Amino acid‐based formula affects the gastrointestinal cytokine milieu of children with non‐IgE mediated cow's milk allergy

Jones, Hannah; Hartog, Anita; Stephenson, Holly; Brunner, K. T.; Harthoorn, Lucien F.; Langford, Jane E.; Shah, Neil; Bajaj-Elliott, Mona; Lindley, Keith

doi:10.1186/2045-7022-5-s3-p41

Cited by 4 publications

(13 citation statements)

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“…The capacity of an AAF to reduce proinflammatory cytokine and chemokine production in inflammatory conditions has been demonstrated previously. For instance, it is shown that intake of an AAF with an AA composition highly similar to that of the AA diet used in this study (ie, Neocate) reduces colonic inflammatory status in infants with non‐IgE‐mediated CMA 26 . This was evidenced by lower baseline levels of proinflammatory cytokines TNF‐α and IL‐6 in biopsy supernatants of the allergic infants with the AAF in their diet compared to those without the AAF in their diet.…”

Section: Discussionmentioning

confidence: 69%

“…Whereas numerous studies have investigated AAFs as a dietary management option for CMA, little is known about the potential of AAFs to prevent allergic sensitization and clinical symptoms of CMA. AAFs have been demonstrated to exert anti‐inflammatory effects both in human and in in vitro immune models, which may inhibit allergic sensitization 26,27 . In infants with non‐IgE‐mediated CMA, an AAF prescribed for dietary management of CMA (ie, Neocate) reduced levels of proinflammatory cytokines interleukin‐6 (IL‐6) and tumor necrosis factor‐α (TNF‐α), which are both indicated to drive allergic sensitization 26,28,29 .…”

Section: Introductionmentioning

confidence: 99%

“…AAFs have been demonstrated to exert anti‐inflammatory effects both in human and in in vitro immune models, which may inhibit allergic sensitization 26,27 . In infants with non‐IgE‐mediated CMA, an AAF prescribed for dietary management of CMA (ie, Neocate) reduced levels of proinflammatory cytokines interleukin‐6 (IL‐6) and tumor necrosis factor‐α (TNF‐α), which are both indicated to drive allergic sensitization 26,28,29 . This reduction was accompanied by a significant decline in epithelial‐derived interleukin‐33 (IL‐33) and in T‐cell helper type 2 (T H 2)‐associated cytokines IL‐4 and IL‐13, which are also known to promote allergic sensitization 30 .…”

Section: Introductionmentioning

confidence: 99%

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A free amino acid‐based diet partially prevents symptoms of cow's milk allergy in mice after oral sensitization with whey

Sadelhoff

Hogenkamp

Wiertsema

et al. 2020

Immunity Inflam & Disease

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Background: Amino acid-based formulas (AAFs) are used for the dietary management of cowʼs milk allergy (CMA). Whether AAFs have the potential to prevent the development and/or symptoms of CMA is not known.Objective: The present study evaluated the preventive effects of an amino acid (AA)-based diet on allergic sensitization and symptoms of CMA in mice and aimed to provide insight into the underlying mechanism. Methods: C3H/HeOuJ mice were sensitized with whey protein or with phosphate-buffered saline as sham-sensitized control. Starting 2 weeks before sensitization, mice were fed with either a protein-based diet or an AA-based diet with an AA composition based on that of the AAF Neocate, a commercially available AAF prescribed for the dietary management of CMA. Upon challenge, allergic symptoms, mast cell degranulation, whey-specific immunoglobulin levels, and FoxP3 + cell counts in jejunum sections were assessed.Results: Compared to mice fed with the protein-based diet, AA-fed mice had significantly lower acute allergic skin responses. Moreover, the AA-based diet prevented the whey-induced symptoms of anaphylaxis and drop in body temperature. Whereas the AA-based diet had no effect on the levels of serum IgE and mucosal mast cell protease-1 (mMCP-1), AA-fed mice had significantly lower serum IgG2a levels and tended to have lower IgG1 levels (P = .076). In addition, the AA-based diet prevented the whey-induced decrease in FoxP3 + cells. In sham-sensitized mice, no differences between the two diets were observed in any of the tested parameters. Conclusion: This study demonstrates that an AA-based diet can at least partially prevent allergic symptoms of CMA in mice. Differences in FoxP3 + cell counts and serum levels of IgG2a and IgG1 may suggest enhanced antiinflammatory and tolerizing capacities in AA-fed mice. This, combined with ---This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.How to cite this article: van Sadelhoff JHJ, Hogenkamp A, Wiertsema SP, et al. A free amino acid-based diet partially prevents symptoms of cowʼs milk allergy in mice after oral sensitization with whey. Immun Inflamm Dis. 2020;8:93-105.

