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Gian Luigi Marseglia
- Pediatric Unit, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
- Pediatric Clinic, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Roberto Berni Canani
- Department of Translational Medical Science, University of Naples “Federico II,”Naples, Italy
- ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, 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
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Ağagündüz D, Cocozza E, Cemali Ö, Bayazıt AD, Nanì MF, Cerqua I, Morgillo F, Saygılı SK, Berni Canani R, Amero P, Capasso R. Understanding the role of the gut microbiome in gastrointestinal cancer: A review. Front Pharmacol 2023; 14:1130562. [PMID: 36762108 PMCID: PMC9903080 DOI: 10.3389/fphar.2023.1130562] [Citation(s) in RCA: 43] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 01/10/2023] [Indexed: 01/26/2023] Open
Abstract
Gastrointestinal cancer represents one of the most diagnosed types of cancer. Cancer is a genetic and multifactorial disease, influenced by the host and environmental factors. It has been stated that 20% of cancer is caused by microorganisms such as Helicobacter pylori, hepatitis B and C virus, and human papillomavirus. In addition to these well-known microorganisms associated with cancer, it has been shown differences in the composition of the microbiota between healthy individuals and cancer patients. Some studies have suggested the existence of the selected microorganisms and their metabolites that can promote or inhibit tumorigenesis via some mechanisms. Recent findings have shown that gut microbiome and their metabolites can act as cancer promotors or inhibitors. It has been shown that gastrointestinal cancer can be caused by a dysregulation of the expression of non-coding RNA (ncRNA) through the gut microbiome. This review will summarize the latest reports regarding the relationship among gut microbiome, ncRNAs, and gastrointestinal cancer. The potential applications of diagnosing and cancer treatments will be discussed.
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Affiliation(s)
- Duygu Ağagündüz
- Department of Nutrition and Dietetics, Gazi University, Emek, Ankara, Turkey
| | | | - Özge Cemali
- Department of Nutrition and Dietetics, Gazi University, Emek, Ankara, Turkey
| | - Ayşe Derya Bayazıt
- Department of Nutrition and Dietetics, Gazi University, Emek, Ankara, Turkey
| | | | - Ida Cerqua
- Department of Pharmacy, University of Naples “Federico II”, Naples, Italy
| | - Floriana Morgillo
- Medical Oncology, Department of Precision Medicine, Università degli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
| | - Suna Karadeniz Saygılı
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States,Department of Histology and Embryology, Kütahya Health Sciences University, Kütahya, Turkey
| | - Roberto Berni Canani
- Department of Translational Medical Science and ImmunoNutritionLab at CEINGE Biotechnologies Research Center and Task Force for Microbiome Studies, University of Naples Federico II, Naples, Italy
| | - Paola Amero
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States,*Correspondence: Raffaele Capasso, ; Paola Amero,
| | - Raffaele Capasso
- Department of Agricultural Sciences, University of Naples Federico II, Portici, Italy,*Correspondence: Raffaele Capasso, ; Paola Amero,
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17
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Coppola S, Carucci L, De Michele R, Berni Canani R. The potential role of preventive and therapeutic immunonutrition strategies for pediatric food allergy: A mini-review. Front Nutr 2022; 9:1050554. [DOI: 10.3389/fnut.2022.1050554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 11/01/2022] [Indexed: 12/05/2022] Open
Abstract
Food allergy (FA) represents one of the main chronic conditions of the pediatric population. The gut microbiome (GM)-immune system axis is a milestone in affecting FA susceptibility. The dynamic and bidirectional crosstalk between the GM and immune system starts early in life, and it is deeply modulated during the first 1,000 days of life. Nutritional factors during this crucial period mainly influence the proper GM-immune system development and function across the lifespan, with potential beneficial or detrimental effects on health status. Immunonutrition strategies, applied from conception, could represent an innovative target for prevention and treatment of pediatric FA. Here we described the potential role of preventive and therapeutic immunonutrition strategies for pediatric FA, highlighting putative future perspectives in this field.
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Coppola S, Nocerino R, Paparo L, Bedogni G, Calignano A, Di Scala C, de Giovanni di Santa Severina AF, De Filippis F, Ercolini D, Berni Canani R. Therapeutic Effects of Butyrate on Pediatric Obesity: A Randomized Clinical Trial. JAMA Netw Open 2022; 5:e2244912. [PMID: 36469320 PMCID: PMC9855301 DOI: 10.1001/jamanetworkopen.2022.44912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
IMPORTANCE The pediatric obesity disease burden imposes the necessity of new effective strategies. OBJECTIVE To determine whether oral butyrate supplementation as an adjunct to standard care is effective in the treatment of pediatric obesity. DESIGN, SETTING, AND PARTICIPANTS A randomized, quadruple-blind, placebo-controlled trial was performed from November 1, 2020, to December 31, 2021, at the Tertiary Center for Pediatric Nutrition, Department of Translational Medical Science, University of Naples Federico II, Naples, Italy. Participants included children aged 5 to 17 years with body mass index (BMI) greater than the 95th percentile. INTERVENTIONS Standard care for pediatric obesity supplemented with oral sodium butyrate, 20 mg/kg body weight per day, or placebo for 6 months was administered. MAIN OUTCOMES AND MEASURES The main outcome was the decrease of at least 0.25 BMI SD scores at 6 months. The secondary outcomes were changes in waist circumference; fasting glucose, insulin, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglyceride, ghrelin, microRNA-221, and interleukin-6 levels; homeostatic model assessment of insulin resistance (HOMA-IR); dietary and lifestyle habits; and gut microbiome structure. Intention-to-treat analysis was conducted. RESULTS Fifty-four children with obesity (31 girls [57%], mean [SD] age, 11 [2.91] years) were randomized into the butyrate and placebo groups; 4 were lost to follow-up after receiving the intervention in the butyrate group and 2 in the placebo group. At intention-to-treat analysis (n = 54), children treated with butyrate had a higher rate of BMI decrease greater than or equal to 0.25 SD scores at 6 months (96% vs 56%, absolute benefit increase, 40%; 95% CI, 21% to 61%; P < .01). At per-protocol analysis (n = 48), the butyrate group showed the following changes as compared with the placebo group: waist circumference, -5.07 cm (95% CI, -7.68 to -2.46 cm; P < .001); insulin level, -5.41 μU/mL (95% CI, -10.49 to -0.34 μU/mL; P = .03); HOMA-IR, -1.14 (95% CI, -2.13 to -0.15; P = .02); ghrelin level, -47.89 μg/mL (95% CI, -91.80 to -3.98 μg/mL; P < .001); microRNA221 relative expression, -2.17 (95% CI, -3.35 to -0.99; P < .001); and IL-6 level, -4.81 pg/mL (95% CI, -7.74 to -1.88 pg/mL; P < .001). Similar patterns of adherence to standard care were observed in the 2 groups. Baseline gut microbiome signatures predictable of the therapeutic response were identified. Adverse effects included transient mild nausea and headache reported by 2 patients during the first month of butyrate intervention. CONCLUSIONS AND RELEVANCE Oral butyrate supplementation may be effective in the treatment of pediatric obesity. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04620057.
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Affiliation(s)
- Serena Coppola
- Department of Translational Medical Science, University of Naples “Federico II,” Naples, Italy
- ImmunoNutritionLab, CEINGE-Advanced Biotechnologies, University of Naples “Federico II,” Naples, Italy
| | - Rita Nocerino
- Department of Translational Medical Science, University of Naples “Federico II,” Naples, Italy
- ImmunoNutritionLab, CEINGE-Advanced Biotechnologies, University of Naples “Federico II,” Naples, Italy
| | - Lorella Paparo
- Department of Translational Medical Science, University of Naples “Federico II,” Naples, Italy
- ImmunoNutritionLab, 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
| | - Antonio Calignano
- Department of Pharmacy, University of Naples “Federico II,” Naples, Italy
| | - Carmen Di Scala
- Department of Translational Medical Science, University of Naples “Federico II,” Naples, Italy
- ImmunoNutritionLab, 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, CEINGE-Advanced Biotechnologies, University of Naples “Federico II,” Naples, Italy
| | - Francesca De Filippis
- Task Force on Microbiome Studies, University of Naples “Federico II,” Naples, Italy
- Department of Agricultural Sciences, University of Naples “Federico II,” Naples, Italy
| | - Danilo Ercolini
- Task Force on Microbiome Studies, University of Naples “Federico II,” Naples, Italy
- Department of Agricultural Sciences, University of Naples “Federico II,” Naples, Italy
| | - Roberto Berni Canani
- Department of Translational Medical Science, University of Naples “Federico II,” Naples, Italy
- ImmunoNutritionLab, CEINGE-Advanced Biotechnologies, University of Naples “Federico II,” Naples, Italy
- Task Force on Microbiome Studies, University of Naples “Federico II,” Naples, Italy
- European Laboratory for the Investigation of Food-Induced Diseases, University of Naples “Federico II,” Naples, Italy
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19
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Coppola S, Paparo L, Chiariotti L, Ercolini D, Nocerino R, de Giovanni di Santa Severina AF, Carucci L, De Filippis F, Agangi A, Napolitano M, Passariello A, Messina F, Berni Canani R. Effects of the Mediterranean Diet during pregnancy on the onset of allergy in at risk children: A study protocol of a multi-center, randomized- controlled, parallel groups, prospective trial (the PREMEDI study). Front Nutr 2022; 9:951223. [PMID: 36313083 PMCID: PMC9608559 DOI: 10.3389/fnut.2022.951223] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 09/23/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction Maternal diet during pregnancy has been linked to offspring allergy risk and it could represent a potential target for allergy prevention. The Mediterranean Diet (MD) is considered one of the healthiest dietary models. Randomized-controlled trials on the effect of MD in preventing pediatric allergic diseases are still needed. Methods and analysis The Mediterranean Diet during Pregnancy study (PREMEDI) will be a 9-month multi-center, randomized-controlled, parallel groups, prospective trial. Healthy women (20–35 years) at their first trimester of pregnancy at risk for atopy baby, will be randomly allocated to Group 1 (standard obstetrical and gynecological follow-up and nutritional counseling to promote MD) or Group 2 (standard obstetrical and gynecological follow-up alone). 138 mother-child pair per group will be needed to detect a reduction in cumulative incidence of ≥1 allergic disease at 24 months of age. The primary study aim will be the evaluation of the occurrence of allergic disorders in the first 24 months of life. The secondary aims will be the evaluation of maternal weight gain, pregnancy/perinatal complications, growth indices and occurrence of other chronic disorders, mother-child pair adherence to MD and gut microbiome features, breastfeeding duration and breast milk composition, epigenetic modulation of genes involved in immune system, and metabolic pathways in the offspring. Ethics and dissemination The study protocol has been approved by the Ethics Committee of the University of Naples Federico II (number 283/21) and it will be conducted in accordance with the Helsinki Declaration (Fortaleza revision, 2013), the Good Clinical Practice Standards (CPMP/ICH/135/95), the Italian Decree-Law 196/2003 regarding personal data and the European regulations on this subject. The study has been registered in the Clinical Trials Protocol Registration System. Clinical trial registration [http://clinicaltrials.gov], identifier [NCT05119868].
