The First People's Hospital of Lianyungang, The First Affiliated Hospital of Kangda College of Nanjing Medical University.
The First People's Hospital of Lianyungang, The First Affiliated Hospital of Kangda College of Nanjing Medical University;
Allergol Immunopathol (Madr). 2022 Sep 1;50(5):162-168. doi: 10.15586/aei.v50i5.592. eCollection 2022.
BACKGROUND: Cow's milk protein allergy (CMPA) is an abnormal immune response caused by milk proteins and is most common in infancy and early childhood. Statistics revealed up to 7.5% of children suffered from milk allergy. Its clinical symptoms were characterized by diversity, non-specificity, and can affect multiple systems, including the digestive tract, skin, and respiratory tract. In this study, we aimed to investigate the effects of IL-12, IL-16, and IL-17A on diagnosing and monitoring CMPA in children for clinical treatment. METHODS: A total of 158 infants with CMPA and 89 healthy babies were recruited and evaluated. Demographic and clinical information of all participants were recorded. An extensive analysis of inflammatory cytokine levels, including IL-12, IL-16, and IL-17A, was performed in blood samples from 247 infants younger than 9 months. Meanwhile, the serological specificity immunoglobulin E (sIgE) levels were evaluated. In addition, the area under the curve (AUC) values of IL-12, IL-16, and IL-17A in differentiating CMP from healthy babies were measured by receiver operating characteristic analysis. Finally, the correlation between sIgE and IL-12, IL-16, and IL-17A levels were detected using Spearman correlation analysis. RESULTS: Compared with healthy control, infants who developed CMPA had decreased IL-12, increased IL-16, and IL-17A. Moreover, a significant correlation between serum IL-12, IL-16, IL-17A and sIgE levels was observed in the CMPA group. In addition, AUC values of IL-12, IL-16, and IL-17A in discriminating CMPA from healthy infants were 0.8425, 0.9196, and 0.8813, respectively. Finally, IL-12 was increased while IL-16 and IL-17A levels were decreased in the CMPA group after three months of milk avoidance treatment. CONCLUSIONS: We found that IL-12, IL-16, and IL-17A levels in children with CMPA were associated with SCORAD scores, sIgE levels, and disease severity, functioning as valuable disease-monitor markers in CMPA.
背景：牛奶蛋白过敏（CMPA）是由牛奶蛋白引起的异常免疫反应，在婴儿和幼儿中最为常见。统计数据显示，高达 7.5%的儿童患有牛奶过敏。其临床症状表现为多样性、非特异性，并可影响多个系统，包括消化道、皮肤和呼吸道。在本研究中，我们旨在探讨白细胞介素-12（IL-12）、白细胞介素-16（IL-16）和白细胞介素-17A（IL-17A）对儿童 CMPA 的诊断和监测作用，为临床治疗提供参考。
方法：共纳入 158 例 CMPA 婴儿和 89 例健康婴儿，并对所有参与者的人口统计学和临床信息进行记录。对 247 例 9 个月以下的婴儿进行了血液样本的炎症细胞因子水平（包括 IL-12、IL-16 和 IL-17A）的广泛分析，并评估了血清特异性免疫球蛋白 E（sIgE）水平。此外，通过受试者工作特征分析（ROC 分析）测量了 IL-12、IL-16 和 IL-17A 在区分 CMP 和健康婴儿方面的曲线下面积（AUC）值。最后，采用 Spearman 相关分析检测 sIgE 与 IL-12、IL-16 和 IL-17A 水平之间的相关性。
结果：与健康对照组相比，发生 CMPA 的婴儿的 IL-12 降低，IL-16 和 IL-17A 升高。此外，在 CMPA 组中，血清 IL-12、IL-16 和 IL-17A 水平与 sIgE 水平之间存在显著相关性。此外，IL-12、IL-16 和 IL-17A 区分 CMPA 与健康婴儿的 AUC 值分别为 0.8425、0.9196 和 0.8813。最后，在进行三个月的牛奶回避治疗后，CMPA 组的 IL-12 增加，而 IL-16 和 IL-17A 水平降低。
结论：我们发现，CMPA 患儿的 IL-12、IL-16 和 IL-17A 水平与 SCORAD 评分、sIgE 水平和疾病严重程度相关，可作为 CMPA 的有价值的疾病监测标志物。
Allergol Immunopathol (Madr). 2022
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