Kara M, Beser O F, Konukoglu D, Cokugras H, Erkan T, Kutlu T, Cokugras F C
Department of Pediatrics, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey.
Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey.
Allergol Immunopathol (Madr). 2020 Jan-Feb;48(1):48-55. doi: 10.1016/j.aller.2019.04.011. Epub 2019 Nov 13.
Several pro-inflammatory and anti-inflammatory mediators play a role in the immunopathogenesis of food allergy (FA). The aim of this study was to investigate the utility of serum biomarkers like interleukin (IL)-10, TNF-α, and IL-6 in the diagnosis and/or follow-up of FA.
Sixty (25 females, 41.6%) newly diagnosed FA patients [IgE mediated (group-1, n=37), non-IgE (group-2, n=23)] with a median age of nine (1-33) months were enrolled. Twenty-four healthy children with a median age of eight (1-36) months constituted the control group (CG). In all the subjects, serum TNF-α, IL-6 and IL-10 levels were evaluated at the time of diagnosis and reassessed four weeks after therapeutic elimination diet (TED).
The mean white blood cell count and median absolute eosinophile count of the CG were significantly lower than group-1 (p values were 0.019 and 0.006, respectively). The mean absolute neutrophile count and the median IL-6 were significantly higher in group-1 when compared with group-2 (p values were 0.005 and 0.032, respectively. Median TNF-α and IL-6 levels were significantly higher in the pre-TED among all patients (p values were 0.005 and 0.018, respectively). In group-1, median TNF-α and IL-6 levels decreased significantly after TED (p values were 0.01 and 0.029, respectively).
Our findings support the role of inflammation in the pathogenesis of FA. Serum TNF-α and IL-6 levels may be useful markers for follow-up in FA, especially among IgE-mediated FA patients. Evaluation of IL-10 results was not sufficient for an interpretation of clinical tolerance.
多种促炎和抗炎介质在食物过敏(FA)的免疫发病机制中起作用。本研究的目的是探讨血清生物标志物如白细胞介素(IL)-10、肿瘤坏死因子-α(TNF-α)和IL-6在FA诊断和/或随访中的效用。
纳入60例新诊断的FA患者[IgE介导(第1组,n = 37),非IgE(第2组,n = 23)],中位年龄为9(1 - 33)个月,其中女性25例(41.6%)。24例中位年龄为8(1 - 36)个月的健康儿童构成对照组(CG)。在所有受试者中,于诊断时评估血清TNF-α、IL-6和IL-10水平,并在治疗性排除饮食(TED)四周后重新评估。
CG组的平均白细胞计数和中位绝对嗜酸性粒细胞计数显著低于第1组(p值分别为0.019和0.006)。与第2组相比,第1组的平均绝对中性粒细胞计数和中位IL-6显著更高(p值分别为0.005和0.032)。所有患者在TED前的中位TNF-α和IL-6水平显著更高(p值分别为0.005和0.018)。在第Ⅰ组中,TED后中位TNF-α和IL-6水平显著降低(p值分别为0.01和0.029)。
我们的研究结果支持炎症在FA发病机制中的作用。血清TNF-α和IL-6水平可能是FA随访的有用标志物,尤其是在IgE介导的FA患者中。对IL-10结果的评估不足以解释临床耐受性。