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Affiliation(s)
- Serena Coppola
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy,CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Lorella Paparo
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy,CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Lorenzo Chiariotti
- CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy,Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples, Italy
| | - Danilo Ercolini
- Task Force on Microbiome Studies, University of Naples Federico II, Naples, Italy,Department of Agricultural Sciences, University of Naples Federico II, Naples, Italy
| | - Rita Nocerino
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy,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,CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Laura Carucci
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy,CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Francesca De Filippis
- Task Force on Microbiome Studies, University of Naples Federico II, Naples, Italy,Department of Agricultural Sciences, University of Naples Federico II, Naples, Italy
| | - Annalisa Agangi
- Neonatal Intensive Care Unit, Betania Evangelical Hospital, Naples, Italy
| | | | - Annalisa Passariello
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy,Department of Pediatric Cardiology, Monaldi Hospital, Naples, Italy
| | - Francesco Messina
- Neonatal Intensive Care Unit, Betania Evangelical Hospital, Naples, Italy
| | - Roberto Berni Canani
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy,CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy,*Correspondence: Roberto Berni Canani,
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20
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Meyer R, Vandenplas Y, Lozinsky AC, Vieira MC, Canani RB, Dupont C, Uysal P, Cavkaytar O, Knibb R, Fleischer DM, Nowak-Wegrzyn A, Venter C. Diagnosis and management of food allergy-associated gastroesophageal reflux disease in young children-EAACI position paper. Pediatr Allergy Immunol 2022; 33:e13856. [PMID: 36282131 DOI: 10.1111/pai.13856] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/26/2022] [Accepted: 09/06/2022] [Indexed: 11/06/2022]
Abstract
Gastro-oesophageal reflux (GOR) and food allergy (FA) are common conditions, especially during the first 12 months of life. When GOR leads to troublesome symptoms, that affect the daily functioning of the infant and family, it is referred to as GOR disease (GORD). The role of food allergens as a cause of GORD remains controversial. This European Academy of Allergy and Clinical Immunology (EAACI) position paper aims to review the evidence for FA-associated GORD in young children and translate this into clinical practice that guides healthcare professionals through the diagnosis of suspected FA-associated GORD and medical and dietary management. The task force (TF) on non-IgE mediated allergy consists of EAACI experts in paediatric gastroenterology, allergy, dietetics and psychology from Europe, United Kingdom, United States, Turkey and Brazil. Six clinical questions were formulated, amended and approved by the TF to guide this publication. A systematic literature search using PubMed, Cochrane and EMBASE databases (until June 2021) using predefined inclusion criteria based on the 6 questions was used. The TF also gained access to the database from the European Society of Paediatric Gastroenterology and Hepatology working group, who published guidelines on GORD and ensured that all publications used within that position paper were included. For each of the 6 questions, practice points were formulated, followed by a modified Delphi method consisting of anonymous web-based voting that was repeated with modified practice points where required, until at least 80% consensus for each practice point was achieved. This TF position paper shares the process, the discussion and consensus on all practice points on FA-associated GORD.
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Affiliation(s)
- Rosan Meyer
- Faculty of Medicine, KU Leuven, Leuven, Belgium.,Department Nutrition and Dietetics, Winchester University, Winchester, London, UK.,Department Paediatrics, Imperial College, London, UK
| | - Yvan Vandenplas
- KidZ Health Castle, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Adriana Chebar Lozinsky
- Department of Allergy and Immune Disorders, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Mario C Vieira
- Department of Paediatrics-Pontifical Catholic University of Paraná and Center for Pediatric Gastroenterology-Hospital Pequeno Príncipe, Curitiba, Brazil
| | - Roberto Berni Canani
- Department of Translational Medical Science and ImmunoNutritionLab at CEINGE-Advanced Biotechnologies Research Center, University of Naples "Federico II", Naples, Italy
| | - Christophe Dupont
- Department of Paediatric Gastroenterology, Necker University Children Hospital, Paris, France
| | - Pinar Uysal
- Department of Allergy and Clinical Immunology, Adnan Menderes University, Aydin, Turkey
| | - Ozlem Cavkaytar
- Department of Pediatric Allergy and Immunology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
| | - Rebecca Knibb
- School of Psychology, Aston University, Birmingham, UK
| | - David M Fleischer
- University of Colorado Denver School of Medicine, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Anna Nowak-Wegrzyn
- Department of Pediatrics, NYU Grossman School of Medicine, New York City, New York, USA.,Department of Pediatrics, Gastroenterology and Nutrition, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
| | - Carina Venter
- University of Colorado Denver School of Medicine Children's Hospital Colorado, Aurora, Colorado, USA
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Nocerino R, Coppola S, Carucci L, Paparo L, De Giovanni Di Santa Severina AF, Berni Canani R. Body growth assessment in children with IgE-mediated cow's milk protein allergy fed with a new amino acid-based formula. Front Allergy 2022; 3:977589. [PMID: 36133404 PMCID: PMC9483007 DOI: 10.3389/falgy.2022.977589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 08/15/2022] [Indexed: 11/13/2022] Open
Abstract
Background Amino acid-based formula (AAF) is a relevant dietary option for non-breastfed children. The present study was designed to evaluate the body growth pattern in cow's milk protein allergy (CMPA) children treated for 6 months with a new AAF. Methods This was an open-label, single arm study evaluating body growth pattern in immunoglobulin E (IgE)-mediated CMPA infants receiving a new AAF for 6 months. The outcomes were anthropometry (weight, length, head circumference), adherence to the study formula and occurrence of adverse events (AEs). Results Fifteen children [all Caucasian and born at term; 53.3% born with spontaneous delivery; 80% male; 80% with familial allergy risk; mean age (±SD) 3 ± 2.5 months at IgE-mediated CMPA diagnosis; mean age (±SD) 16.7 ± 5.9 months at enrolment, mean total serum IgE (±SD) 298.2 ± 200.4 kU/L] were included and completed the 6-month study. Data from fifteen age- and sex-matched healthy controls were also adopted as comparison. At baseline, all CMPA patients were weaned and were receiving the new AAF. All 15 patients completed the 6-month study period. For the entire CMPA pediatric patients’ cohort, from baseline to the end of the study period, the body growth pattern resulted within the normal range of World Health Organization (WHO) growth references and resulted similar to healthy controls anthropometric values. The formula was well tolerated. The adherence was optimal and no AEs related to AAF use were reported. Conclusions The new AAF ensured normal growth in subjects affected by IgE-mediated CMPA. This formula constitutes another suitable safe option for the management of pediatric patients affected by CMPA.
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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
| | - Lorella Paparo
- 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
| | - 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
- Correspondence: Roberto Berni Canani
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22
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Carucci L, Nocerino R, Paparo L, De Filippis F, Coppola S, Giglio V, Cozzolino T, Valentino V, Sequino G, Bedogni G, Russo R, Ercolini D, Berni Canani R. Therapeutic effects elicited by the probiotic Lacticaseibacillus rhamnosus GG in children with atopic dermatitis. The results of the ProPAD trial. Pediatr Allergy Immunol 2022; 33:e13836. [PMID: 36003050 PMCID: PMC9542056 DOI: 10.1111/pai.13836] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 07/08/2022] [Accepted: 07/11/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Atopic dermatitis (AD) is a chronic inflammatory skin disease affecting up to 20% of the pediatric population associated with alteration of skin and gut microbiome. Probiotics have been proposed for AD treatment. The ProPAD study aimed to investigate the therapeutic effects of the probiotic Lacticaseibacillus rhamnosus GG (LGG) in children with AD. METHODS In total, 100 AD patients aged 6-36 months were enrolled in a randomized, double-blind, controlled trial to receive placebo (Group A) or LGG (1 x 1010 CFU/daily) (Group B) for 12 weeks. The primary outcome was the evaluation of the efficacy of LGG supplementation on AD severity comparing the Scoring Atopic Dermatitis (SCORAD) index at baseline (T0) and at 12-week (T12). A reduction of ≥8.7 points on the SCORAD index was considered as minimum clinically important difference (MCID). The secondary outcomes were the SCORAD index evaluation at 4-week (T16) after the end of LGG treatment, number of days without rescue medications, changes in Infant Dermatitis Quality Of Life questionnaire (IDQOL), gut microbiome structure and function, and skin microbiome structure. RESULTS The rate of subjects achieving MCID at T12 and at T16 was higher in Group B (p < .05), and remained higher at T16 (p < .05)The number of days without rescue medications was higher in Group B. IDQOL improved at T12 in the Group B (p < .05). A beneficial modulation of gut and skin microbiome was observed only in Group B patients. CONCLUSIONS The probiotic LGG could be useful as adjunctive therapy in pediatric AD. The beneficial effects on disease severity and quality of life paralleled with a beneficial modulation of gut and skin microbiome.
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Affiliation(s)
- Laura Carucci
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy
| | - Rita Nocerino
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy
| | - Lorella Paparo
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy
| | - Francesca De Filippis
- Department of Agricultural Sciences, University of Naples Federico II, Naples, Italy.,Task Force on Microbiome Studies University of Naples Federico II, Naples, Italy
| | - Serena Coppola
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy
| | - Veronica Giglio
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy
| | - Tommaso Cozzolino
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy
| | - Vincenzo Valentino
- Department of Agricultural Sciences, University of Naples Federico II, Naples, Italy
| | - Giuseppina Sequino
- Department of Agricultural Sciences, University of Naples Federico II, Naples, Italy
| | - Giorgio Bedogni
- Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy.,Internal Medicine, S. Maria delle Croci Hospital, AUSL Romagna, Ravenna, Italy
| | - Roberto Russo
- Department of Pharmacy, University of Naples Federico II, Naples, Italy
| | - Danilo Ercolini
- Department of Agricultural Sciences, University of Naples Federico II, Naples, Italy.,Task Force on Microbiome Studies University of Naples Federico II, Naples, Italy
| | - Roberto Berni Canani
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy.,Task Force on Microbiome Studies University of Naples Federico II, Naples, Italy.,European Laboratory for the Investigation of Food-Induced Diseases, University of Naples Federico II, Naples, Italy
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23
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Berni Canani R, Caffarelli C, Calvani M, Martelli A, Carucci L, Cozzolino T, Alvisi P, Agostoni C, Lionetti P, Marseglia GL. Diagnostic therapeutic care pathway for pediatric food allergies and intolerances in Italy: a joint position paper by the Italian Society for Pediatric Gastroenterology Hepatology and Nutrition (SIGENP) and the Italian Society for Pediatric Allergy and Immunology (SIAIP). Ital J Pediatr 2022; 48:87. [PMID: 35689252 PMCID: PMC9188074 DOI: 10.1186/s13052-022-01277-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 05/10/2022] [Indexed: 11/10/2022] Open
Abstract
Epidemiologic data suggest an increased prevalence of pediatric food allergies and intolerances (FAIs) during the last decades. This changing scenario has led to an increase in the overall healthcare costs, due to a growing demand for diagnostic and treatment services. There is the need to establish Evidence-based practices for diagnostic and therapeutic intervention that could be adopted in the context of public health policies for FAIs are needed. This joint position paper has been prepared by a group of experts in pediatric gastroenterology, allergy and nutrition from the Italian Society for Pediatric Gastroenterology Hepatology and Nutrition (SIGENP) and the Italian Society for Pediatric Allergy and Immunology (SIAIP). The paper is focused on the Diagnostic Therapeutic Care Pathway (DTCP) for pediatric FAIs in Italy.
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Affiliation(s)
- Roberto Berni Canani
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy. .,CEINGE-Biotecnologie Avanzate s.c.ar.l. 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.
| | - Carlo Caffarelli
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Mauro Calvani
- Pediatric Unit, S. Camillo Forlanini Hospital, Rome, Italy
| | - Alberto Martelli
- Department of Pediatrics, G. Salvini Hospital, Garbagnate Milanese, Milan, Italy
| | - Laura Carucci
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,CEINGE-Biotecnologie Avanzate s.c.ar.l. University of Naples Federico II, Naples, Italy
| | - Tommaso Cozzolino
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,CEINGE-Biotecnologie Avanzate s.c.ar.l. University of Naples Federico II, Naples, Italy
| | - Patrizia Alvisi
- Pediatric Gastroenterology Unit, Maggiore Hospital, Bologna, Italy
| | - Carlo Agostoni
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Pediatric Intermediate Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paolo Lionetti
- Pediatric Gastroenterology and Nutrition Unit, Meyer Children's Hospital, Florence, Italy
| | - Gian Luigi Marseglia
- Pediatric Clinic, IRCCS "S. Matteo" Foundation, University of Pavia, Pavia, Italy
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24
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Bruno C, Paparo L, Pisapia L, Romano A, Cortese M, Punzo E, Berni Canani R. Protective effects of the postbiotic deriving from cow's milk fermentation with L. paracasei CBA L74 against Rotavirus infection in human enterocytes. Sci Rep 2022; 12:6268. [PMID: 35428750 PMCID: PMC9012738 DOI: 10.1038/s41598-022-10083-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 03/11/2022] [Indexed: 01/17/2023] Open
Abstract
Rotavirus (RV) is the leading cause of acute gastroenteritis-associated mortality in early childhood. Emerging clinical evidence suggest the efficacy of the postbiotic approach based on cow's milk fermentation with the probiotic Lacticaseibacillus paracasei CBAL74 (FM-CBAL74) in preventing pediatric acute gastroenteritis, but the mechanisms of action are still poorly characterized. We evaluated the protective action of FM-CBAL74 in an in vitro model of RV infection in human enterocytes. The number of infected cells together with the relevant aspects of RV infection were assessed: epithelial barrier damage (tight-junction proteins and transepithelial electrical resistance evaluation), and inflammation (reactive oxygen species, pro-inflammatory cytokines IL-6, IL-8 and TNF-α, and mitogen-activated protein kinase pathway activation). Pre-incubation with FM-CBA L74 resulted in an inhibition of epithelial barrier damage and inflammation mediated by mitogen-activated protein kinase pathway activation induced by RV infection. Modulating several protective mechanisms, the postbiotic FM-CBAL74 exerted a preventive action against RV infection. This approach could be a disrupting nutritional strategy against one of the most common killers for the pediatric age.
