ISSN:0905-6157    

DOI:10.1111/j.1399-3038.1991.tb00199.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Allergic (immune‐mediated) reactions to cow milk and other dietary proteins encountered during infancy are responsible for some of the adverse symptoms and syndromes observed in infants intolerant to cow milk, infant formulas and occasionally human milk. Iron deficiency anemia associated with gastrointestinal blood loss, protein losing enteropathy, enterocolitis, colitis, and malabsorption syndrome are examples of putative allergic reactions to dietary antigens which occur in infancy. A number of symptoms referable to the gastrointestinal tract such as, vomiting, colic and chronic non‐specific diarrhea occur in infants both with and without immune‐mediated reactions to dietary antigens. Verification of adverse reactions to dietary antigens, including allergic reactions, should be accomplished through the use of double‐blind, placebo‐controlled food challenge, with the dietary antigen to be tested presented in a liquid vehicle or, in older children, in capsule form. Approximately 8%–25% of children with immediate hypersensitivity to cow milk have been found to be allergic to soy products. Soy and other intact protein substitutes for cow milk, such as beef and lamb based formulas, have produced anaphylactic reactions both in human infants and in animal models. Hypoallergenic formulas should have a chemically modified protein base which demonstrates significant reduction in anti‐genicity when tested in the laboratory bothin vitroandin vivo.Such formulas should meet rigorous standards for hypoallergenicity in clinical testing in human allergic infants or infants at high risk for developing allergy before being labelled h

ISSN:0905-6157    

DOI:10.1111/j.1399-3038.1991.tb00200.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Allergenicity and antigenicity of various commercially available cow milk hydrolysates intended for infant feeding were analysed in 45 children with cow milk allergy. The hydrolysates included the whey hydrolysates Beba HA® (Good Start HA®) and Profylac®, and the casein hydrolysates Alimentum® and Nutramigen®. Positive skin prick tests were recorded against Beba HA in 10 of 41 tested children (24%), against Profylac® in 5/34 (15%) and in one each (2.5%) against Alimentum and Nutramigen. Double‐blind placebo‐controlled oral challenge tests were performed in 11 children with cow milk allergy using Alimentum, cow milk (positive control) and their regular well‐tolerated formula (Nutramigen or soy) used as negative control. One child reacted to Alimentum. This patient was the only one with circulating antibodies against the product, as indicated by a positive RAST. High density SDS‐PAGE electrophoresis showed that Beba HA contained a number of unresolved proteins, and non‐degraded or partially degraded whey proteins in the range of 5–20 kD. Profylac contained strongly stained protein material in the low molecular weight region 1–10 kD. No protein bands could be identified in the casein‐based hydrolysates. Residual antigenicity was tested by measuring the content of betalactoglobulin in the hydrolysates. Three of the hydrolysates contained<0.06 μg/g dry weight, while the concentration in Beba HA was 200 μg/g dry weight. Positive RAST against Beba HA was detected in 11/45 sera (24%) compared to 7–13% against the other hydrolysates. RAST inhibition with the hydrolysates using cow milk discs was very low for all of them. Using dot immuno‐binding assay a weak IgE binding with Alimentum was detected in 4 sera, Beba HA and Profylac in each 2 sera and with Nutramigen in one. The data taken together show that all 4 tested hydrolysates retain some allergenicity. There were differences between the products, one of the whey hydrolysates being substantially more allergenic and antigenic than the other tested formulas. The casein hydrolysate Alimentum showed few reactionsin vivoandin vitroin this selected group of children but one child reacted when challenged with Alimentum, indicating that there is a risk for general reactions when using any hydrolysed product in su

ISSN:0905-6157    

DOI:10.1111/j.1399-3038.1991.tb00201.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Spontaneous histamine release from basophils was evaluated in children with atopic dermatitis and in healthy controls. Patients were divided into 2 groups, one with specific IgE antibodies for food allergens (Group 1) and one without specific reaginic antibodies (Group 2). Group 1 showed significantly higher histamine release (median 7.25%) than Group 2 (median 4.2%) and healthy controls (median 2.05%). Histamine release was also significantly greater in Group 2 patients compared with healthy controls (p<0.005). Group 1 was studied again after an exclusion diet which resulted in an improvement of symptoms and a significant reduction (p<0.001) of histamine release. Children with atopic dermatitis both with and without IgE antibodies for food allergens present a degree of “basophil hyperreactivity” which decreases after an appropriate exclusion diet in children with associated food alle

ISSN:0905-6157    

DOI:10.1111/j.1399-3038.1991.tb00202.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Repeated exposure of immunocompetent adult rats to aerosolised allergen stimulates persistent IgG responses to the allergen, the magnitude of which varies as a function of genetic background. In contrast, exposed adult animals develop immunological tolerance in the IgE isotype, and are unable to produce allergen‐specific IgE antibody in response to subsequent parenteral immunization. Infant rats appear anergic to challenge with inhaled allergen either in relation to IgG synthesis or expression of tolerance in the IgE antibody class, and both these functions were subsequently acquired during the first week after weaning. Systemic immune responses were essentially normal in the infant animals, suggesting that the failure to ‘recognise’ inhaled antigen in the early postnatal period was due to a selective maturational defect in local respiratory mucosal immune fun

