Perezabad Laura, López-Abente Jacobo, Alonso-Lebrero Elena, Seoane Elena, Pion Marjorie, Correa-Rocha Rafael
Department of Bioactivity and Food Analysis of the CIAL-CSIC, Madrid, Spain.
Laboratory of Immune-regulation, Hospital General Universitario Gregorio Marañón and Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
Pediatr Res. 2017 May;81(5):722-730. doi: 10.1038/pr.2017.12. Epub 2017 Jan 18.
Cow's milk protein allergy (CMPA) is the most common food allergy in infants. However, little is known about which specific immune mechanisms are related with the CMPA onset. The objective was to investigate which immune alterations constitute differential factors between allergy and tolerance, and hence could be implicated in the CMPA establishment in infants.
An extensive analysis of immune subsets, including Treg and cytokine-secreting cells was performed in blood samples from 28 infants younger than 9 mo obtained 1-4 d after the first adverse reaction to milk.
Less than 4 d after first allergic reaction, infants who developed CMPA had decreased Treg counts and increased frequency of IL4-secreting CD4 T cells compared to controls. The deficit of Tregs was correlated with decreased serum levels of vitamin D. Values of Tregs, IL4-secreting cells and vitamin D were good predictors of CMPA diagnosis. Basal vitamin D levels in CMPA infants also predicted those CMPA patients developing spontaneous tolerance in the first year.
Establishment of CMPA in infants was related with lower Treg and vitamin D levels. These immune alterations would be crucial factors behind the CMPA establishment and they could constitute a therapeutic target for treatment of CMPA.
牛奶蛋白过敏（CMPA）是婴儿中最常见的食物过敏。然而，对于哪些特定免疫机制与CMPA发病相关知之甚少。目的是研究哪些免疫改变构成过敏与耐受之间的差异因素，从而可能与婴儿CMPA的发生有关。
对28名9个月以下婴儿在首次出现牛奶不良反应后1 - 4天采集的血样进行了广泛的免疫亚群分析，包括调节性T细胞（Treg）和分泌细胞因子的细胞。
首次过敏反应后不到4天，与对照组相比，发生CMPA的婴儿Treg计数减少，分泌白细胞介素4（IL4）的CD4 T细胞频率增加。Treg的缺乏与血清维生素D水平降低相关。Treg、分泌IL4的细胞和维生素D的值是CMPA诊断的良好预测指标。CMPA婴儿的基础维生素D水平也可预测那些在第一年出现自发耐受的CMPA患者。
婴儿CMPA的发生与较低的Treg和维生素D水平有关。这些免疫改变可能是CMPA发生的关键因素，它们可能构成治疗CMPA的治疗靶点。