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Affiliation(s)
- Cristina Bruno
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Lorella Paparo
- 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 Pisapia
- Institute of Genetics and Biophysics, CNR, Naples, Italy
| | - Alessia Romano
- ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Maddalena Cortese
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Erika Punzo
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, 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. .,Task Force for Nutraceuticals and Functional Foods, University of Naples Federico II, Naples, Italy.
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25
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D'Auria E, Berni Canani R, Zuccotti GV. Editorial: Dietary Interventions and Nutritional Factors in the Prevention of Allergic Diseases in Infants. Front Pediatr 2022; 10:866894. [PMID: 35311048 PMCID: PMC8927865 DOI: 10.3389/fped.2022.866894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 02/11/2022] [Indexed: 12/03/2022] Open
Affiliation(s)
- Enza D'Auria
- Department of Pediatrics-Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy.,Department of Translational Medical Science-Pediatric Section, University "Federico II", Naples, Italy
| | - Roberto Berni Canani
- Department of Translational Medical Science-Pediatric Section, University "Federico II", Naples, Italy.,ImmunoNutrition Lab at CEINGE-Advanced Biotechnologies, University "Federico II", Naples, Italy.,European Laboratory for the Investigation of Food-Induced Diseases, University "Federico II", Naples, Italy
| | - Gian Vincenzo Zuccotti
- Department of Pediatrics-Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy.,Department of Biomedical and Clinical Science Luigi Sacco, Milan, Italy
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26
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Paparo L, Bruno C, Ferrucci V, Punto E, Viscardi M, Fusco G, Cerino P, Romano A, Zollo M, Berni Canani R. Protective effects elicited by cow milk fermented with L. Paracasei CBAL74 against SARS-CoV-2 infection in human enterocytes. J Funct Foods 2021; 87:104787. [PMID: 34630633 PMCID: PMC8491972 DOI: 10.1016/j.jff.2021.104787] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/21/2021] [Accepted: 09/30/2021] [Indexed: 01/06/2023] Open
Abstract
Fermented foods have been proposed in limiting SARS-CoV-2 infection. Emerging evidence suggest the efficacy of cow's milk fermented with the probiotic L. paracasei CBAL74 (FM-CBAL74) in preventing infectious diseases. We evaluated the protective action of FM-CBAL74 against SARS-CoV-2 infection in human enterocytes. Relevant aspects of SARS-CoV-2 infection were assessed: infectivity, host functional receptor angiotensin-converting enzyme-2 (ACE2), transmembrane protease serine 2 (TMPRSS2), and pro-inflammatory cytokines expression (IL-6, IL-15, IL-1β, VEGFβ, TNF-α, MCP-1, CXCL1). Pre-incubation with FM-CBA L74 reduced the number of infected cells. The expression of ACE2 and the pro-inflammatory cytokines IL-6, VEGFβ, IL-15, IL-1β was downregulated by the pre-treatment with this fermented food. No effect on TMPRSS2, MCP-1, TNF-α and CXCL1 expression was observed. Modulating the crucial aspects of the infection, the fermented food FM-CBAL74 exerts a preventive action against SARS-CoV-2. These evidence could pave the way to innovative nutritional strategy to mitigate the COVID-19.
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Affiliation(s)
- Lorella Paparo
- Department of Translational Medical Science, University of Naples, "Federico II", Naples, Italy
- CEINGE - Advanced Biotechnologies Research Center s.c.ar.l., University of Naples "Federico II", Naples, Italy
| | - Cristina Bruno
- Department of Translational Medical Science, University of Naples, "Federico II", Naples, Italy
- CEINGE - Advanced Biotechnologies Research Center s.c.ar.l., University of Naples "Federico II", Naples, Italy
| | - Veronica Ferrucci
- CEINGE - Advanced Biotechnologies Research Center s.c.ar.l., University of Naples "Federico II", Naples, Italy
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche (DMMBM), University of Naples "Federico II", Naples, Italy
| | - Erika Punto
- Department of Translational Medical Science, University of Naples, "Federico II", Naples, Italy
- CEINGE - Advanced Biotechnologies Research Center s.c.ar.l., University of Naples "Federico II", Naples, Italy
| | - Maurizio Viscardi
- DAI Medicina di Laboratorio e Trasfusionale, AOU Azienda Ospedaliera, University of Naples "Federico II", Naples, Italy
| | - Giovanna Fusco
- DAI Medicina di Laboratorio e Trasfusionale, AOU Azienda Ospedaliera, University of Naples "Federico II", Naples, Italy
| | - Pellegrino Cerino
- DAI Medicina di Laboratorio e Trasfusionale, AOU Azienda Ospedaliera, University of Naples "Federico II", Naples, Italy
| | - Alessia Romano
- CEINGE - Advanced Biotechnologies Research Center s.c.ar.l., University of Naples "Federico II", Naples, Italy
| | - Massimo Zollo
- CEINGE - Advanced Biotechnologies Research Center s.c.ar.l., University of Naples "Federico II", Naples, Italy
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche (DMMBM), University of Naples "Federico II", Naples, Italy
| | - Roberto Berni Canani
- Department of Translational Medical Science, University of Naples, "Federico II", Naples, Italy
- CEINGE - Advanced Biotechnologies Research Center s.c.ar.l., 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
- Task Force for Nutraceuticals and Functional Foods, University of Naples "Federico II", Naples, Italy
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27
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Norsa L, Berni Canani R, Duclaux-Loras R, Bequet E, Köglmeier J, Russell RK, Uhlig HH, Travis S, Hollis J, Koletzko S, Grimaldi G, Castaldo G, Rodrigues A, Deflandre J, Dembinski L, Shah N, Heinz-Erian P, Janecke A, Leskinen S, Wedenoja S, Koskela R, Lachaux A, Kolho KL, Ruemmele FM. Inflammatory Bowel Disease in Patients with Congenital Chloride Diarrhoea. J Crohns Colitis 2021; 15:1679-1685. [PMID: 33770165 DOI: 10.1093/ecco-jcc/jjab056] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Congenital chloride diarrhoea [CLD] is a rare autosomal recessive disease caused by mutations in the solute family carrier 26 member 3 [SLC26A3] gene. Patients suffer from life-long watery diarrhoea and chloride loss. Inflammatory bowel disease [IBD] has been reported in individual patients with CLD and in scl26a3-deficient mice. METHODS We performed an international multicentre analysis to build a CLD cohort and to identify cases with IBD. We assessed clinical and genetic characteristics of subjects and studied the cumulative incidence of CLD-associated IBD. RESULTS In a cohort of 72 patients with CLD caused by 17 different SLC26A3 mutations, we identified 12 patients [17%] diagnosed with IBD. Nine patients had Crohn's disease, two ulcerative colitis and one IBD-unclassified [IBD-U]. The prevalence of IBD in our cohort of CLD was higher than the highest prevalence of IBD in Europe [p < 0.0001]. The age of onset was variable [13.5 years, interquartile range: 8.5-23.5 years]. Patients with CLD and IBD had lower z-score for height than those without IBD. Four of 12 patients had required surgery [ileostomy formation n = 2, ileocaecal resection due to ileocaecal valve stenosis n = 1 and colectomy due to stage II transverse colon cancer n = 1]. At last follow-up, 5/12 were on biologics [adalimumab, infliximab or vedolizumab], 5/12 on immunosuppressants [azathioprine or mercaptopurine], one on 5-ASA and one off-treatment. CONCLUSIONS A substantial proportion of patients with CLD develop IBD. This suggests the potential involvement of SL26A3-mediated anion transport in IBD pathogenesis. Patients with CLD-associated IBD may require surgery for treatment failure or colon cancer.
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Affiliation(s)
- Lorenzo Norsa
- Assistance Publique - Hôpitaux de Paris, Hôpital Necker Enfants Malades, Pediatric Gastroenterology Hepatology and Nutrition, Paris, France.,Pediatric Gastroenterology Hepatology and Transplantation, ASST Papa Giovanni XXIII, Bergamo, Italy.,Université de Paris, Faculté de Médecine, Paris, France
| | - Roberto Berni Canani
- Department of Translational Medical Science - Pediatric Section, University 'Federico II', Naples, Italy.,CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy.,European Laboratory for the Investigation of Food Induced Diseases, University 'Federico II', Naples, Italy
| | - Remi Duclaux-Loras
- Department of Paediatric Gastroenterology Hepatology and Nutrition, Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Bron, France.,CIRI unité Inserm U1111, ENS Lyon, France
| | - Emeline Bequet
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University Hospital Liège, Belgium
| | - Jutta Köglmeier
- Pediatric Gastroenterology Hepatology and Nutrition, Great Ormond Street Hospital for Sick Children, London, UK
| | - Richard K Russell
- Pediatric Gastroenterology Hepatology and Nutrition, Royal Hospital for Children, Glasgow, UK
| | - Holm H Uhlig
- Translational Gastroenterology Unit and Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Simon Travis
- Translational Gastroenterology Unit and Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Jennifer Hollis
- Translational Gastroenterology Unit and Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Sibylle Koletzko
- Division of Gastroenterology and Hepatology, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, Munich, Germany.,Department of Paediatrics, School of Medicine Collegium Medicum University of Warmia and Mazury, Olsztyn, Poland
| | - Giusi Grimaldi
- Department of Translational Medical Science - Pediatric Section, University 'Federico II', Naples, Italy
| | - Giuseppe Castaldo
- CEINGE Advanced Biotechnologies, University Federico II, Naples, Italy
| | - Astor Rodrigues
- Translational Gastroenterology Unit and Biomedical Research Centre, University of Oxford, Oxford, UK
| | | | - Lukasz Dembinski
- Department of Paediatrics, Gastroenterology and Nutrition, Medical University of Warsaw, Warsaw, Poland
| | - Neil Shah
- Pediatric Gastroenterology Hepatology and Nutrition, Great Ormond Street Hospital for Sick Children, London, UK
| | - Peter Heinz-Erian
- Department of Pediatrics I, Medical University of Innsbruck, Innsbruck, Austria
| | - Andreas Janecke
- Department of Pediatrics I, Medical University of Innsbruck, Innsbruck, Austria
| | - Saara Leskinen
- Department of Paediatric Gastroenterology, Kuopio University Hospital, Kuopio, Finland
| | - Satu Wedenoja
- Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Ritva Koskela
- Department of Internal Medicine, Oulu University Hospital, Oulu, Finland
| | - Alain Lachaux
- Department of Paediatric Gastroenterology Hepatology and Nutrition, Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Bron, France
| | - Kaija-Leena Kolho
- Department of Paediatric Gastroenterology, Children's Hospital and University of Helsinki, Helsinki, Finland and Tampere University, Tampere, Finland
| | - Frank M Ruemmele
- Assistance Publique - Hôpitaux de Paris, Hôpital Necker Enfants Malades, Pediatric Gastroenterology Hepatology and Nutrition, Paris, France
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28
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Nocerino R, Cecere G, Micillo M, De Marco G, Ferri P, Russo M, Bedogni G, Berni Canani R. Letter: ginger as anti-emetic for acute gastroenteritis in children: interpreting evidence gingerly. Authors' reply. Aliment Pharmacol Ther 2021; 54:860-861. [PMID: 34425012 DOI: 10.1111/apt.16557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
LINKED CONTENTThis article is linked to Nocerino et al and Philips & Abraham papers. To view these articles, visit https://doi.org/10.1111/apt.16404 and https://doi.org/10.1111/apt.16474
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Affiliation(s)
- Rita Nocerino
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- 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
| | - Giulio De Marco
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Pasqualina Ferri
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Mariateresa Russo
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Giorgio Bedogni
- CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
- Clinical Epidemiology Unit, Liver Research Center, Basovizza, Trieste, Italy
| | - Roberto Berni Canani
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- 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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29
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Carucci L, Coppola S, Luzzetti A, Voto L, Giglio V, Paparo L, Nocerino R, Berni Canani R. Immunonutrition for Pediatric Patients With Cow's Milk Allergy: How Early Interventions Could Impact Long-Term Outcomes. Front Allergy 2021; 2:676200. [PMID: 35386962 PMCID: PMC8974760 DOI: 10.3389/falgy.2021.676200] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 05/18/2021] [Indexed: 12/25/2022] Open
Abstract
Cow's milk allergy (CMA) is one of the most common food allergies and one of the main causes of food-induced anaphylaxis in the pediatric age. Moreover, up to 45% of CMA children develop other atopic manifestations later in life, a phenomenon commonly named atopic march. Thus, CMA imposes a significant cost to health care systems as well as to families, and has emerged as one of the most expensive allergic diseases. The immunonutrition strategy builds its foundation on the ability of selected dietary factors to modulate immune system development and function. Recent studies highlighted the potential of immunonutrition in the management of CMA. This review is focused on the mechanisms and long-term clinical outcomes of the immunonutrition approach in children with CMA.
