Nentwich I, Michková E, Nevoral J, Urbanek R, Szépfalusi Z
Department of Pediatrics, University of Vienna, Wahringer Guertel 18-20, A-1090 Vienna, Austria.
Allergy. 2001 Dec;56(12):1144-56. doi: 10.1111/j.1398-9995.2001x.00926.x.
Hydrolyzed milk formulas are recommended to feed infants at high risk of atopy if breast-feeding is not possible. We studied the specific cellular and humoral immune response to cow's milk proteins and occurrence of atopic dermatitis under different feeding regimens: two hydrolyzed infant milk formulas (partially [pHF] and extensively hydrolyzed [eHF]) and under exclusive breast-feeding (BF).
Seventy-two infants from families with atopic symptoms were randomized in the pHF and eHF groups, respectively. At 6 and 12 months of age, peripheral blood mononuclear cell proliferation along with specific IgG and IgE to cow's milk proteins was determined in infants fed pHF or eHF, respectively, and those who had not yet received any formula at 6 months of age (BF). Cases of atopic dermatitis were recorded throughout the first 12 months of life, and their severity was evaluated with SCORAD points.
A significantly decreased proliferation to cow's milk caseins was found in the pHF group compared to the exclusively breast-fed group. Medians of stimulation indexes for CAS at 6 months were as follows: pHF 1.18; n=24; BF 1.70; n=24 (P=0.033, Mann-Whitney U-test). Higher levels of plasma IgG antibodies to BCAS were found in infants fed pHF than in those fed eHF at 12 months. Optical density (OD): (25th percentile; median; 75th percentile): pHF: 0.00; 0.14; 0.38; n=30; eHF: 0.00; 0.03; 0.14; n=28; P=0,089, Mann-Whitney U-test. Cow's milk-specific IgE was detected at 6 months as follows: BF: 3 of 24; eHF: 2 of 21; pHF: 0 of 23. The number of cases of atopic dermatitis and their severity did not differ among the groups during the first 12 months.
Feeding pHF appears to suppress cow's milk-specific cellular responses and stimulate specific IgG production. Specific IgE sensitization can occur also with breast-feeding.
如果无法进行母乳喂养，建议使用水解奶粉喂养有特应性风险的婴儿。我们研究了在不同喂养方案下，即两种水解婴儿奶粉（部分水解奶粉[pHF]和深度水解奶粉[eHF]）以及纯母乳喂养（BF）时，对牛奶蛋白的特异性细胞免疫和体液免疫反应以及特应性皮炎的发生情况。
72名有特应性症状家庭的婴儿分别随机分为pHF组和eHF组。在6个月和12个月时，分别测定了喂养pHF或eHF的婴儿以及6个月时尚未接受任何奶粉喂养（BF）的婴儿外周血单个核细胞增殖情况以及针对牛奶蛋白的特异性IgG和IgE。在生命的前12个月记录特应性皮炎病例，并使用SCORAD评分评估其严重程度。
与纯母乳喂养组相比，pHF组对牛奶酪蛋白的增殖明显降低。6个月时酪蛋白刺激指数的中位数如下：pHF组为1.18；n = 24；BF组为1.70；n = 24（P = 0.033，曼-惠特尼U检验）。在12个月时，喂养pHF的婴儿血浆中针对β-酪蛋白的IgG抗体水平高于喂养eHF的婴儿。光密度（OD）：（第25百分位数；中位数；第75百分位数）：pHF组：0.00；0.14；0.38；n = 30；eHF组：0.00；0.03；0.14；n = 28；P = 0.089，曼-惠特尼U检验。6个月时检测到的牛奶特异性IgE如下：BF组：24例中有3例；eHF组：21例中有2例；pHF组：23例中无。在最初12个月内，各组特应性皮炎病例数及其严重程度无差异。
喂养pHF似乎会抑制牛奶特异性细胞反应并刺激特异性IgG产生。纯母乳喂养时也可能发生特异性IgE致敏。
