Blanco Quirós A, Garrote Adrados J A, Andión Dapena R, Alonso Franch M, Calvo Romero C, Bobillo del Amo H
Departamento de Pediatría, Hospital Clínico, Universidad de Valladolid.
An Esp Pediatr. 1993 Apr;38(4):330-6.
The levels of soluble interleukin-2 receptor (sIL-2R) were measured in 35 serum samples from children with food intolerance; 19 had an IgE-mediated sensitization and were considered as atopic patients, skin tests and RAST were negative in the remaining 16 children and they were diagnosed as having cow milk intolerance (CMI) Forty-three coeliac patients were included as a positive control group and 18 normal children as the negative control group. The atopic group showed normal values of sIL-2R (1,183 +/- 468 u/ml); however, it was increased in children with CMI (1,453 +/- 469 u/ml, p < 0.05). The sIL-2R mean value was highest in patients with gastrointestinal symptoms (1,458 +/- 461 u/ml, p: 0.03) and the presence of atopic dermatitis was not relevant. The sIL-2R was also elevated in 8 children with igE-mediated sensitization against cow's milk (1,477 +/- 328 u/ml, p < 0.05). These results suggest that a delayed cellular mechanism occurred in CMI, similar to that present in coeliac disease, although it was less severe. In addition, there is an overlap of humoral and cellular immunological mechanisms in the IgE-mediated sensitization to cow's milk, but we did not find this coincidence in the allergy to remaining foods. From a pathogenic point of view, to separate CMI from IgE-mediated allergies to milk does not seem to be sufficiently justified at the present time. It is possible that the atopy against cow milk proteins in children has a different immunological mechanism than the atopy to other foods, which would explain its better prognosis.
对35名食物不耐受儿童的血清样本进行了可溶性白细胞介素-2受体（sIL-2R）水平检测；其中19名有IgE介导的致敏反应，被视为特应性患者，其余16名儿童皮肤试验和放射性变应原吸附试验（RAST）均为阴性，他们被诊断为牛奶不耐受（CMI）。纳入43名乳糜泻患者作为阳性对照组，18名正常儿童作为阴性对照组。特应性组sIL-2R值正常（1183±468 U/ml）；然而，CMI儿童的sIL-2R值升高（1453±469 U/ml，p<0.05）。有胃肠道症状的患者sIL-2R平均值最高（1458±461 U/ml，p:0.03），特应性皮炎的存在与之无关。8名对牛奶有IgE介导致敏反应的儿童sIL-2R也升高（1477±328 U/ml，p<0.05）。这些结果表明，CMI中发生了延迟性细胞机制，类似于乳糜泻中的情况，尽管程度较轻。此外，在IgE介导的牛奶致敏反应中存在体液和细胞免疫机制的重叠，但在对其他食物的过敏反应中未发现这种巧合。从发病机制的角度来看，目前将CMI与IgE介导的牛奶过敏区分开来似乎没有充分的依据。儿童对牛奶蛋白的特应性可能具有与对其他食物的特应性不同的免疫机制，这可以解释其较好的预后。