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Affiliation(s)
- Laura Carucci
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunonutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy
- *Correspondence: Laura Carucci
| | - Serena Coppola
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunonutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy
| | - Anna Luzzetti
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunonutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy
| | - Luana Voto
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunonutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy
| | - Veronica Giglio
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunonutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy
| | - Lorella Paparo
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunonutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy
| | - Rita Nocerino
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunonutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy
| | - Roberto Berni Canani
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
- ImmunonutritionLab at the CEINGE Advanced Biotechnologies Research Center, 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
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30
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Nocerino R, Di Scala C, Coppola S, Giglio V, Carucci L, Cosenza L, Voto L, Iannicelli AM, Luzzetti A, Berni Canani R. Tolerability of a new amino acid-based formula for children with IgE-mediated cow's milk allergy. Ital J Pediatr 2021; 47:151. [PMID: 34217356 PMCID: PMC8254988 DOI: 10.1186/s13052-021-01096-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 05/31/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Amino acid-based formula (AAF) is a relevant dietary strategy for paediatric patients affected by cow's milk allergy (CMA). The present study was designed to evaluate the hypoallergenicity of a new AAF in children with immunoglobulin (Ig)E-mediated CMA. METHODS According to the criteria provided by the American Academy of Pediatrics Subcommittee on Nutrition and Allergic Diseases, we designed a prospective trial in CMA children (aged 1-36 months) aimed to demonstrate the hypoallergenicity of the new AAF in 90% of subjects with 95% confidence during the double-blind, placebo-controlled challenge (DBPCFC). A skin prick test (SPT) with the new AAF was also performed. RESULTS Twenty-nine children [all Caucasian, 55.2% male, mean age (±SD) 16.9 ± 5.7 months] were enrolled. The SPT and the DBPCFC with the new AAF were negative in all study subjects. CONCLUSIONS The study results support the hypoallergenicity of the new AAF. This formula could be considered an additional dietary option for non-breastfed children affected by CMA. TRIAL REGISTRATION The trial was registered in the ClinicalTrials.gov Protocol Registration System (ID number: NCT03909113 ).
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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
| | - Carmen Di Scala
- 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
| | - Veronica Giglio
- 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
| | - Linda Cosenza
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,ImmunoNutritionLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Luana Voto
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Anna Maria Iannicelli
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Anna Luzzetti
- Department of Translational Medical Science, University of Naples Federico II, Naples, 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, Via S. Pansini 5, 80131, Naples, Italy.
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Nocerino R, Cecere G, Micillo M, De Marco G, Ferri P, Russo M, Bedogni G, Berni Canani R. Efficacy of ginger as antiemetic in children with acute gastroenteritis: a randomised controlled trial. Aliment Pharmacol Ther 2021; 54:24-31. [PMID: 34018223 PMCID: PMC8252074 DOI: 10.1111/apt.16404] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/18/2020] [Accepted: 04/18/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Ginger is a spice with a long history of use as a traditional remedy for nausea and vomiting. No data on the efficacy of ginger are presently available for children with vomiting associated with acute gastroenteritis (AGE). AIM To test whether ginger can reduce vomiting in children with AGE. METHODS Double-blind, randomised placebo-controlled trial in outpatients aged 1 to 10 years with AGE-associated vomiting randomised to ginger or placebo. The primary outcome was the occurrence of ≥1 episode of vomiting after the first dose of treatment. Severity of vomiting and safety were also assessed. RESULTS Seventy-five children were randomised to the ginger arm and 75 to the placebo arm. Five children in the ginger arm and 4 in the placebo arm refused to participate in the study shortly after randomisation, leaving 70 children in the ginger arm and 71 in the placebo arm (N = 141). At intention-to-treat analysis (N = 150), assuming that all children lost to follow-up had reached the primary outcome, the incidence of the main outcome was 67% (95% CI 56 to 77) in the ginger group and 87% (95% CI 79 to 94) in the placebo group, corresponding to the absolute risk reduction for the ginger versus the placebo group of -20% (95% CI -33% to -7%, P = 0.003), with a number needed to treat of 5 (95% CI 3 to 15). CONCLUSION Oral administration of ginger is effective and safe at improving vomiting in children with AGE. TRIAL REGISTRATION The trial was registered on https://clinicaltrials.gov/ with the identifier NCT02701491.
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Affiliation(s)
- Rita Nocerino
- Department of Translational Medical ScienceUniversity of Naples Federico IINaplesItaly
- CEINGE Advanced BiotechnologiesUniversity of Naples Federico IINaplesItaly
| | - Gaetano Cecere
- Department of Translational Medical ScienceUniversity of Naples Federico IINaplesItaly
| | - Maria Micillo
- Department of Translational Medical ScienceUniversity of Naples Federico IINaplesItaly
| | - Giulio De Marco
- Department of Translational Medical ScienceUniversity of Naples Federico IINaplesItaly
| | - Pasqualina Ferri
- Department of Translational Medical ScienceUniversity of Naples Federico IINaplesItaly
| | - Mariateresa Russo
- Department of Translational Medical ScienceUniversity of Naples Federico IINaplesItaly
| | - Giorgio Bedogni
- CEINGE Advanced BiotechnologiesUniversity of Naples Federico IINaplesItaly
- Clinical Epidemiology Unit, Liver Research CenterBasovizza, TriesteItaly
| | - Roberto Berni Canani
- Department of Translational Medical ScienceUniversity of Naples Federico IINaplesItaly
- CEINGE Advanced BiotechnologiesUniversity of Naples Federico IINaplesItaly
- European Laboratory for the Investigation of Food‐induced DiseasesUniversity of Naples Federico IINaplesItaly
- Task Force on Microbiome StudiesUniversity of Naples Federico IINaplesItaly
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Di Meglio L, Castaldo G, Mosca C, Paonessa A, Gelzo M, Esposito MV, Berni Canani R. Congenital chloride diarrhea clinical features and management: a systematic review. Pediatr Res 2021; 90:23-29. [PMID: 33173177 DOI: 10.1038/s41390-020-01251-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 10/06/2020] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Congenital chloride diarrhea (CLD) is a rare autosomal recessive disorder characterized by watery diarrhea with a high level of fecal Cl-, metabolic alkalosis, and electrolyte alterations. Several intestinal and extraintestinal complications and even death can occur. An optimal knowledge of the clinical features and best therapeutic strategies is mandatory for an effective management. METHODS Articles published between 1 January 1965 and 31 December 2019, reported in PUBMED and EMBASE, were evaluated for a systematic review analyzing four categories: anamnestic features, clinical features, management, and follow-up strategies. RESULTS Fifty-seven papers reporting information on 193 CLD patients were included. The most common anamnestic features were positive family anamnesis for chronic diarrhea (44.4%), consanguinity (75%), polyhydramnios (98.3%), preterm delivery (78.6%), and failure to pass meconium (60.7%). Mean age at diarrhea onset was 6.63 days. Median diagnostic delay was 60 days. Prenatal diagnosis, based on molecular analysis, was described in 40/172 (23.3%). All patients received NaCl/KCl-substitutive therapy. An improvement of diarrhea during adulthood was reported in 91.3% of cases. Failure to thrive (21.6%) and chronic kidney disease (17.7%) were the most common complications. CONCLUSIONS This analysis of a large population suggests the necessity of better strategies for the management of CLD. A close follow-up and a multidisciplinary approach is mandatory to manage this condition characterized by heterogeneous and multisystemic complications. IMPACT In this systematic review, we describe data regarding anamnestic features, clinical features, management, and follow-up of CLD patients obtained from the largest population of patients ever described to date. The results of our investigation could provide useful insights for the diagnostic approach and the management of this condition.
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Affiliation(s)
- Lavinia Di Meglio
- Department of Translational Medical Science, University Federico II, Naples, Italy.,Diagnostica Ecografica e Prenatale di A.Di Meglio, Naples, Italy
| | - Giuseppe Castaldo
- CEINGE Advanced Biotechnologies Research Center, University Federico II, Naples, Italy
| | - Caterina Mosca
- Department of Translational Medical Science, University Federico II, Naples, Italy
| | - Andrea Paonessa
- Department of Translational Medical Science, University Federico II, Naples, Italy
| | - Monica Gelzo
- CEINGE Advanced Biotechnologies Research Center, University Federico II, Naples, Italy.,Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples, Italy
| | | | - Roberto Berni Canani
- Department of Translational Medical Science, University Federico II, Naples, Italy. .,CEINGE Advanced Biotechnologies Research Center, University Federico II, Naples, Italy.
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Di Costanzo M, De Paulis N, Peveri S, Montagni M, Berni Canani R, Biasucci G. Anaphylaxis caused by artisanal honey in a child: a case report. J Med Case Rep 2021; 15:235. [PMID: 33985563 PMCID: PMC8120922 DOI: 10.1186/s13256-021-02823-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 03/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Honey is a rare cause of food allergy, especially in children, but it can cause severe systemic allergic reactions. In the pediatric age group, only a few cases have been reported in the literature. Honey allergy may be caused by pollen content or bee-derived proteins. A role for Compositae has been suggested among pollen allergens. Allergology workup of a patient with suspected honey allergy is not well defined. Here we describe a rare case of anaphylaxis in a 5-year-old boy, sensitized to Compositae pollen (ragweed and mugwort), after the ingestion of artisanal honey. CASE PRESENTATION The Slavic patient was referred to our hospital emergency department for generalized urticaria and breathing impairment. All the symptoms occurred approximately 30 minutes after the ingestion of a meal containing salmon and artisanal honey. The allergology workup revealed that a skin prick-by-prick test with the implicated artisanal honey was positive, while a variety of different commercial honey and salmon products yielded negative results. Skin prick test and serum-specific immunoglobulin E (IgE) results were also positive for Compositae pollen (ragweed and mugwort). Patients sensitized to weed pollens who ingest bee products may experience an immediate allergic reaction because of the cross-reaction between weed pollens and Compositae bee product pollen. In this case, primary sensitization may be due to airborne Compositae pollen. Commercial honey is heavily processed due to pasteurization and filtration, which removes most of the pollen. These observations highlight the role of Compositae pollen in the observed allergic reaction and suggest that the different pollen content in the artisanal honey relative to commercial honey was responsible for the allergic reaction in our patient. CONCLUSIONS This is the first reported pediatric case of honey-induced anaphylaxis in a child under 6 years of age sensitized to Compositae pollen. Pediatricians should be aware of the potential risk of severe allergic reactions upon ingestion of honey and bee products, especially in patients sensitized to weed pollens. To diagnose honey allergy, obtaining a proper clinical history is essential. In addition, skin prick-by-prick tests are helpful, and may represent a simple method to screen for honey allergy in patients sensitized to Compositae pollen, in light of the potential risk.
