Bottaro G, Failla P, Rotolo N, Azzaro F, Pennisi P, Pasqualetto A, Castiglione N, Patané R
1a Clinica Pediatrica, Università di Catania, Italia.
Pediatr Med Chir. 1992 Jan-Feb;14(1):21-5.
Cow's Milk Protein Intolerance (CMPI) is the most common food intolerance in childhood. The I, III and IV type of the immunological mechanisms are involved in the pathogenesis. Nowadays there are no diagnostic tests with good reliability excluding the IgE-mediated clinical pictures. Recently the evaluation of antibodies (IgA and IgG classes) versus milk proteins has been proposed as reliable test. In order to establish the pattern of antibody response against milk proteins we studied 37 children (17 males and 20 females), aged from 3 months to 6 years, divided as follows: 23 with CMPI of which 16 suffering from gastrointestinal complaints (GI) and 7 from cutaneous ones (CT); 5 children with coeliac disease; 9 normal healthy children without any clinical manifestation. All children at the time of the assessment assuming a diet containing cow's milk proteins. IgA, IgG and IgM antibody classes against cow's milk proteins such as alpha-lactoalbumin (alpha LA), beta-lactoglobulin (beta LG), casein (CAS) and pooled proteins (PPL) were measured using an ELISA method. The results obtained in the various groups were as follows: CMPI-GI group: the percentage of positivity for alpha LA-IgA was 43.8% and alpha LA-IgG 68.7%, for beta LG-IgA was 50% and beta LG-IgG 75%, for CAS-IgA was 43.8% and CAS-IgG 68.7%, for PPL-IgA was 37.5% and PPL-IgG 62.5%. CMPI-CT group: the percentage of positivity for alpha LA-IgA was 42.8% and alpha LA-IgG 57.1%, for beta LG-IgA was 71.4% and beta LG-IgG 42.8%, for CAS-IgA and CAS-IgG was 85.7%, for PPL-IgA was 71.4% and PPL-IgG 57.1%.(ABSTRACT TRUNCATED AT 250 WORDS)
牛奶蛋白不耐受(CMPI)是儿童期最常见的食物不耐受。免疫机制的I、III和IV型参与其发病过程。目前尚无可靠的诊断测试能排除IgE介导的临床表现。最近,针对牛奶蛋白的抗体(IgA和IgG类)评估被提议作为可靠的检测方法。为了确定针对牛奶蛋白的抗体反应模式,我们研究了37名年龄在3个月至6岁的儿童(17名男性和20名女性),分组如下:23名患有CMPI,其中16名有胃肠道症状(GI),7名有皮肤症状(CT);5名患有乳糜泻的儿童;9名无任何临床表现的正常健康儿童。所有儿童在评估时均摄入含牛奶蛋白的饮食。使用酶联免疫吸附测定(ELISA)方法检测针对牛奶蛋白如α-乳白蛋白(αLA)、β-乳球蛋白(βLG)、酪蛋白(CAS)和混合蛋白(PPL)的IgA、IgG和IgM抗体类别。各小组获得的结果如下:CMPI-GI组:αLA-IgA阳性率为43.8%,αLA-IgG为68.7%;βLG-IgA为50%,βLG-IgG为75%;CAS-IgA为43.8%,CAS-IgG为68.7%;PPL-IgA为37.5%,PPL-IgG为62.5%。CMPI-CT组:αLA-IgA阳性率为42.8%,αLA-IgG为57.1%;βLG-IgA为71.4%,βLG-IgG为42.8%;CAS-IgA和CAS-IgG为85.7%;PPL-IgA为71.4%,PPL-IgG为57.1%。(摘要截取自250字)