We present three infants who showed hypertransaminasemia without extrahepatic symptoms, which improved by eliminating cows' milk formulas. The levels of milk protein-specific lymphocyte proliferation were elevated in all three patients. These cases indicate the importance of food allergy in the diagnosis of infantile hepatic dysfunction.
Background: Although hen’s eggs are considered a cause of infantile atopic dermatitis (AD), little is known about cytokine production upon egg stimulation in infants with AD. Objective: This study aimed to characterize the production of IL-4, IL-5 and IFN-γ upon stimulation with ovalbumin (OVA), a representative allergenic protein of egg, in infants with AD. Methods: Peripheral blood mononuclear cells (PBMCs) from 68 children with AD, including 46 infants (<1 year), were stimulated with OVA and the production of IL-4, IL-5 and IFN-γ was measured with ELISA kits. Results: Upon stimulation with OVA, the production of IL-4 and IL-5, but not IFN-γ, by PBMCs was significantly higher in infants with AD than in non-atopic controls. OVA-induced IL-5 production peaked in younger infants (2–5 months) and then decreased with age increase. In contrast, OVA-induced IL-4 production peaked at the age of 1–2. This coincided with the serum level of egg white-specific IgE (EW-IgE). There was a significant positive correlation between IL-5 production and the severity of symptoms in infants with AD, while IL-4 production significantly correlated with the serum level of EW-IgE. Conclusion: These results demonstrate that OVA-induced IL-5 production fluctuates with age in a different manner than IL-4 or EW-IgE. Our results suggest that egg contributes to the development of AD in younger infants by inducing the production of IL-5, but not IL-4.
Background: Although food allergens and house dust mites are thought to contribute to the development of atopic dermatitis (AD) in infants, the influence of pollens has not yet been well defined. Objective: This study attempted to clarify the effect of Japanese cedar pollens (JCPs), which are scattered in Japan between February and April, on AD in infants. Methods: In the first study, seasonal changes in the number of patients who first visited our institute due to AD were analyzed by reviewing medical records of 184 infants with AD. In the second study, peripheral blood mononuclear cells from 81 children (50 infants <1 year and 31 older children) with AD were stimulated with a standardized JCP allergen. The production of IL-5 was measured and its correlation with the severity of AD in infants was analyzed. Results: The number of infants who first visited the institute due to AD peaked in spring. JCP-specific IL-5 production began to increase immediately after the first contact with JCPs in infants with AD. The production of IL-5 in infants with AD exposed to JCPs was significantly higher than in control subjects (p < 0.002) or in AD infants never exposed to JCPs (p < 0.02). There was a significant positive correlation between IL-5 production and the severity of AD in infants (p < 0.0001). Conclusion: These results suggest that JCPs play an important role in the aggravation of infantile AD in spring by inducing IL-5 production.
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