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Affiliation(s)
- Margherita Di Costanzo
- Department of Pediatrics and Neonatology, Guglielmo da Saliceto Hospital, Piacenza, Italy. .,Department of Translational Medical Science - Pediatric Section, University "Federico II", Naples, Italy.
| | - Nicoletta De Paulis
- Department of Pediatrics and Neonatology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Silvia Peveri
- Department of Allergology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Marcello Montagni
- Department of Allergology, Guglielmo da Saliceto Hospital, Piacenza, Italy
| | - Roberto Berni Canani
- Department of Translational Medical Science - Pediatric Section, University "Federico II", Naples, Italy.,ImmunoNutritionLab - CEINGE Advanced Biotechnologies, University "Federico II", Naples, Italy.,Task Force on Microbiome Studies, University of Naples "Federico II", Naples, Italy.,European Laboratory for the Investigation of Food-Induced Diseases, University of Naples "Federico II", Naples, Italy
| | - Giacomo Biasucci
- Department of Pediatrics and Neonatology, Guglielmo da Saliceto Hospital, Piacenza, Italy
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Paparo L, Nocerino R, Ciaglia E, Di Scala C, De Caro C, Russo R, Trinchese G, Aitoro R, Amoroso A, Bruno C, Di Costanzo M, Passariello A, Messina F, Agangi A, Napolitano M, Voto L, Gatta GD, Pisapia L, Montella F, Mollica MP, Calignano A, Puca A, Berni Canani R. Butyrate as a bioactive human milk protective component against food allergy. Allergy 2021; 76:1398-1415. [PMID: 33043467 PMCID: PMC8247419 DOI: 10.1111/all.14625] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 08/31/2020] [Accepted: 09/10/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Food allergy (FA) is a growing health problem worldwide. Effective strategies are advocated to limit the disease burden. Human milk (HM) could be considered as a protective factor against FA, but its mechanisms remain unclear. Butyrate is a gut microbiota-derived metabolite able to exert several immunomodulatory functions. We aimed to define the butyrate concentration in HM, and to see whether the butyrate concentration detected in HM is able to modulate the mechanisms of immune tolerance. METHODS HM butyrate concentration from 109 healthy women was assessed by GS-MS. The effect of HM butyrate on tolerogenic mechanisms was assessed in in vivo and in vitro models. RESULTS The median butyrate concentration in mature HM was 0.75 mM. This butyrate concentration was responsible for the maximum modulatory effects observed in all experimental models evaluated in this study. Data from mouse model show that in basal condition, butyrate up-regulated the expression of several biomarkers of gut barrier integrity, and of tolerogenic cytokines. Pretreatment with butyrate significantly reduced allergic response in three animal models of FA, with a stimulation of tolerogenic cytokines, inhibition of Th2 cytokines production and a modulation of oxidative stress. Data from human cell models show that butyrate stimulated human beta defensin-3, mucus components and tight junctions expression in human enterocytes, and IL-10, IFN-γ and FoxP3 expression through epigenetic mechanisms in PBMCs from FA children. Furthermore, it promoted the precursors of M2 macrophages, DCs and regulatory T cells. CONCLUSION The study's findings suggest the importance of butyrate as a pivotal HM compound able to protect against FA.
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Affiliation(s)
- Lorella Paparo
- Department of Translational Medical Science University of Naples Federico II Naples Italy
- ImmunoNutritionLab at the CEINGE‐Biotecnologie Avanzate s.c.ar.l Research Center University of Naples Federico II Naples Italy
- European Laboratory for the Investigation of Food‐Induced Diseases University of Naples Federico II Naples Italy
| | - Rita Nocerino
- Department of Translational Medical Science University of Naples Federico II Naples Italy
- ImmunoNutritionLab at the CEINGE‐Biotecnologie Avanzate s.c.ar.l Research Center University of Naples Federico II Naples Italy
| | - Elena Ciaglia
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" University of Salerno Fisciano Italy
| | - Carmen Di Scala
- Department of Translational Medical Science University of Naples Federico II Naples Italy
- ImmunoNutritionLab at the CEINGE‐Biotecnologie Avanzate s.c.ar.l Research Center University of Naples Federico II Naples Italy
| | - Carmen De Caro
- Department of Pharmacy University of Naples Federico II Naples Italy
| | - Roberto Russo
- Department of Pharmacy University of Naples Federico II Naples Italy
| | | | - Rosita Aitoro
- Department of Translational Medical Science University of Naples Federico II Naples Italy
| | - Antonio Amoroso
- Department of Translational Medical Science University of Naples Federico II Naples Italy
| | - Cristina Bruno
- Department of Translational Medical Science University of Naples Federico II Naples Italy
- ImmunoNutritionLab at the CEINGE‐Biotecnologie Avanzate s.c.ar.l Research Center University of Naples Federico II Naples Italy
| | - Margherita Di Costanzo
- Department of Translational Medical Science University of Naples Federico II Naples Italy
- ImmunoNutritionLab at the CEINGE‐Biotecnologie Avanzate s.c.ar.l Research Center University of Naples Federico II Naples Italy
| | - Annalisa Passariello
- Department of Translational Medical Science University of Naples Federico II Naples Italy
- Department of Pediatric Cardiology Monaldi Hospital Naples Italy
| | - Francesco Messina
- Neonatal Intensive Care Unit "Betania" Evangelical Hospital Naples Italy
| | - Annalisa Agangi
- Neonatal Intensive Care Unit "Betania" Evangelical Hospital Naples Italy
| | | | - Luana Voto
- Department of Translational Medical Science University of Naples Federico II Naples Italy
| | - Giusy Della Gatta
- Department of Translational Medical Science University of Naples Federico II Naples Italy
- ImmunoNutritionLab at the CEINGE‐Biotecnologie Avanzate s.c.ar.l Research Center University of Naples Federico II Naples Italy
| | - Laura Pisapia
- Department of Translational Medical Science University of Naples Federico II Naples Italy
- ImmunoNutritionLab at the CEINGE‐Biotecnologie Avanzate s.c.ar.l Research Center University of Naples Federico II Naples Italy
| | - Francesco Montella
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" University of Salerno Fisciano Italy
| | | | - Antonio Calignano
- Department of Pharmacy University of Naples Federico II Naples Italy
| | - Annibale Puca
- European Laboratory for the Investigation of Food‐Induced Diseases University of Naples Federico II Naples Italy
- Cardiovascular Research Unit IRCCS MultiMedica Milan Italy
| | - Roberto Berni Canani
- Department of Translational Medical Science University of Naples Federico II Naples Italy
- ImmunoNutritionLab at the CEINGE‐Biotecnologie Avanzate s.c.ar.l Research Center 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
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Nocerino R, Bedogni G, Carucci L, Cosenza L, Cozzolino T, Paparo L, Palazzo S, Riva L, Verduci E, Berni Canani R. The Impact of Formula Choice for the Management of Pediatric Cow's Milk Allergy on the Occurrence of Other Allergic Manifestations: The Atopic March Cohort Study. J Pediatr 2021; 232:183-191.e3. [PMID: 33524387 DOI: 10.1016/j.jpeds.2021.01.059] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 01/16/2021] [Accepted: 01/23/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To compare the impact of different formulas on the occurrence of other atopic manifestations and the time of immune tolerance acquisition. STUDY DESIGN In a 36-month prospective cohort study, the occurrence of other atopic manifestations (eczema, urticaria, asthma, and rhinoconjunctivitis) and the time of immune tolerance acquisition were comparatively evaluated in immunoglobulin E-mediated children with cow's milk allergy (CMA) treated with extensively hydrolyzed casein formula containing the probiotic L. rhamnosus GG (EHCF + LGG), rice hydrolyzed formula, soy formula, extensively hydrolyzed whey formula (EHWF), or amino acid-based formula. RESULTS In total, 365 subjects were enrolled into the study, 73 per formula cohort. The incidence of atopic manifestations was 0.22 (Bonferroni-corrected 95% CI 0.09-0.34) in the EHCF + LGG cohort; 0.52 (0.37-0.67) in the rice hydrolyzed formula cohort; 0.58 (0.43-0.72) in the soy formula cohort; 0.51 (0.36-0.66) in the EHWF cohort; and 0.77 (0.64-0.89) in the amino acid-based formula cohort. The incidence of atopic manifestations in the rice hydrolyzed formula, soy formula, EHWF, and amino acid-based formula cohorts vs the EHCF + LGG cohort was always greater than the prespecified absolute difference of 0.25 at an alpha-level of 0.0125, with corresponding risk ratios of 2.37 (1.46-3.86, P < .001) for rice hydrolyzed formula vs EHCF + LGG; 2.62 (1.63-4.22, P < .001) for soy formula vs EHCF + LGG; 2.31 (1.42-3.77, P < .001) for EHWF vs EHCF + LGG; and 3.50 (2.23-5.49, P < .001) for amino acid-based formula vs EHCF + LGG. The 36-month immune tolerance acquisition rate was greater in the EHCF + LGG cohort. CONCLUSIONS The use of EHCF + LGG for CMA treatment is associated with lower incidence of atopic manifestations and greater rate of immune tolerance acquisition.
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MESH Headings
- Amino Acids
- Asthma/epidemiology
- Asthma/immunology
- Asthma/prevention & control
- Caseins
- Child, Preschool
- Conjunctivitis, Allergic/epidemiology
- Conjunctivitis, Allergic/immunology
- Conjunctivitis, Allergic/prevention & control
- Dermatitis, Atopic/epidemiology
- Dermatitis, Atopic/immunology
- Dermatitis, Atopic/prevention & control
- Female
- Follow-Up Studies
- Humans
- Immune Tolerance
- Incidence
- Infant
- Infant Formula/adverse effects
- Infant Formula/chemistry
- Infant Formula/microbiology
- Lacticaseibacillus rhamnosus
- Male
- Milk Hypersensitivity/complications
- Milk Hypersensitivity/diet therapy
- Milk Hypersensitivity/immunology
- Oryza
- Probiotics/therapeutic use
- Prospective Studies
- Rhinitis, Allergic/epidemiology
- Rhinitis, Allergic/immunology
- Rhinitis, Allergic/prevention & control
- Glycine max
- Treatment Outcome
- Whey
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Affiliation(s)
- Rita Nocerino
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy; 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.
| | - Giorgio Bedogni
- CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy; Clinical Epidemiology Unit, Liver Research Center, Basovizza, Trieste, Italy
| | - Laura Carucci
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy; CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Linda Cosenza
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy; CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Tommaso Cozzolino
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy; CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Lorella Paparo
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy; CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | | | - Luca Riva
- Ospedale Vittore Buzzi University of Milan, Milan, Italy
| | - Elvira Verduci
- Ospedale Vittore Buzzi University of Milan, Milan, Italy
| | - Roberto Berni Canani
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy; 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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Carucci L, Coppola S, Luzzetti A, Giglio V, Vanderhoof J, Berni Canani R. The role of probiotics and postbiotics in modulating the gut microbiome-immune system axis in the pediatric age. Minerva Pediatr (Torino) 2021; 73:115-127. [PMID: 33880903 DOI: 10.23736/s2724-5276.21.06188-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The complex microbial community of the gut microbiome plays a fundamental role in driving development and function of the human immune system. This phenomenon is named the gut microbiome-immune system axis. When operating optimally, this axis influences both innate and adaptive immunity, which orchestrates the maintenance of crucial elements of host-microorganisms symbiosis, in a dialogue that modulates responses in the most beneficial way. Growing evidence reveals some environmental factors which can positively and negatively modulate the gut microbiome-immune system axis with consequences on the body health status. Several conditions which increasingly affect the pediatric age, such as allergies, autoimmune and inflammatory disorders, arise from a failure of the gut microbiome-immune system axis. Prenatal or postnatal modulation of this axis through some interventional strategies (including diet, probiotics and postbiotics), may lead to a positive gene-environment interaction with improvement of immune-modulatory effects and final positive effect on human health. In particular probiotics and postbiotics exerting pleiotropic regulatory actions on the gut-microbiome-immune system axis provide an innovative preventive and therapeutic strategy for many pediatric conditions.
