Food Protein-induced Enterocolitis: Altered Antibody Response to Ingested Antigen

McDonald, Philip; Goldblum, Randall M.; Sickle, Greggory J. Van; Powell, Geraldine K.

doi:10.1203/00006450-198408000-00016

Cited by 74 publications

(42 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[70][71][72][73] In case series of infantile food protein-induced enterocolitis caused by cow milk protein, 30% to 64% of infants had concomitant soy-induced enterocolitis, [74][75][76][77] with enterocolitis manifested by bloody diarrhea, ulcerations, and histologic features of acute and chronic inflammatory bowel disease. 69,75,[78][79][80] Afflicted infants have responded to replacing the soy protein-based formula with a hydrolyzed protein formula. It is theorized that the intestinal mucosa damaged by cow milk allows increased uptake and, therefore, increased immunologic response to the subsequent soy antigen.…”

Section: Severe Gastrointestinal Reactions To Soy Formulamentioning

confidence: 99%

Use of Soy Protein-Based Formulas in Infant Feeding

Bhatia¹,

Greer²

2008

Pediatrics

323

333

View full text Add to dashboard Cite

Soy protein-based formulas have been available for almost 100 years. Since the first use of soy formula as a milk substitute for an infant unable to tolerate a cow milk protein-based formula, the formulation has changed to the current soy protein isolate. Despite very limited indications for its use, soy protein-based formulas in the United States may account for nearly 25% of the formula market. This report reviews the limited indications and contraindications of soy formulas. It will also review the potential harmful effects of soy protein-based formulas and the phytoestrogens contained in these formulas.T HE AMERICAN ACADEMY of Pediatrics (AAP) is committed to the use of human milk as the ideal source of nutrition for infant feeding. However, by 2 months of age, the majority of infants in North America are receiving at least some formula. Soy-based infant formulas have been available for almost 100 years. 1 Despite limited indications, soy protein-based formula accounts for approximately 20% of the formula market in the United States. Because an infant formula provides a source of nutrition for an extended interval, its nutritional adequacy must be proven, and the indications for its use must be substantiated and well understood. This statement updates the 1998 AAP review of soy protein-based formulas and addresses the ongoing concern of phytoestrogens in soy formulas. COMPOSITIONIsolated soy protein-based formulas currently on the market are all free of cow milk protein and lactose and provide 67 kcal/dL. All are iron-fortified and meet the vitamin, mineral, and electrolyte specifications addressed in the 2004 guidelines from the AAP for feeding term infants 2 and established by the US Food and Drug Administration. 3 The protein is a soy isolate supplemented with L-methionine, L-carnitine, and taurine to provide a protein content of 2.45 to 2.8 g per 100 kcal or 1.65 to 1.9 g/dL. The fat content of soy protein-based formulas is derived primarily from vegetable oils. The quantity of specific fats varies by manufacturer and is usually similar to those in the manufacturer's corresponding cow milk-based formula. The fat content ranges from 5.02 to 5.46 g per 100 kcal or 3.4 to 3.6 g/dL. The oils used include soy, palm, sunflower, olein, safflower, and coconut. Docosahexaenoic and arachidonic acids now are added routinely.In formulas, carbohydrate sources are corn maltodextrin, corn syrup solids, and sucrose, with content ranging from 10.26 to 10.95 g per 100 kcal or 6.9 to 7.4 g/dL. Until 1980, mineral absorption from soy formulas was erratic because of poor stability of the suspensions and the presence of excessive soy phytates. 4 Because soy protein isolate formulas still contain 1.5% phytates, and up to 30% of the total phosphorus is phytate bound, they contain 20% more calcium and phosphorus than cow milk-based formulas and maintain the ratio of calcium to available phosphorus of 1.1 to 2.0:1. With the current formulations, bone mineralization, serum concentrations of calcium and phosphorus, and alka...

show abstract

Section: Severe Gastrointestinal Reactions To Soy Formulamentioning

confidence: 99%

Use of Soy Protein-Based Formulas in Infant Feeding

Bhatia¹,

Greer²

2008

Pediatrics

323

333

View full text Add to dashboard Cite

show abstract

“…Humoral immune response may also be involved in the pathophysiology of FPIES, with an increase of specific IgA and IgG and a decrease in specific IgG4 antibodies (8,9,21).…”

Section: Discussionmentioning

confidence: 99%

“…Many immunologic alterations have been described in FPIES as humoral antibody-specific responses, especially the involvement of antigenspecific T cells with proinflammatory cytokine production, and subsequent regulation of the intestinal barrier permeability (8,9).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Usefulness of Atopy Patch Test on a Child with Milk Protein-Induced Enterocolitis Syndrome: A Case Report

Scaparrotta

Pillo

Consilvio

et al. 2013

Int J Immunopathol Pharmacol

View full text Add to dashboard Cite

We describe the case of a child affected by milk-protein induced enterocolitis, in which oral challenge with corn was performed without symptoms after a negative specific Atopy Patch Test. Food protein-induced enterocolitis syndrome (FPIES) is an uncommon non-IgE-mediated gastrointestinal food hypersensitivity of infancy, characterized by severe vomiting and diarrhea arising within 1 to 3 hours after ingestion of the causative food. Little is known about the pathophysiology of FPIES. The absence of food-specific IgE as demonstrated by negative skin prick tests suggests that the disease is not caused by an early onset IgE-mediated reaction. Atopy Patch Test has been described as sensitive and predictive in this syndrome. The hypothesis on the immunological pathogenesis has been discussed on the basis of literature data.

show abstract

“…9 It also might shed insight into the underlying immunopathology of other disorders, such as inflammatory bowel disease, which might represent a loss of tolerance to gut microbial flora. Food protein-induced enterocolitis syndrome, first described in young infants by Powell et al, 10 is a non-IgEmediated disorder that can provoke hypotensive shock. In case studies, Sicherer 11 provides the clinical spectrum of this disorder and discusses appropriate evaluation.…”

mentioning

confidence: 99%

Food allergy: When mucosal immunity goes wrong

Sampson

2005

Journal of Allergy and Clinical Immunology

View full text Add to dashboard Cite

Food Protein-induced Enterocolitis: Altered Antibody Response to Ingested Antigen

Cited by 74 publications

References 15 publications

Use of Soy Protein-Based Formulas in Infant Feeding

Use of Soy Protein-Based Formulas in Infant Feeding

Usefulness of Atopy Patch Test on a Child with Milk Protein-Induced Enterocolitis Syndrome: A Case Report

Food allergy: When mucosal immunity goes wrong

Contact Info

Product

Resources

About