Vierucci A, Macagno F, Janes A, Rossi M E, Resti M, Azzari C
Clinica Pediatrica III, Università degli Studi di Firenze, Italia.
Pediatr Med Chir. 1993 Jan-Feb;15(1):17-21.
Prevention of food allergy in infancy has been the aim of important researches in the last years but many studies have produced conflicting conclusions. The use of hydrolysate formulas seems to be an helpful tool in prevention of cow milk protein allergy but confusion often remains about capability of small hydrolysate molecules to be "allergens" or "antigens". In order to clarify this point IgE, IgG and IgM as well as IgG subclasses against alfa-lactoalbumin (ALA) and beta-lactoglobulin (BLG) have been evaluated in 41 infants at risk for allergy and in 30 controls at the fourth month. The same evaluation has been done on their mothers. The 41 "at risk" children were fed with breast milk or with an hypoallergenic formula (Nidina HA, Nestlè) or both. The control children received an adapted formula. No difference between the two groups of children was found regarding IgM or IgG against ALA while antibodies against BLG were more frequently found in controls than in "at risk" children. Only one child in the group fed with Nidina HA developed specific IgE against whole milk. Therefore hydrolysate formula seems to be as antigenic (not allergenic) as adapted formula in respect of ALA while BLG contained in adapted formula seems to be a stronger immunogen. The pattern of specific IgG subclasses against ALA and BLG is different between the two groups of children because of the absence in "at risk" group of specific IgG2 and IgG3. As for the mothers, the presence in their sera of IgG against ALA or BLG seems to induce in infants a reduced response to the same antigen.
近年来，婴儿食物过敏的预防一直是重要研究的目标，但许多研究得出了相互矛盾的结论。水解配方奶粉的使用似乎是预防牛奶蛋白过敏的一种有用工具，但对于小分子水解产物作为“过敏原”或“抗原”的能力，人们常常感到困惑。为了阐明这一点，我们对41名有过敏风险的婴儿和30名对照组婴儿在第四个月时针对α-乳白蛋白（ALA）和β-乳球蛋白（BLG）的IgE、IgG和IgM以及IgG亚类进行了评估。对他们的母亲也进行了同样的评估。41名“有风险”的儿童喂食母乳或低敏配方奶粉（雀巢Nidina HA）或两者兼而有之。对照组儿童接受适配配方奶粉。两组儿童在针对ALA的IgM或IgG方面没有差异，而针对BLG的抗体在对照组中比“有风险”的儿童中更常见。在喂食雀巢Nidina HA的组中只有一名儿童产生了针对全脂牛奶的特异性IgE。因此，就ALA而言，水解配方奶粉似乎与适配配方奶粉一样具有抗原性（而非过敏性），而适配配方奶粉中含有的BLG似乎是一种更强的免疫原。由于“有风险”组中缺乏特异性IgG2和IgG3，两组儿童针对ALA和BLG的特异性IgG亚类模式不同。至于母亲，她们血清中存在针对ALA或BLG的IgG似乎会使婴儿对相同抗原的反应降低。
