Dupont C, de Boissieu D
Service de néonatalogie, Hôpital Saint-Vincent de Paul, 82, avenue Denfert-Rochereau, 75674 Paris, France.
Allerg Immunol (Paris). 2002 Mar;34(3):85-90.
A hydrolysate of proteins is considered to be adapted to treatment of allergy to cow's milk proteins when it is tolerated by 90% of allergic children. This suggestion implies that 10% of the children who are allergic to cow's milk proteins do not tolerate the preparations based on hydrolysates of proteins and presupposes the case of intolerance or allergy henceforth widely reported. The diagnosis must mention before the existence or the persistence in an infant fed with a hydrolysate of proteins of non-specific clinical signs often attached to more frequent pathologies, such as gastro-oesophageal reflux or colic. Substitution of a hydrolysate by another is one alternative, but the level of residual peptides of protein hydrolysates explains only the cases of severe allergy, the child may show reactions to these residual epitopes. The alternative is use of a formulation based on amino-acids, which allows diagnosis by an elimination-provocation test of protein hydrolysate. An elementary formulation based on amino-acids may permit to await the period of acquisition of tolerance.
当90%的过敏儿童能够耐受时，蛋白质水解物被认为适用于治疗对牛奶蛋白的过敏。这一建议意味着，10%对牛奶蛋白过敏的儿童不能耐受基于蛋白质水解物的制剂，并预先假定了此后广泛报道的不耐受或过敏情况。诊断必须提及在喂食蛋白质水解物的婴儿中存在或持续存在的非特异性临床症状，这些症状通常与更常见的病症有关，如胃食管反流或绞痛。用另一种水解物替代是一种选择，但蛋白质水解物的残留肽水平仅能解释严重过敏的情况，儿童可能会对这些残留表位产生反应。另一种选择是使用基于氨基酸的配方，这可以通过蛋白质水解物的排除激发试验进行诊断。基于氨基酸的基本配方可能有助于等待获得耐受性的时期。