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Affiliation(s)
- Laura Carucci
- Department of Translational Medical Science, Federico II University, Naples, Italy.,ImmunoNutritionLab at CEINGE Advanced Biotechnologies, Federico II University, Naples, Italy
| | - Serena Coppola
- Department of Translational Medical Science, Federico II University, Naples, Italy.,ImmunoNutritionLab at CEINGE Advanced Biotechnologies, Federico II University, Naples, Italy
| | - Anna Luzzetti
- Department of Translational Medical Science, Federico II University, Naples, Italy.,ImmunoNutritionLab at CEINGE Advanced Biotechnologies, Federico II University, Naples, Italy
| | - Veronica Giglio
- Department of Translational Medical Science, Federico II University, Naples, Italy.,ImmunoNutritionLab at CEINGE Advanced Biotechnologies, Federico II University, Naples, Italy
| | - Jon Vanderhoof
- Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Roberto Berni Canani
- Department of Translational Medical Science, Federico II University, Naples, Italy - .,ImmunoNutritionLab at CEINGE Advanced Biotechnologies, Federico II University, Naples, Italy.,European Laboratory for the Investigation of Food-Induced Diseases, Federico II University, Naples, Italy.,Task Force for Microbiome Studies, Federico II University, Naples, Italy
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Di Costanzo M, Biasucci G, Maddalena Y, Di Scala C, De Caro C, Calignano A, Canani RB. Lactose Intolerance in Pediatric Patients and Common Misunderstandings About Cow's Milk Allergy. Pediatr Ann 2021; 50:e178-e185. [PMID: 34039171 DOI: 10.3928/19382359-20210312-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Lactose intolerance is a common gastrointestinal condition caused by the inability to digest and absorb dietary lactose. Primary lactose intolerance is the most common type of lactose intolerance. It is one of the most common forms of food intolerance and occurs when lactase activity is reduced in the brush border of the small bowel mucosa. People may be lactose intolerant to varying degrees, depending on the severity of these symptoms. When lactose is not digested, it is fermented by gut microbiota, leading to abdominal pain, bloating, flatulence, and diarrhea with a considerable intraindividual and interindividual variability in the severity of clinical manifestations. These gastrointestinal symptoms are similar to cow's milk allergy and could be wrongly labeled as symptoms of "milk allergy." There are important differences between lactose intolerance and cow's milk allergy. Therefore, a better knowledge of these differences could limit misunderstandings in the diagnostic approach and in the management of these conditions. [Pediatr Ann. 2021;50(4):e178-e185.].
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Paparo L, Picariello G, Bruno C, Pisapia L, Canale V, Sarracino A, Nocerino R, Carucci L, Cosenza L, Cozzolino T, Berni Canani R. Tolerogenic Effect Elicited by Protein Fraction Derived From Different Formulas for Dietary Treatment of Cow's Milk Allergy in Human Cells. Front Immunol 2021; 11:604075. [PMID: 33679694 PMCID: PMC7928417 DOI: 10.3389/fimmu.2020.604075] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 12/29/2020] [Indexed: 01/07/2023] Open
Abstract
Several formulas are available for the dietary treatment of cow’s milk allergy (CMA). Clinical data suggest potentially different effect on immune tolerance elicited by these formulas. We aimed to comparatively evaluate the tolerogenic effect elicited by the protein fraction of different formulas available for the dietary treatment of CMA. Five formulas were compared: extensively hydrolyzed whey formula (EHWF), extensively hydrolyzed casein formula (EHCF), hydrolyzed rice formula (HRF), soy formula (SF), and amino acid-based formula (AAF). The formulas were reconstituted in water according to the manufacturer’s instructions and subjected to an in vitro infant gut simulated digestion using a sequential gastric and duodenal static model. Protein fraction was then purified and used for the experiments on non-immune and immune components of tolerance network in human enterocytes and in peripheral mononuclear blood cells (PBMCs). We assessed epithelial layer permeability and tight junction proteins (occludin and zonula occludens-1, ZO-1), mucin 5AC, IL-33, and thymic stromal lymphopoietin (TSLP) in human enterocytes. In addition, Th1/Th2 cytokine response and Tregs activation were investigated in PBMCs from IgE-mediated CMA infants. EHCF-derived protein fraction positively modulated the expression of gut barrier components (mucin 5AC, occludin and ZO-1) in human enterocytes, while SF was able to stimulate the expression of occludin only. EHWF and HRF protein fractions elicited a significant increase in TSLP production, while IL-33 release was significantly increased by HRF and SF protein fractions in human enterocytes. Only EHCF-derived protein fraction elicited an increase of the tolerogenic cytokines production (IL-10, IFN-γ) and of activated CD4+FoxP3+ Treg number, through NFAT, AP1, and Nf-Kb1 pathway. The effect paralleled with an up-regulation of FoxP3 demethylation rate. Protein fraction from all the study formulas was unable to induce Th2 cytokines production. The results suggest a different regulatory action on tolerogenic mechanisms elicited by protein fraction from different formulas commonly used for CMA management. EHCF-derived protein fraction was able to elicit tolerogenic effect through at least in part an epigenetic modulation of FoxP3 gene. These results could explain the different clinical effects observed on immune tolerance acquisition in CMA patients and on allergy prevention in children at risk for atopy observed using EHCF.
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Affiliation(s)
- Lorella Paparo
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy.,CEINGE Advanced Biotechnologies, University of Naples "Federico II", Naples, Italy
| | - Gianluca Picariello
- Institute of Food Sciences, National Research Council (CNR), Avellino, Italy
| | - Cristina Bruno
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy.,CEINGE Advanced Biotechnologies, University of Naples "Federico II", Naples, Italy
| | - Laura Pisapia
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy.,CEINGE Advanced Biotechnologies, University of Naples "Federico II", Naples, Italy
| | - Valentina Canale
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy.,CEINGE Advanced Biotechnologies, University of Naples "Federico II", Naples, Italy
| | - Antonietta Sarracino
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy.,CEINGE Advanced Biotechnologies, University of Naples "Federico II", Naples, Italy
| | - Rita Nocerino
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy.,CEINGE Advanced Biotechnologies, University of Naples "Federico II", Naples, Italy
| | - Laura Carucci
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy.,CEINGE Advanced Biotechnologies, University of Naples "Federico II", Naples, Italy
| | - Linda Cosenza
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy.,CEINGE Advanced Biotechnologies, University of Naples "Federico II", Naples, Italy
| | - Tommaso Cozzolino
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy
| | - Roberto Berni Canani
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy.,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
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Coppola S, Avagliano C, Calignano A, Berni Canani R. The Protective Role of Butyrate against Obesity and Obesity-Related Diseases. Molecules 2021; 26:molecules26030682. [PMID: 33525625 PMCID: PMC7865491 DOI: 10.3390/molecules26030682] [Citation(s) in RCA: 112] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 01/21/2021] [Accepted: 01/25/2021] [Indexed: 12/14/2022] Open
Abstract
Worldwide obesity is a public health concern that has reached pandemic levels. Obesity is the major predisposing factor to comorbidities, including type 2 diabetes, cardiovascular diseases, dyslipidemia, and non-alcoholic fatty liver disease. The common forms of obesity are multifactorial and derive from a complex interplay of environmental changes and the individual genetic predisposition. Increasing evidence suggest a pivotal role played by alterations of gut microbiota (GM) that could represent the causative link between environmental factors and onset of obesity. The beneficial effects of GM are mainly mediated by the secretion of various metabolites. Short-chain fatty acids (SCFAs) acetate, propionate and butyrate are small organic metabolites produced by fermentation of dietary fibers and resistant starch with vast beneficial effects in energy metabolism, intestinal homeostasis and immune responses regulation. An aberrant production of SCFAs has emerged in obesity and metabolic diseases. Among SCFAs, butyrate emerged because it might have a potential in alleviating obesity and related comorbidities. Here we reviewed the preclinical and clinical data that contribute to explain the role of butyrate in this context, highlighting its crucial contribute in the diet-GM-host health axis.
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Affiliation(s)
- Serena Coppola
- Department of Translational Medical Science, University of Naples Federico II, 80131 Naples, Italy;
- ImmunoNutriton Lab at CEINGE Advanced Biotechnologies, University of Naples Federico II, 80131 Naples, Italy
| | - Carmen Avagliano
- Department of Pharmacy, University of Naples Federico II, 80131 Naples, Italy; (C.A.); (A.C.)
| | - Antonio Calignano
- Department of Pharmacy, University of Naples Federico II, 80131 Naples, Italy; (C.A.); (A.C.)
| | - Roberto Berni Canani
- Department of Translational Medical Science, University of Naples Federico II, 80131 Naples, Italy;
- ImmunoNutriton Lab at CEINGE Advanced Biotechnologies, University of Naples Federico II, 80131 Naples, Italy
- European Laboratory for the Investigation of Food Induced Diseases (ELFID), University of Naples Federico II, 80131 Naples, Italy
- Task Force on Microbiome Studies, University of Naples Federico II, 80131 Naples, Italy
- Correspondence: ; Tel.: +39-081-7462680
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40
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Berni Canani R, Comegna M, Paparo L, Cernera G, Bruno C, Strisciuglio C, Zollo I, Gravina AG, Miele E, Cantone E, Gennarelli N, Nocerino R, Carucci L, Giglio V, Amato F, Castaldo G. Age-Related Differences in the Expression of Most Relevant Mediators of SARS-CoV-2 Infection in Human Respiratory and Gastrointestinal Tract. Front Pediatr 2021; 9:697390. [PMID: 34395341 PMCID: PMC8355889 DOI: 10.3389/fped.2021.697390] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 07/05/2021] [Indexed: 12/13/2022] Open
Abstract
Background: Clinical features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection seem to differ in children compared to that in adults. It has been hypothesized that the lower clinical severity in children could be influenced by differential expression of the main host functional receptor to SARS-CoV-2, the angiotensin-converting enzyme 2 (ACE2), but data are still conflicting. To explore the origin of age-dependent clinical features of coronavirus disease 2019 (COVID-19), we comparatively evaluated the expression in children and adult subjects of the most relevant mediators of the SARS-CoV-2 infection: ACE2, angiotensin-converting enzyme 1 (ACE1), transmembrane serine protease-2 (TMPRSS2), and neuropilin-1 (NRP1), at upper respiratory tract and small intestine level. Methods: The expression of ACE2, ACE1, TMPRSS2, and NRP1 in nasal epithelium and in small intestine epithelium was investigated by quantitative real-time PCR analysis. Results: We found no differences in ACE2, ACE1, and TMPRSS2 expression in the nasal epithelium comparing children and adult subjects. In contrast, nasal epithelium NRP1 expression was lower in children compared to that in adults. Intestinal ACE2 expression was higher in children compared to that in adults, whereas intestinal ACE1 expression was higher in adults. Intestinal TMPRSS2 and NRP1 expression was similar comparing children and adult subjects. Conclusions: The lower severity of SARS-CoV-2 infection observed in children may be due to a different expression of nasal NRP1, that promotes the virus interaction with ACE2. However, the common findings of intestinal symptoms in children could be due to a higher expression of ACE2 at this level. The insights from these data will be useful in determining the treatment policies and preventive measures for COVID-19.