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Section: Discussionmentioning

confidence: 69%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A free amino acid‐based diet partially prevents symptoms of cow's milk allergy in mice after oral sensitization with whey

Sadelhoff

Hogenkamp

Wiertsema

et al. 2020

Immunity Inflam & Disease

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“…Amino acid-based formulas (AAF) are used for the dietary management of cow’s milk allergy and multiple food protein intolerances. A recent study showed that intake of AAF, in addition to a milk-, egg-, wheat- and soy-free diet, results in a reduced colonic inflammatory status in pediatric patients (≤ 5 years, both control and formula group were negative for eosinophilia, [ 1 ] ). The present study aimed to evaluate the immune modulating effect of an amino acid-based formula (Neocate) and its pure total amino acid fraction.…”

mentioning

confidence: 99%

“…This effect might be mediated through specific amino acids or combinations thereof, including glycine. These in vitro studies show that the anti-inflammatory capacity of amino acid-based formulas (as indicated in [ 1 ] ) could, at least partially, be induced by the amino acid composition of the formula used.…”

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confidence: 99%

Anti‐inflammatory features of the amino acid‐based formula Neocate

Hartog

Bastiaans

Buurman

et al. 2015

Clinical & Translational All

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Effect of amino acid‐based formula added to four‐food elimination in adult eosinophilic esophagitis patients: A randomized clinical trial

Rooij

Boerstra

Warners

et al. 2021

Neurogastroenterology Motil

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Background: Elimination of key foods restricts dietary options in eosinophilic esophagitis (EoE) patients. Addition of amino acid-based formula (AAF) to an elimination diet might facilitate adherence and, therefore, enhance efficacy of dietary management. Aim:To evaluate whether addition of AAF to a four-food elimination diet (FFED) is more effective than FFED alone in decreasing eosinophilia, endoscopic signs, and clinical outcomes.Methods: This randomized controlled trial enrolled 41 adult patients with active EoE (≥15 eosinophils (eos) per high power field (hpf)) at baseline biopsy. Subjects were randomized (1:1 ratio) to groups given a FFED or FFED with addition of AAF providing 30% of their daily energy needs (FFED + AAF). Histological disease activity, endoscopic signs, symptoms, and disease-related quality of life (EoEQoL) were measured at baseline and after 6 weeks of intervention.Results: Patients (60% male, age 34.5 (interquartile range (IQR) 29-42.8 years))were randomized to FFED (n = 20) or FFED + AAF (n = 21); 40 participants completed the diet. Complete histological remission (<15 eos/hpf) was achieved in 48% of FFED + AAF subjects (n = 21) vs. 25% of FFED subjects (n = 20), respectively (p = 0.204). Peak eosinophil counts (PEC) decreased significantly in both groups between baseline and week 6, but the change in PEC between groups was not different (p = 0.130). A significant but similar endoscopic and symptomatic reduction was observed in both groups (all; p<0.05). Total EoEQoL scores significantly improved in the FFED + AAF group between baseline and week 6 (p = 0.007), and not in the FFED group.

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Amino acid‐based formula affects the gastrointestinal cytokine milieu of children with non‐IgE mediated cow's milk allergy

Cited by 4 publications

References 1 publication

A free amino acid‐based diet partially prevents symptoms of cow's milk allergy in mice after oral sensitization with whey

A free amino acid‐based diet partially prevents symptoms of cow's milk allergy in mice after oral sensitization with whey

Anti‐inflammatory features of the amino acid‐based formula Neocate

Effect of amino acid‐based formula added to four‐food elimination in adult eosinophilic esophagitis patients: A randomized clinical trial

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