Department of Screening Tests and Metabolic Diagnostics, Institute of Mother and Child, Kasprzaka 17A, 01-211 Warsaw, Poland.
Department of Nutrition, Institute of Mother and Child, Kasprzaka 17A, 01-211 Warsaw, Poland.
Nutrients. 2021 Mar 24;13(4):1057. doi: 10.3390/nu13041057.
The aim of the study was to establish whether the use of a strict milk-free diet in children with cow's milk allergy, resulting in the resolution of clinical symptoms of the disease, also extinguishes the inflammatory reaction induced by the allergy.
We examined 64 children (aged 3-6 years) with a diagnosed cow's milk allergy who had been treated with an elimination diet for at least six months and showed remission of the disease's clinical symptoms as a result of the treatment. The control group consisted of 30 healthy children of the same age following an unrestricted age-appropriate diet. Concentrations of cytokines, calprotectin, and adipokines (leptin, resistin, chemerin, neutrophilic lipocalin associated with gelatinase-NGAL) were determined in the serum samples obtained from the studied children by immunoenzymatic assays.
Patients with CMA had significantly higher median values of serum IL-6, TNF-α, resistin, chemerin and NGAL in comparison to the healthy children ( < 0.05, < 0.001, < 0.05, < 0.01, < 0.001, respectively). Serum concentrations of IL-10, leptin, calprotectin and CRP as well as in WBC count were in the same range in both studied groups. We observed direct statistically significant correlations between levels of IL-10 and CRP ( = 0.005), IL-10 and WBC ( = 0.045), TNF-α and WBC ( = 0.038), calprotectin and WBC ( < 0.001), chemerin and CRP ( < 0.001) as well as between NGAL and WBC ( = 0.002) in children with CMA.
The use of a strict milk-free diet by children with CMA, resulting in the resolution of clinical symptoms of the disease, does not seem to extinguish the inflammation induced by the allergy. The findings of this study-elevated IL-6, TNF-α, resistin, chemerin and NGAL levels in patients with CMA-suggest that these parameters seem to be involved in the generation of a low-grade proinflammatory environment observed in cow's milk allergy and could be used to monitor the effectiveness of treatment.
本研究旨在确定在患有牛奶过敏的儿童中采用严格的无牛奶饮食是否能消除疾病的临床症状，同时也能消除过敏引起的炎症反应。
我们检查了 64 名（年龄 3-6 岁）被诊断患有牛奶过敏的儿童，他们接受了至少六个月的消除饮食治疗，并且由于治疗而使疾病的临床症状得到缓解。对照组由 30 名年龄相仿、饮食不受限制的健康儿童组成。通过免疫酶联测定法从研究儿童的血清样本中测定细胞因子、钙卫蛋白和脂肪因子（瘦素、抵抗素、趋化素和与明胶酶-NGAL 相关的嗜中性粒细胞脂质运载蛋白）的浓度。
与健康儿童相比，患有 CMA 的患者血清中 IL-6、TNF-α、抵抗素、趋化素和 NGAL 的中位数显著升高（<0.05，<0.001，<0.05，<0.01，<0.001，分别）。两组的血清 IL-10、瘦素、钙卫蛋白和 CRP 浓度以及白细胞计数均处于相同范围内。我们观察到患有 CMA 的儿童的 IL-10 和 CRP（=0.005）、IL-10 和白细胞（=0.045）、TNF-α和白细胞（=0.038）、钙卫蛋白和白细胞（<0.001）、趋化素和 CRP（<0.001）以及 NGAL 和白细胞（=0.002）之间存在直接统计学显著相关性。
患有 CMA 的儿童采用严格的无牛奶饮食，使疾病的临床症状得到缓解，似乎并不能消除过敏引起的炎症。本研究发现 CMA 患者的 IL-6、TNF-α、抵抗素、趋化素和 NGAL 水平升高，表明这些参数似乎参与了牛奶过敏中观察到的低度炎症环境的产生，并且可以用于监测治疗效果。
