Çelik Menşure Nur, Köksal Eda, Terece Sinem Polat, Köken Gizem, Karagöl Hacer İlbilge Ertoy, Bakirtas Arzu
Ondokuz Mayis University, Department of Nutrition and Dietetics, Samsun, Türkiye.
Gazi University, Department of Nutrition and Dietetics, Ankara, Türkiye.
Pediatr Res. 2025 May 13. doi: 10.1038/s41390-025-04117-7.
There are no data on using the Cow's Milk Protein Related Symptom Score (CoMiSS), a clinical screening tool, to monitor symptom improvement in infants with cow's milk protein allergy (CMPA). This study aimed to evaluate the efficacy of CoMiSS on elimination diet response in infants diagnosed with Cow's Milk Protein Associated Proctocolitis (CMPAP) compared with healthy controls METHODS: A case-control study with follow-up compared infants with CMPAP on an elimination diet to healthy peers. Infants with CMPAP (n = 13) and healthy infants (n = 22), aged 17-26 weeks, were included. Four visits were conducted at six, seven, nine, and 12 months of age. CoMiSS was assessed at each visit.
CoMiSS significantly decreased after the four-week elimination diet (p < 0.05). At study's end, total CoMiSS scores increased in both groups (p < 0.05). The crying score's median was higher in CMPAP infants than controls at Visits 1 and 3 (p < 0.05). No significant changes were found for other symptoms.
CoMiSS tends to decrease during elimination diet in infants with CMPAP, which is promising for its use in evaluating dietary response. Monitoring the crying score and developing the defecation score specific to CMPAP would serve this purpose more.
The CoMiSS can be a promising tool for monitoring responses to elimination diets in infants with proctocolitis, a specific subgroup of CMPA. It highlights the potential of CoMiSS to monitor dietary response and suggests refinements for its application, such as focusing on crying scores and developing a CMPA-specific defecation score. The findings pave the way for a novel use of CoMiSS beyond its screening purpose, potentially enhancing clinical management of CMPA in infants with proctocolitis. This approach could lead to more tailored and effective dietary interventions, improving patient outcomes and contributing to the refinement of CMPA management tools.
目前尚无关于使用牛奶蛋白相关症状评分（CoMiSS）这一临床筛查工具来监测牛奶蛋白过敏（CMPA）婴儿症状改善情况的数据。本研究旨在评估CoMiSS在诊断为牛奶蛋白相关性直肠结肠炎（CMPAP）的婴儿中对排除饮食反应的疗效，并与健康对照进行比较。方法：一项有随访的病例对照研究，将接受排除饮食的CMPAP婴儿与健康同龄人进行比较。纳入了年龄在17 - 26周的CMPAP婴儿（n = 13）和健康婴儿（n = 22）。在6、7、9和12月龄时进行了四次访视。每次访视时评估CoMiSS。
四周的排除饮食后CoMiSS显著降低（p < 0.05）。在研究结束时，两组的CoMiSS总分均升高（p < 0.05）。在第1次和第3次访视时，CMPAP婴儿的哭闹评分中位数高于对照组（p < 0.05）。其他症状未发现显著变化。
CMPAP婴儿在排除饮食期间CoMiSS往往会降低，这使其在评估饮食反应方面具有应用前景。监测哭闹评分并制定针对CMPAP的排便评分将更有助于实现这一目的。
CoMiSS可能是监测直肠结肠炎（CMPA的一个特定亚组）婴儿对排除饮食反应的有前景的工具。它突出了CoMiSS监测饮食反应的潜力，并建议对其应用进行改进，例如关注哭闹评分并制定特定于CMPA的排便评分。这些发现为CoMiSS超越其筛查目的的新用途铺平了道路，有可能加强对患有直肠结肠炎的CMPA婴儿的临床管理。这种方法可能会带来更具针对性和有效的饮食干预，改善患者预后，并有助于完善CMPA管理工具。
