食用两种水解配方奶粉的牛奶蛋白过敏儿童的症状缓解及生长结果：墨西哥的一项回顾性研究
Symptom's resolution and growth outcome of children with cow's milk protein allergy consuming two hydrolyzed formulas: A retrospective study in Mexico.
作者信息
Estrada Reyes Elizabeth, Zepeda Ortega Benjamín, Ten Haaf Dominique, Kudla Urszula, Muhardi Leilani, Hofman Denise L, Hageman Jeske H J, Huerta Hernández Rosa E
机构信息
Consultorio Médico, Hospital Ángeles Metropolitano, Mexico City, Mexico.
Clinica San Antonio, Metepec, Mexico.
出版信息
Front Allergy. 2023 Jan 30;4:1073430. doi: 10.3389/falgy.2023.1073430. eCollection 2023.
BACKGROUND
Cow's milk protein allergy (CMPA) is the leading cause of food allergy in infants and young children. An extensively hydrolyzed formula (eHF) is the first choice of dietary management, however, not all of them have similar peptide profiles and degree of hydrolysis. The aim of this retrospective study was to investigate the use of two commercially available infant formulas in the clinical management of CMPA in Mexico in terms of symptoms' resolution and growth trajectories.
METHODS
Medical records of 79 subjects from four sites in Mexico were included to retrospectively evaluate the trajectory of atopic dermatitis, other symptoms of cow's milk protein allergy and growth outcomes. The study formulas were based on hydrolyzed whey protein (eHF-W) and hydrolyzed casein protein (eHF-C).
RESULTS
Medical records of 79 patients were enrolled, 3 were excluded from analysis based on previous formula consumption. Seventy-six children with confirmed CMPA based on skin prick test and/or serum specific IgE levels were included in the analysis. 82% of patients ( = 65) consumed the eHF-C, reflecting the doctors' preference for formulas with a higher grade of hydrolysis and the high incidence of positive reactions to beta-lactoglobulin amongst subjects. During their first visit to the doctors, 55% of the subjects consuming the casein-based formula and 45% of subjects consuming the whey-based formula presented with mild or moderate dermatological symptoms. Other frequently reported symptoms included respiratory issues, enteropathies and colitis which improved during the consumption of both formulas. All CMPA-related symptoms showed improvement during formula consumption. During the period of retrospective observation, growth significantly improved for both groups.
CONCLUSION
Consumption of eHF-C and eHF-W effectively improved symptoms' resolution and growth outcomes among children with CMPA in Mexico. More preference was reported towards eHF-C due to its hydrolysate profile and lack of b-lactoglobulin.
TRIAL REGISTRATION
The study was registered at ClinicalTrials.gov: NCT04596059.
背景
牛奶蛋白过敏（CMPA）是婴幼儿食物过敏的主要原因。深度水解配方奶粉（eHF）是饮食管理的首选，然而，并非所有产品都具有相似的肽谱和水解程度。这项回顾性研究的目的是从症状缓解和生长轨迹方面，调查两种市售婴儿配方奶粉在墨西哥CMPA临床管理中的使用情况。
方法
纳入来自墨西哥四个地点的79名受试者的病历，以回顾性评估特应性皮炎的病程、牛奶蛋白过敏的其他症状和生长结果。研究用配方奶粉基于水解乳清蛋白（eHF-W）和水解酪蛋白（eHF-C）。
结果
共纳入79例患者的病历，3例因之前食用过配方奶粉而被排除在分析之外。基于皮肤点刺试验和/或血清特异性IgE水平确诊为CMPA的76名儿童被纳入分析。82%的患者（n = 65）食用了eHF-C，这反映了医生对水解程度较高配方奶粉的偏好以及受试者中β-乳球蛋白阳性反应的高发生率。在首次就诊时，食用酪蛋白基配方奶粉的受试者中有55%以及食用乳清蛋白基配方奶粉的受试者中有45%出现轻度或中度皮肤症状。其他常见症状包括呼吸道问题、肠病和结肠炎，在两种配方奶粉食用期间均有所改善。所有与CMPA相关的症状在食用配方奶粉期间均有改善。在回顾性观察期间，两组儿童的生长均有显著改善。
结论
在墨西哥，食用eHF-C和eHF-W可有效改善CMPA儿童的症状缓解情况和生长结果。由于其水解产物谱以及不含β-乳球蛋白，更多人倾向于选择eHF-C。
试验注册
该研究已在ClinicalTrials.gov注册：NCT04596059。
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