Division of Pediatrics, Department of Clinical and Experimental Medicine, and Unit of Clinical Experimental Research, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
Pediatr Allergy Immunol. 2010 Jun;21(4 Pt 1):649-55. doi: 10.1111/j.1399-3038.2009.00937.x.
Infants with eczema and sensitization to foods are recommended skin care and, if food allergy is proven, an elimination diet. Although most of these children tolerate foods before 3 yr of age, some children experience prolonged food allergy. To our knowledge, no prospective study has investigated the cytokine profile in food-sensitized eczematous children with prolonged food intolerance. The aim of the study was to prospectively investigate the development of cytokine production induced by food allergen in food-sensitized eczematous children who, at 4(1/2) yr of age, were allergic or tolerant to egg or milk. Twenty-one eczematous infants, [age 5 (3-10) months; median and range], sensitized to egg and/or milk were included, put on elimination diet and followed prospectively. At 4(1/2) yr of age, the children were defined as tolerant or allergic to egg and/or milk based on open or double-blind placebo-controlled food challenges. Peripheral blood mononuclear cells (PBMC) were isolated from the children on inclusion, after 6 wk of elimination diet, and at 3 and 4(1/2) yr of age. Ovalbumin, beta-lactoglobulin and tetanus toxoid-induced IL-4, -5, -10, -13 and IFN-gamma production from PBMC were analyzed with enzyme-linked immunosorbent assay. The IFN-gamma and IL-5 secretion induced by food allergen at 4(1/2) yr was higher in cell cultures from children who were allergic to egg or milk than in tolerant children. In food-allergic children, the levels of IFN-gamma and IL-5 were higher at 4(1/2) yr compared with inclusion levels, but this increase was generally not observed in the tolerant children who consumed milk and egg. In conclusion, immune cells from food-allergic children on an elimination diet respond with up-regulated T helper 1 and T helper 2 cytokine secretion induced by food allergen. We hypothesize that allergen elimination may influence the regulatory mechanisms maintaining balanced immune responses to innocuous food antigens.
患有特应性皮炎且对食物过敏的婴儿建议进行皮肤护理，如果证实存在食物过敏，则进行饮食排除。尽管大多数此类儿童在 3 岁前可以耐受食物，但有些儿童会出现食物过敏持续时间延长。据我们所知，尚无前瞻性研究调查过食物过敏特应性皮炎儿童中持续食物不耐受的细胞因子谱。本研究的目的是前瞻性地研究食物过敏特应性皮炎儿童的细胞因子产生情况，这些儿童在 4 岁半时对鸡蛋或牛奶过敏或耐受。21 名患有特应性皮炎的婴儿（年龄 5 个月（3-10 个月）；中位数和范围），对鸡蛋和/或牛奶过敏，进行了饮食排除，并进行了前瞻性随访。在 4 岁半时，根据开放或双盲安慰剂对照食物挑战，将儿童定义为对鸡蛋和/或牛奶过敏或耐受。在纳入时、排除饮食 6 周后以及 3 岁和 4 岁半时，从儿童中分离外周血单核细胞（PBMC）。使用酶联免疫吸附试验分析 PBMC 对卵白蛋白、β-乳球蛋白和破伤风类毒素诱导的 IL-4、-5、-10、-13 和 IFN-γ的产生。在 4 岁半时，对食物过敏原诱导的 IFN-γ和 IL-5 的分泌，在对鸡蛋或牛奶过敏的儿童的细胞培养物中高于耐受的儿童。在食物过敏的儿童中，与纳入时相比，4 岁半时 IFN-γ和 IL-5 的水平更高，但这种增加在食用牛奶和鸡蛋的耐受儿童中通常观察不到。总之，在饮食排除的食物过敏儿童的免疫细胞中，食物过敏原诱导的 T 辅助 1 和 T 辅助 2 细胞因子的分泌呈上调反应。我们假设过敏原消除可能会影响维持对无害食物抗原平衡免疫反应的调节机制。