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Affiliation(s)
- Roberto Berni Canani
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,CEINGE-Biotecnologie Avanzate s.c.ar.l., 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
| | - Marika Comegna
- CEINGE-Biotecnologie Avanzate s.c.ar.l., University of Naples Federico II, Naples, Italy.,Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Lorella Paparo
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,CEINGE-Biotecnologie Avanzate s.c.ar.l., University of Naples Federico II, Naples, Italy
| | - Gustavo Cernera
- CEINGE-Biotecnologie Avanzate s.c.ar.l., University of Naples Federico II, Naples, Italy.,Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Cristina Bruno
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,CEINGE-Biotecnologie Avanzate s.c.ar.l., University of Naples Federico II, Naples, Italy
| | - Caterina Strisciuglio
- Department of Woman, Child and General and Specialistic Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Immacolata Zollo
- CEINGE-Biotecnologie Avanzate s.c.ar.l., University of Naples Federico II, Naples, Italy.,Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Antonietta Gerarda Gravina
- Division of Hepatogastroenterology, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Erasmo Miele
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Elena Cantone
- Department of Neuroscience, Reproductive and Odontostomatological Sciences, Ear, Nose and Throat (ENT) Section, University of Naples Federico II, Naples, Italy
| | - Nicola Gennarelli
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Rita Nocerino
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,CEINGE-Biotecnologie Avanzate s.c.ar.l., University of Naples Federico II, Naples, Italy
| | - Laura Carucci
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,CEINGE-Biotecnologie Avanzate s.c.ar.l., University of Naples Federico II, Naples, Italy
| | - Veronica Giglio
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,CEINGE-Biotecnologie Avanzate s.c.ar.l., University of Naples Federico II, Naples, Italy
| | - Felice Amato
- CEINGE-Biotecnologie Avanzate s.c.ar.l., University of Naples Federico II, Naples, Italy.,Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Giuseppe Castaldo
- CEINGE-Biotecnologie Avanzate s.c.ar.l., University of Naples Federico II, Naples, Italy.,Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
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Carucci L, Coppola S, Nocerino R, Paparo L, Di Scala C, Berni Canani R. Commentary: Raw Cow Milk Consumption and Atopic March. Front Pediatr 2021; 9:684662. [PMID: 34169049 PMCID: PMC8217621 DOI: 10.3389/fped.2021.684662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/12/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Laura Carucci
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy.,ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples "Federico II", Naples, Italy
| | - Serena Coppola
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy.,ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples "Federico II", Naples, Italy
| | - Rita Nocerino
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy.,ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples "Federico II", Naples, Italy
| | - Lorella Paparo
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy.,ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples "Federico II", Naples, Italy
| | - Carmen Di Scala
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy.,ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples "Federico II", Naples, Italy
| | - Roberto Berni Canani
- Department of Translational Medical Science, University of Naples "Federico II", Naples, Italy.,ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, 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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42
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Di Meglio L, Grimaldi G, Esposito F, Gelzo M, Esposito MV, Castaldo G, Canani RB. Step-Up Approach for Sodium Butyrate Treatment in Children With Congenital Chloride Diarrhea. Front Pediatr 2021; 9:810765. [PMID: 35127600 PMCID: PMC8811473 DOI: 10.3389/fped.2021.810765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 12/28/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Oral salt substitutive therapy is pivotal for the survival of patients with congenital chloride diarrhea (CLD), however this therapy is unable to influence the symptoms severity. Butyrate has been proposed to limit diarrhea severity in CLD. Unfortunately, the optimal dose schedule is still largely undefined. In addition, butyrate seems not to be well-tolerated by all patients, with some subjects reporting diarrhea worsening. We investigated the efficacy of a step-up therapeutic approach with sodium butyrate in patients who experienced a diarrhea worsening or an absent improvement after the direct administration of 100 mg/kg/day of sodium butyrate. METHODS The efficacy of a step-up therapeutic approach starting from 50 mg/Kg/day with a subsequent 25 mg/kg/day weekly increase up to 100 mg/kg/day of oral sodium butyrate was investigated in previously three unresponsive CLD children. RESULTS The step-up therapeutic approach resulted effective in limiting diarrhea severity in all our three previously unresponsive CLD patients. CONCLUSIONS Our results suggest the efficacy of the step-up therapeutic approach in CLD children.
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Affiliation(s)
- Lavinia Di Meglio
- Department of Translational Medical Science, University Federico II, Naples, Italy.,Diagnostica Ecografica e Prenatale Aniello Di Meglio, Naples, Italy
| | - Giusi Grimaldi
- Department of Translational Medical Science, University Federico II, Naples, Italy
| | - Francesco Esposito
- Department of Translational Medical Science, University Federico II, Naples, Italy
| | - Monica Gelzo
- Genetic Engineering and Advanced Biotechnology Center (CEINGE) Advanced Biotechnologies Research Center, University Federico II, Naples, Italy
| | - Maria Valeria Esposito
- Genetic Engineering and Advanced Biotechnology Center (CEINGE) Advanced Biotechnologies Research Center, University Federico II, Naples, Italy
| | - Giuseppe Castaldo
- Genetic Engineering and Advanced Biotechnology Center (CEINGE) Advanced Biotechnologies Research Center, University Federico II, Naples, Italy
| | - Roberto Berni Canani
- Department of Translational Medical Science, University Federico II, Naples, Italy.,Genetic Engineering and Advanced Biotechnology Center (CEINGE) Advanced Biotechnologies Research Center, University Federico II, Naples, Italy.,Task Force for Microbiome Studies, University Federico II, Naples, Italy
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43
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Berni Canani R, Comegna M, Paparo L, Cernera G, Bruno C, Strisciuglio C, Zollo I, Gravina AG, Miele E, Cantone E, Gennarelli N, Nocerino R, Carucci L, Giglio V, Amato F, Castaldo G. Corrigendum: Age-Related Differences in the Expression of Most Relevant Mediators of SARS-CoV-2 Infection in Human Respiratory and Gastrointestinal Tract. Front Pediatr 2021; 9:790285. [PMID: 34858910 PMCID: PMC8631725 DOI: 10.3389/fped.2021.790285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 10/15/2021] [Indexed: 11/13/2022] Open
Abstract
[This corrects the article DOI: 10.3389/fped.2021.697390.].
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Affiliation(s)
- Roberto Berni Canani
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,CEINGE-Biotecnologie Avanzate s.c.ar.l., 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
| | - Marika Comegna
- CEINGE-Biotecnologie Avanzate s.c.ar.l., University of Naples Federico II, Naples, Italy.,Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Lorella Paparo
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,CEINGE-Biotecnologie Avanzate s.c.ar.l., University of Naples Federico II, Naples, Italy
| | - Gustavo Cernera
- CEINGE-Biotecnologie Avanzate s.c.ar.l., University of Naples Federico II, Naples, Italy.,Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Cristina Bruno
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,CEINGE-Biotecnologie Avanzate s.c.ar.l., University of Naples Federico II, Naples, Italy
| | - Caterina Strisciuglio
- Department of Woman, Child and General and Specialistic Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Immacolata Zollo
- CEINGE-Biotecnologie Avanzate s.c.ar.l., University of Naples Federico II, Naples, Italy.,Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Antonietta Gerarda Gravina
- Division of Hepatogastroenterology, Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Erasmo Miele
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Elena Cantone
- Department of Neuroscience, Reproductive and Odontostomatological Sciences, Ear, Nose and Throat (ENT) Section, University of Naples Federico II, Naples, Italy
| | - Nicola Gennarelli
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Rita Nocerino
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,CEINGE-Biotecnologie Avanzate s.c.ar.l., University of Naples Federico II, Naples, Italy
| | - Laura Carucci
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,CEINGE-Biotecnologie Avanzate s.c.ar.l., University of Naples Federico II, Naples, Italy
| | - Veronica Giglio
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,CEINGE-Biotecnologie Avanzate s.c.ar.l., University of Naples Federico II, Naples, Italy
| | - Felice Amato
- CEINGE-Biotecnologie Avanzate s.c.ar.l., University of Naples Federico II, Naples, Italy.,Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Giuseppe Castaldo
- CEINGE-Biotecnologie Avanzate s.c.ar.l., University of Naples Federico II, Naples, Italy.,Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy
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Berni Canani R, Di Costanzo M, Bedogni G, Amoroso A, Cosenza L, Di Scala C, Granata V, Nocerino R. Reply to "Efficacy and safety of hydrolyzed formulas for cow's milk allergy management: A systematic review of randomized controlled trials". Clin Exp Allergy 2020; 51:155-157. [PMID: 33047369 DOI: 10.1111/cea.13758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 10/01/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Roberto Berni Canani
- Department of Translational Medical Science, University Federico II of Naples, Naples, Italy.,European Laboratory for the Investigation of Food-Induced Diseases, University of Naples Federico II, Naples, Italy.,Task Force on Microbiome Studies, University Federico II of Naples, Naples, Italy.,ImmunoNutritioonLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Margherita Di Costanzo
- Department of Translational Medical Science, University Federico II of Naples, Naples, Italy.,ImmunoNutritioonLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Giorgio Bedogni
- Italian Liver Foundation, Basovizza, Trieste, Italy.,ImmunoNutritioonLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Antonio Amoroso
- Department of Translational Medical Science, University Federico II of Naples, Naples, Italy.,ImmunoNutritioonLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Linda Cosenza
- Department of Translational Medical Science, University Federico II of Naples, Naples, Italy.,ImmunoNutritioonLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Carmen Di Scala
- Department of Translational Medical Science, University Federico II of Naples, Naples, Italy.,ImmunoNutritioonLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Viviana Granata
- Department of Translational Medical Science, University Federico II of Naples, Naples, Italy.,ImmunoNutritioonLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Rita Nocerino
- Department of Translational Medical Science, University Federico II of Naples, Naples, Italy.,ImmunoNutritioonLab at CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
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Cutignano A, Siano F, Romano R, Aiello A, Pizzolongo F, Berni Canani R, Paparo L, Nocerino R, Di Scala C, Addeo F, Picariello G. Short-term effects of dietary bovine milk on fatty acid composition of human milk: A preliminary multi-analytical study. J Chromatogr B Analyt Technol Biomed Life Sci 2020; 1154:122189. [PMID: 32861173 DOI: 10.1016/j.jchromb.2020.122189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 05/13/2020] [Accepted: 05/20/2020] [Indexed: 12/11/2022]
Abstract
The fatty acid (FA) composition of human milk (HM) from N = 9 Italian healthy donors following a free diet exhibited FA-dependent ranges of variability, as assessed by GC-FID. The possible short-term changes in the FA profile were monitored in the milk of lactating mothers (three) collected at five time points over a 6 h period, following an oral load (200 mL) of bovine milk. An array of techniques was exploited, including UHPLC-ESI-MS/MS of intact lipids and MALDI-TOF MS before and after chemical hydrogenation or bromination, in addition to MALDI-TOF MS analysis of FA after saponification, to monitor short-chain and odd-chain FA in HM as markers of bovine milk fat. A single administration of bovine milk did not appreciably modify the lipid pattern, suggesting that the maternal diet could induce not detectable short-term changes on the lipid composition of HM. Diet-induced increase of butyric acid was also excluded by 13C NMR. The functions that HM FA exert in infant physiology appear finely regulated through maternal metabolism.
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Affiliation(s)
- Adele Cutignano
- Istituto di Chimica Biomolecolare, Consiglio Nazionale delle Ricerche (CNR), Via Campi Flegrei 34, 80078 Pozzuoli (Napoli), Italy
| | - Francesco Siano
- Istituto di Scienze dell'Alimentazione, Consiglio Nazionale delle Ricerche (CNR), Via Roma 64, 83100 Avellino, Italy
| | - Raffaele Romano
- Dipartimento di Agraria, Università di Napoli "Federico II", Parco Gussone, 80055 Portici (Napoli), Italy
| | - Alessandra Aiello
- Dipartimento di Agraria, Università di Napoli "Federico II", Parco Gussone, 80055 Portici (Napoli), Italy
| | - Fabiana Pizzolongo
- Dipartimento di Agraria, Università di Napoli "Federico II", Parco Gussone, 80055 Portici (Napoli), Italy
| | - Roberto Berni Canani
- Dipartimento di Science Mediche Traslazionali e Laboratorio Europeo per lo Studio delle Malattie Indotte da Alimenti, Università degli Studi di Napoli Federico II, Via S. Pansini 5, 80131 Napoli, Italy; ImmunoNutritionLab at CEINGE Biotechinogie Avanzate, Università degli Studi di Napoli Federico II, Via Comunale Margherita, 484-538, 80131 Napoli, Italy; Task Force di Ateneo per gli Studi sul Microbioma, Università degli Studi di Napoli Federico II, Via S. Pansini 5, 80131 Napoli, Italy
| | - Lorella Paparo
- Dipartimento di Science Mediche Traslazionali e Laboratorio Europeo per lo Studio delle Malattie Indotte da Alimenti, Università degli Studi di Napoli Federico II, Via S. Pansini 5, 80131 Napoli, Italy; ImmunoNutritionLab at CEINGE Biotechinogie Avanzate, Università degli Studi di Napoli Federico II, Via Comunale Margherita, 484-538, 80131 Napoli, Italy; Task Force di Ateneo per gli Studi sul Microbioma, Università degli Studi di Napoli Federico II, Via S. Pansini 5, 80131 Napoli, Italy
| | - Rita Nocerino
- Dipartimento di Science Mediche Traslazionali e Laboratorio Europeo per lo Studio delle Malattie Indotte da Alimenti, Università degli Studi di Napoli Federico II, Via S. Pansini 5, 80131 Napoli, Italy; ImmunoNutritionLab at CEINGE Biotechinogie Avanzate, Università degli Studi di Napoli Federico II, Via Comunale Margherita, 484-538, 80131 Napoli, Italy; Task Force di Ateneo per gli Studi sul Microbioma, Università degli Studi di Napoli Federico II, Via S. Pansini 5, 80131 Napoli, Italy
| | - Carmen Di Scala
- Dipartimento di Science Mediche Traslazionali e Laboratorio Europeo per lo Studio delle Malattie Indotte da Alimenti, Università degli Studi di Napoli Federico II, Via S. Pansini 5, 80131 Napoli, Italy; ImmunoNutritionLab at CEINGE Biotechinogie Avanzate, Università degli Studi di Napoli Federico II, Via Comunale Margherita, 484-538, 80131 Napoli, Italy; Task Force di Ateneo per gli Studi sul Microbioma, Università degli Studi di Napoli Federico II, Via S. Pansini 5, 80131 Napoli, Italy
| | - Francesco Addeo
- Dipartimento di Agraria, Università di Napoli "Federico II", Parco Gussone, 80055 Portici (Napoli), Italy
| | - Gianluca Picariello
- Istituto di Scienze dell'Alimentazione, Consiglio Nazionale delle Ricerche (CNR), Via Roma 64, 83100 Avellino, Italy.
