Food Protein-Induced Non-Immunoglobulin E-Mediated Allergic Colitis in Infants and Older Children: What Cytokines Are Involved?

Abstract

Background: Food protein-induced allergic proctocolitis (FPIAP) is mostly a non-immunoglobulin E-mediated disease where a T-cell-mediated reaction to cow's milk protein has been suggested. We determined the expression of transforming growth factor (TGF)-β, TGF-β receptor-1, tumor necrosis factor (TNF)-α, CD86, and CD23 on the colon mucosa to investigate their roles in the pathogenesis of the two subtypes of FPIAP, i.e. infantile FPIAP and FPIAP in older children. Methods: Group 1 comprised children with infantile FPIAP (age <6 months, n = 21), group 2 referred to FPIAP in older children (age >1.5 years, n = 7), and group 3 included children with juvenile hyperplastic polyps (n = 22). Immunohistochemical staining of colonic biopsy specimens was performed. Results: The expression of TNF-α was significantly higher in groups 1 and 2 compared to group 3. Group 2 patients had a significantly lower TGF-β expression compared to the other groups. The expression of CD86 was higher in group 1 than in group 3 (p = 0.012). Eosinophil counts per high-power field in the lamina propria were significantly correlated with CD86 expression (p = 0.026, r = 0.388). Conclusion: Our results suggest that TNF-α is implicated in the pathogenesis of both types of FPIAP. The decreased activity of TGF-β receptor-1 accompanied by the increased expression of CD86 in infants and the decreased activity of TGF-β in older children appear to play a role in the development of FPIAP.

Fecal microbiota transplantation induces remission of infantile allergic colitis through gut microbiota re-establishment

“…Bloody purulent stools, abdominal pain, and vomiting are also used to diagnose AC[ 3 ]. Various factors such as food allergens, aberrant immune system, and imbalanced gut microbiota (GM) are thought to contribute to AC[ 4 - 6 ].…”

Food protein-induced allergic proctocolitis in infants: Literature review and proposal of a management protocol

“…A former research on toddlers with multiple food allergies showed by flow cytometry, immunohistochemistry, and in situ hybridization that the expression of TGF-β significantly decreased in the duodenal mucosa with either immediate or delayed adverse food reactions. 12 Ozen et al support that a reduced expression of TGF-β might be implicated in the sensitization of children to dietary proteins. 11 , 12 …”

Food Protein-Induced Proctocolitis

“…Белки коровьего молока являются наиболее распространенными аллергенами, способствующими развитию проктоколита, индуцированного пищевыми белками. За ним следуют соя и яйцо [1,2,[13][14][15][16]. При обследовании группы пациентов (n=77) молоко было идентифицировано как триггер у 78%, молоко и яйцо -у 13%, а яйцо -только у 5% [16].…”

“…Возраст манифестации, клинические проявления Заболевание обычно дебютирует в возрасте от нескольких дней до 6 мес (в среднем 1-4 нед) у детей, находящихся на естественном или искусственном вскармливании с использованием стандартной молочной или соевой смеси, и значительно чаще встречается у детей раннего возраста, чем у подростков [1-3, 6, 13, 14, 22]. Тем не менее отмечено, что проктоколит, индуцированный пищевыми белками, может проявляться и у детей старше года [15]. Авторами описаны 16 детей в возрасте 2-14 лет с персистирующими или рецидивирующими ректальными кровоте-чениями, легкими формами левостороннего колита с эозинофильной инфильтрацией, фокальной гиперплазией лимфоидных фолликулов и положительным клиническим и гистологическим ответом на элиминацию из диеты коровьего молока.…”