Amino acid formulas and hydrolyzed formulas given to infants in Japan with milk allergies theoretically contain little, if any, biotin and carnitine. We assessed biotin and carnitine insufficiency in six infants with milk allergy who were fed amino acid formulas and/or hydrolyzed formulas, by measuring urine 3-hydroxyisovaleric acid (3-HIA) and serum free carnitine (C0), respectively. All patients presented with elevated urine 3-HIA and lowered serum C0 compared with post-menstrual age-matched infants who were fed breast milk or standard infant formulas. Supplementation with biotin and L-carnitine immediately improved the insufficiency. Care should be taken to avoid biotin and carnitine deficiency in allergic infants fed amino acid or hydrolyzed formulas.

Background: Expression of the tumor necrosis factor-α receptor by human eosinophils has not been determined. We examined the surface expression and mRNA for tumor necrosis factor-α receptors I and II (TNF-αRI and TNF-αRII) on peripheral eosinophils. Methods: Eosinophils were obtained from 17 asthma patients and 3 healthy volunteers. Flow cytometry was used to examine receptor expression, and the reverse transcriptase-polymerase chain reaction was used to examine receptor mRNA expression. Results: Flow cytometry revealed that 16 out of 20 subjects had eosinophils expressing TNF-αRI and 18 subjects had eosinophils expressing TNF-αRII. All eosinophils expressed at least one receptor. The mRNA for TNF-αRII was detected in all eosinophils examined, but the signals for TNF-αRI mRNA were only found in cells expressing this receptor. Conclusions: Human peripheral eosinophils show heterogeneous expression of TNF-αRI and TNF-αRII.

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