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Russo M, Guida F, Paparo L, Trinchese G, Aitoro R, Avagliano C, Fiordelisi A, Napolitano F, Mercurio V, Sala V, Li M, Ghigo A, EmilioHirsch, Sorriento D, Ciccarelli M, Bianco R, Iaccarino G, Abete P, Bonaduce D, Calignano A, Canani RB, Tocchetti CG. The novel butyrate derivative phenylalanine-butyramide protects from doxorubicin-induced cardiotoxicity. Vascul Pharmacol 2020. [DOI: 10.1016/j.vph.2020.106747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Di Costanzo M, Carucci L, Berni Canani R, Biasucci G. Gut Microbiome Modulation for Preventing and Treating Pediatric Food Allergies. Int J Mol Sci 2020; 21:ijms21155275. [PMID: 32722378 PMCID: PMC7432728 DOI: 10.3390/ijms21155275] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 12/11/2022] Open
Abstract
The increasing prevalence and severity of pediatric food allergies (FA) demands innovative preventive and therapeutic strategies. Emerging evidence suggests a pivotal role for the gut microbiome in modulating susceptibility to FA. Studies have demonstrated that alteration of gut microbiome could precede FA, and that particular microbial community structures early in life could influence also the disease course. The identification of gut microbiome features in pediatric FA patients is driving new prevention and treatment approaches. This review is focused on the potential role of the gut microbiome as a target for FA prevention and treatment.
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Affiliation(s)
- Margherita Di Costanzo
- Department of Pediatrics and Neonatology, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy;
- Department of Translational Medical Science-Pediatric Section, University “Federico II”, 80131 Naples, Italy; (L.C.); (R.B.C.)
- ImmunoNutritionLab-CEINGE Advanced Biotechnologies, University “Federico II”, 80131 Naples, Italy
- Correspondence:
| | - Laura Carucci
- Department of Translational Medical Science-Pediatric Section, University “Federico II”, 80131 Naples, Italy; (L.C.); (R.B.C.)
- ImmunoNutritionLab-CEINGE Advanced Biotechnologies, University “Federico II”, 80131 Naples, Italy
| | - Roberto Berni Canani
- Department of Translational Medical Science-Pediatric Section, University “Federico II”, 80131 Naples, Italy; (L.C.); (R.B.C.)
- ImmunoNutritionLab-CEINGE Advanced Biotechnologies, University “Federico II”, 80131 Naples, Italy
- Task Force on Microbiome Studies, University of Naples “Federico II”, 80131 Naples, Italy
- European Laboratory for the Investigation of Food-Induced Diseases, University of Naples “Federico II”, 80131 Naples, Italy
| | - Giacomo Biasucci
- Department of Pediatrics and Neonatology, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy;
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48
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Nocerino R, De Filippis F, Cecere G, Marino A, Micillo M, Di Scala C, de Caro C, Calignano A, Bruno C, Paparo L, Iannicelli AM, Cosenza L, Maddalena Y, Della Gatta G, Coppola S, Carucci L, Ercolini D, Berni Canani R. Editorial: interventions in infantile colic - can efficacy be attributed to treatment or to time? Authors' reply. Aliment Pharmacol Ther 2020; 51:398-399. [PMID: 31943267 DOI: 10.1111/apt.15627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- Rita Nocerino
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Francesca De Filippis
- Department of Agricultural Sciences, University of Naples Federico II, Portici, Italy.,Task Force on Microbiome Studies, University of Naples Federico II, Naples, Italy
| | - Gaetano Cecere
- 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
| | - Maria Micillo
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Carmen Di Scala
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Carmen de Caro
- Department of Pharmacy, University of Naples Federico II, Naples, Italy
| | - Antonio Calignano
- Department of Pharmacy, University of Naples Federico II, Naples, Italy
| | - Cristina Bruno
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Lorella Paparo
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Anna Maria Iannicelli
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy
| | - Linda Cosenza
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Ylenia Maddalena
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Giusy Della Gatta
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Serena Coppola
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Laura Carucci
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy
| | - Danilo Ercolini
- Department of Agricultural Sciences, University of Naples Federico II, Portici, Italy.,Task Force on Microbiome Studies, University of Naples Federico II, Naples, Italy
| | - Roberto Berni Canani
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,CEINGE Advanced Biotechnologies, University of Naples Federico II, Naples, Italy.,Task Force on Microbiome Studies, University of Naples Federico II, Naples, Italy.,European Laboratory for the Investigation of Food-Induced Diseases, University of Naples Federico II, Naples, Italy
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49
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Carucci L, Nocerino R, Paparo L, Di Scala C, Berni Canani R. Dietary Prevention of Atopic March in Pediatric Subjects With Cow's Milk Allergy. Front Pediatr 2020; 8:440. [PMID: 32850553 PMCID: PMC7431922 DOI: 10.3389/fped.2020.00440] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 06/23/2020] [Indexed: 12/14/2022] Open
Abstract
Cow's milk allergy (CMA) is one of the most prevalent food allergies and the most expensive allergic diseases in the pediatric age. There is no cure for CMA, and actual disease management is based on strict avoidance of cow milk protein-containing foods, access to rescue medication, and use of substitutive formulas. Early-life CMA could be one of the first steps of the "allergic march" (AM), leading to the occurrence of other atopic manifestations later in the life, including asthma and oculorhinitis, with subsequent further increase of costs for health care systems and families of affected children. In the last years, diet is emerged as a relevant strategy to prevent allergic diseases through, at least in part, epigenetic modulation of immune system. We provide an overview of studies that investigate the potential role of different dietary strategies in preventing the AM in pediatric patients with CMA.
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Affiliation(s)
- Laura Carucci
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy
| | - Rita Nocerino
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy
| | - Lorella Paparo
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy
| | - Carmen Di Scala
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy
| | - Roberto Berni Canani
- Department of Translational Medical Science, University of Naples Federico II, Naples, Italy.,ImmunoNutritionLab at the CEINGE Advanced Biotechnologies Research Center, 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
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50
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Nocerino R, De Filippis F, Cecere G, Marino A, Micillo M, Di Scala C, de Caro C, Calignano A, Bruno C, Paparo L, Iannicelli AM, Cosenza L, Maddalena Y, della Gatta G, Coppola S, Carucci L, Ercolini D, Berni Canani R. The therapeutic efficacy of Bifidobacterium animalis subsp. lactis BB-12 ® in infant colic: A randomised, double blind, placebo-controlled trial. Aliment Pharmacol Ther 2020; 51:110-120. [PMID: 31797399 PMCID: PMC6973258 DOI: 10.1111/apt.15561] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 06/24/2019] [Accepted: 10/06/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND The pathogenesis of infant colic is poorly defined. Gut microbiota seems to be involved, supporting the potential therapeutic role of probiotics. AIMS To assess the rate of infants with a reduction of ≥50% of mean daily crying duration after 28 days of intervention with the probiotic Bifidobacterium animalis subsp. lactis BB-12® (BB-12). Secondary outcomes were daily number of crying episodes, sleeping time, number of bowel movements and stool consistency. METHODS Randomized controlled trial (RCT) on otherwise healthy exclusively breastfed infants with infant colic randomly allocated to receive BB-12 (1 × 109 CFU/day) or placebo for 28 days. Gut microbiota structure and butyrate, beta-defensin-2 (HBD-2), cathelicidin (LL-37), secretory IgA (sIgA) and faecal calprotectin levels were assessed. RESULTS Eighty infants were randomised, 40/group. The rate of infants with reduction of ≥50% of mean daily crying duration was higher in infants treated with BB-12, starting from the end of 2nd week. No infant relapsed when treatment was stopped. The mean number of crying episodes decreased in both groups, but with a higher effect in BB-12 group (-4.7 ± 3.4 vs -2.3 ± 2.2, P < 0.05). Mean daily stool frequency decreased in both groups but the effect was significantly higher in the BB-12 group; stool consistency was similar between the two groups. An increase in Bifidobacterium abundance (with significant correlation with crying time reduction), butyrate and HBD-2, LL-37, sIgA levels associated with a decrease in faecal calprotectin level were observed in the BB-12 group. CONCLUSIONS Supplementation with BB-12 is effective in managing infant colic. The effect could derive from immune and non-immune mechanisms associated with a modulation of gut microbiota structure and function.
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Affiliation(s)
- Rita Nocerino
- Department of Translational Medical ScienceUniversity of Naples Federico IINaplesItaly,CEINGE Advanced BiotechnologiesUniversity of Naples Federico IINaplesItaly
| | - Francesca De Filippis
- Department of Agricultural SciencesUniversity of Naples Federico IIPorticiItaly,Task Force on Microbiome StudiesUniversity of Naples Federico IINaplesItaly
| | - Gaetano Cecere
- Department of Translational Medical ScienceUniversity of Naples Federico IINaplesItaly
| | - Antonio Marino
- Department of Translational Medical ScienceUniversity of Naples Federico IINaplesItaly
| | - Maria Micillo
- Department of Translational Medical ScienceUniversity of Naples Federico IINaplesItaly
| | - Carmen Di Scala
- Department of Translational Medical ScienceUniversity of Naples Federico IINaplesItaly,CEINGE Advanced BiotechnologiesUniversity of Naples Federico IINaplesItaly
| | - Carmen de Caro
- Department of PharmacyUniversity of Naples Federico IINaplesItaly
| | | | - Cristina Bruno
- Department of Translational Medical ScienceUniversity of Naples Federico IINaplesItaly,CEINGE Advanced BiotechnologiesUniversity of Naples Federico IINaplesItaly
| | - Lorella Paparo
- Department of Translational Medical ScienceUniversity of Naples Federico IINaplesItaly,CEINGE Advanced BiotechnologiesUniversity of Naples Federico IINaplesItaly
| | - Anna M. Iannicelli
- Department of Translational Medical ScienceUniversity of Naples Federico IINaplesItaly
| | - Linda Cosenza
- Department of Translational Medical ScienceUniversity of Naples Federico IINaplesItaly,CEINGE Advanced BiotechnologiesUniversity of Naples Federico IINaplesItaly
| | - Ylenia Maddalena
- Department of Translational Medical ScienceUniversity of Naples Federico IINaplesItaly,CEINGE Advanced BiotechnologiesUniversity of Naples Federico IINaplesItaly
| | - Giusy della Gatta
- Department of Translational Medical ScienceUniversity of Naples Federico IINaplesItaly,CEINGE Advanced BiotechnologiesUniversity of Naples Federico IINaplesItaly
| | - Serena Coppola
- Department of Translational Medical ScienceUniversity of Naples Federico IINaplesItaly,CEINGE Advanced BiotechnologiesUniversity of Naples Federico IINaplesItaly
| | - Laura Carucci
- Department of Translational Medical ScienceUniversity of Naples Federico IINaplesItaly,CEINGE Advanced BiotechnologiesUniversity of Naples Federico IINaplesItaly
| | - Danilo Ercolini
- Department of Agricultural SciencesUniversity of Naples Federico IIPorticiItaly,Task Force on Microbiome StudiesUniversity of Naples Federico IINaplesItaly
| | - Roberto Berni Canani
- Department of Translational Medical ScienceUniversity of Naples Federico IINaplesItaly,CEINGE Advanced BiotechnologiesUniversity of Naples Federico IINaplesItaly,Task Force on Microbiome StudiesUniversity of Naples Federico IINaplesItaly,European Laboratory for the Investigation of Food‐Induced DiseasesUniversity of Naples Federico IINaplesItaly
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