Pérez-Moreno Jimena, Bernaldo-de-Quirós Esther, Tolín Hernani Mar, Álvarez-Calatayud Guillermo, Perezábad Laura, Sánchez Sánchez César, Correa-Rocha Rafael
Servicio de Pediatria, Digestivo Infantil, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain.
Laboratory of Immune-Regulation, Gregorio Marañón Health Research Institute, 28009 Madrid, Spain.
Children (Basel). 2025 May 27;12(6):688. doi: 10.3390/children12060688.
The pathophysiology of non-IgE-mediated cow's milk allergy is mostly unknown. Previous studies suggested a mechanism mediated by T cells, but this was not confirmed in subsequent studies. The aim of this study was to investigate the immunological mechanisms, especially the role of regulatory T cells (Tregs), in the pathophysiology of allergic proctocolitis (FPIAP).
A prospective observational study was conducted on infants with FPIAP and a control group of healthy infants with similar ages. The main variables were lymphocyte populations, included Tregs, which were extracted from peripheral blood and processed immediately by flow cytometry at two time points: in the acute phase ("T0") and after clinical resolution ("Tres").
A total of 32 patients with FPIAP and 10 healthy infants were enrolled. There was a higher T-CD4 memory cell count, increased numbers of regulatory B cells and a higher percentage of Tregs ( < 0.01) in patients with acute FPIAP in contrast to the healthy group. The levels of granulocytes (mainly eosinophils), dendritic cells (mDC2) and NK16+56- cells were also significantly higher in the FPIAP group. NK16+56- cells and the number of granulocytes appeared to be the best markers for distinguishing between the healthy and FPIAP infants based on the ROC curves.
FPIAP does not appear to have an immune mechanism mediated by T cells, but it may be associated with innate immunity responses characterized by an increase in NK16+56- cells, eosinophils and dendritic cells. These cells could be evaluated in future studies as possible markers of non-IgE-mediated cow's milk protein allergy.
非IgE介导的牛奶过敏的病理生理学大多未知。先前的研究提出了一种由T细胞介导的机制，但在后续研究中未得到证实。本研究的目的是探讨免疫机制，特别是调节性T细胞（Tregs）在过敏性直肠结肠炎（FPIAP）病理生理学中的作用。
对患有FPIAP的婴儿和年龄相似的健康婴儿对照组进行了一项前瞻性观察研究。主要变量是淋巴细胞群体，包括从外周血中提取的Tregs，并在两个时间点通过流式细胞术立即进行处理：急性期（“T0”）和临床缓解后（“Tres”）。
共纳入32例FPIAP患者和10例健康婴儿。与健康组相比，急性FPIAP患者的T-CD4记忆细胞计数更高，调节性B细胞数量增加，Tregs百分比更高（<0.01）。FPIAP组的粒细胞（主要是嗜酸性粒细胞）、树突状细胞（mDC2）和NK16 + 56-细胞水平也显著更高。根据ROC曲线，NK16 + 56-细胞和粒细胞数量似乎是区分健康婴儿和FPIAP婴儿的最佳标志物。
FPIAP似乎没有由T细胞介导的免疫机制，但可能与以NK16 + 56-细胞、嗜酸性粒细胞和树突状细胞增加为特征的先天免疫反应有关。这些细胞在未来的研究中可作为非IgE介导的牛奶蛋白过敏的可能标志物进行评估。