ISSN:0905-6157    

DOI:10.1111/j.1399-3038.1991.tb00203.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Elevation of salivary SIgA‐anti‐casein has been shown to occur in newborn infants at risk of allergy. The present study was designed to follow 158 infants over 3 years to relate the onset of clinical disease to SIgA levels at birth. Newborn infants were divided into 3 groups according to their risk of allergy: Group I, (n= 62; no allergy risk); Group II, (n‐30; low allergy risk); Group III (n= 66; high risk group). The groups were matched for smoking, social background, sex, and dietary habits of the patients. SIgA‐anti‐casein was determined by a direct ELIS A. During the first year 59 infants developed atopic diseases (n= 37 of Groups I and II;n= 22 of Group III). After 3 years 37/61 infants of the high risk group had developed allergic symptoms. The frequency of atopic disease correlated with increased salivary antibody titers at birth (p250 EU/ml developed atopic symptoms at 1 year, 76% high risk infants with this titer developed atopic symptoms at 3 years of age. This study provides evidence that elevation of SIgA‐anti‐casein at birth not only reflects atopic risk as defined by cord blood IgE or family history, but correlates with the actual development of allergic disease during the first 3

ISSN:0905-6157    

DOI:10.1111/j.1399-3038.1991.tb00204.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

The appearance of metachromatic cells in nasal scrapings was studied prospectively in 67 children from birth to 18 months of age. The findings were related to family history of atopy and development of allergic disease in the infants. Allergic disease was diagnosed during the 18‐month follow‐up period in 54% of the infants with heredity for atopic disease. The corresponding figure for children with no heredity was 11%. Using a gentle scraping‐cytocentrifugation method for collection of mucosal specimens, metachromatic cells were identified in the nasal scrapings in 20 of 30 children who developed definite allergic disease (67%) and in 6 of 9 with probable allergy. The cells appeared before or at the time of diagnosis in 19 of the infants with definite allergic disease. Metachromatic cells were also found in 7 of 25 healthy children who did not develop allergic disease during the follow‐up period. Six of them had definite and one possible heredity for allergic disease. No metachromatic cells were found in any of the 8 infants who lacked heredity for atopy and did not develop atopic disease. In conclusion, the appearance of metachromatic cells in the nasal mucosa during the first 18 months of life of infants was associated with atopic propensity, as defined by development of atopic disease and/or a strong family history of

ISSN:0905-6157    

DOI:10.1111/j.1399-3038.1991.tb00205.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

A 10 year‐old boy presenting with an empyema and a previous medical history of recurrent and disseminated infections was investigated immunologically. The serum immunoelectrophoresis showed hypogammaglobulinaemia. Thein vitrolymphocyte proliferation to T‐cell mitogens (PHA and Con A) was diminished and the response to a T‐dependent B cell mitogen (PWM) was severely diminished. Phenotypic analysis of his lymphocytes with monoclonal antibodies revealed normal CD3+, CD4+and CD8+cells with a normal CD4: CD8 ratio. Double immunofluorescence with Leu 8 antibody revealed a selective deficiency of the CD4+LAM 1−subset. Co‐culture experiments between patient's B cells and supernatants from normal T cells showed that the patient's B cells could secrete Igin vitro.We suggest that the Leu 8 monoclonal antibody may be useful in defining abnormalities in the regulatory subsets of T lymphocytes and that these abnormalities may be relevant in the pathogenesis of common variable immunod

ISSN:0905-6157    

DOI:10.1111/j.1399-3038.1991.tb00206.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Measles vaccines are prepared in chick embryo fibroblast culture and used throughout the world. Since 1963 dramatic reductions in the incidence of measles have been observed where the vaccination was extensively applied in the pediatric population. The best results were observed when the target population in the initial phase was that which produced over 90% of cases in the pre‐vaccinal era. A possible limiting factor to the diffusion of measles vaccination is the assumption that allergy to egg proteins is a contraindication. In this paper current knowledge about the safety of measles immunization in children with egg allergy is discusse

ISSN:0905-6157    

DOI:10.1111/j.1399-3038.1991.tb00207.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

The new diagnostic criteria of coeliac disease (CD) give more importance to serological markers. Immunoglobulin A antiendomysial antibodies (IgA‐EmA) were determined in 138 sera from 79 coeliac children and the antibody levels compared to IgG and IgA antigliadin antibodies (IgG‐AGA, IgA‐AGA) in the sera. The assessment was also carried out in 29 children with other gastrointestinal diseases, 29 with non‐gastrointestinal diseases and 35 healthy children. The IgA‐EmA had a 91.4% specificity and a 88.4% sensitivity for active CD. The corresponding figures were 89.8% and 64.4% for IgA‐AGA and 73.7% and 86.2% for IgG‐AGA, respectively. The results of IgA‐EmA determinations were concordant with the intestinal biopsy findings in 90% of cases, versus 80% for IgA‐AGA and 83% for IgG‐AGA. In most of the discordant cases the biopsy showed only minor changes, making the classification difficult. All patients with positive IgA2‐EmA also had positive IgA1EmA antibodies. IgA‐EmA are an excellent serological marker of CD activity in children and they are useful to decrease the number of intestinal biopsies which are needed to confirm the diagno

ISSN:0905-6157    

DOI:10.1111/j.1399-3038.1991.tb00208.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY