High Prevalence of Neutrophil Cytoplasmic Autoantibodies in Infants with Food Protein-Induced Proctitis/Proctocolitis: Autoimmunity Involvement?

Sekerkova, Alena; Fuchs, M; Cecrdlova, Eva; Švachová, Veronika; Lesná, I. Králová; Striz, Ilja; Tlaskalová‐Hogenová, Helena

doi:10.1155/2015/902863

Cited by 6 publications

(4 citation statements)

References 32 publications

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“…Estudos recentes detectam possível mecanismo autoimune em casos de PCA. 20,21 Portanto, além da APLV, imaturidade imunológica, alterações na microbiota intestinal ou isquemia de parede podem ser fatores causais de PCA.…”

Section: Discussionunclassified

Proctocolite Alérgica Em Lactentes: Fatores De Risco E Evolução Clínica

CRUZ

Barbosa²,

Rebouças³

2022

BioSCIENCE

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Introdução: Proctocolite alégica (PCA) é uma condição transitória benigna, com início nos primeiros 6 meses de vida. Objetivo: avaliar os potenciais fatores de risco para ocorrência de proctocolite alérgica em lactentes encaminhados com suspeita diagnóstica de alergia à proteína do leite de vaca (PLV), a duração do sintoma e ocorrência de recidiva. Método: estudo retrospectivo com avaliação dos prontuários de lactentes com menos de dois anos de vida com suspeita diagnóstica de PCA por PLV. Resultados: dos 193 lactentes estudados a mediana de idade de início da colite foi 40 dias (IIQ 20–75 dias). A duração mediana do sintoma foi 18 dias (IIQ 6–50 dias). Recidiva da colite ocorreu em 47 pacientes (24%). Conclusões: a evolução da PCA é transitória e benigna, independentemente de sua duração. Recidivas não são ameaçadoras. Muitos casos são idiopáticos. O principal fator de risco para duração prolongada (>30 dias) é o aleitamento materno, e os fatores associados a duração curta são ingestão de PLV, prematuridade, antibióticos e infecções. Não é justificável promover o desmame ou contraindicar antibióticos ou vacinas. PALAVRAS-CHAVE: Lactente. Colite. Proctocolite. Alergia à proteína do leite de vaca.

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Section: Discussionunclassified

Proctocolite Alérgica Em Lactentes: Fatores De Risco E Evolução Clínica

CRUZ

Barbosa²,

Rebouças³

2022

BioSCIENCE

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“…In fact, the nfi IgG values in the high cohort targeting several distinct autoantigens reached clinically relevant levels based on a comparison with a cohort of adult lupus patients. Several autoimmune diseases in children have been reported, including juvenile idiopathic arthritis, juvenile dermatomyositis, autoimmune thrombocytopenia, and proctitis-proctocolitis (food allergen response) [ 47 – 49 ]. However, the cohort in our study did not have any indication of such autoimmune presentations.…”

Section: Discussionmentioning

confidence: 99%

Serum IgG Profiling of Toddlers Reveals a Subgroup with Elevated Seropositive Antibodies to Viruses Correlating with Increased Vaccine and Autoantigen Responses

Reto

Raj

et al. 2021

J Clin Immunol

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Purpose The human antibody repertoire forms in response to infections, the microbiome, vaccinations, and environmental exposures. The specificity of such antibody responses was compared among a cohort of toddlers to identify differences between seropositive versus seronegative responses. Methods An assessment of the serum IgM and IgG antibody reactivities in 197 toddlers of 1- and 2-years of age was performed with a microfluidic array containing 110 distinct antigens. Longitudinal profiling was done from years 1 to 2. Seropositivity to RNA and DNA viruses; bacteria; live attenuated, inactive, and subunit vaccines; and autoantigens was compared. A stratification was developed based on quantitative variations in the IgG responses. Clinical presentations and previously known genetic risk alleles for various immune system conditions were investigated in relation to IgG responses. Results IgG reactivities stratified toddlers into low, moderate, and high responder groups. The high group (17%) had elevated IgG responses to multiple RNA and DNA viruses (e.g., respiratory syncytial virus, Epstein-Barr virus, adenovirus, Coxsackievirus) and this correlated with increased responses to live attenuated viral vaccines and certain autoantigens. This high group was more likely to be associated with gestational diabetes and an older age. Genetic analyses identified polymorphisms in the IL2RB , TNFSF4 , and INS genes in two high responder individuals that were associated with their elevated cytokine levels and clinical history of eczema and asthma. Conclusion Serum IgG profiling of toddlers reveals correlations between the magnitude of the antibody responses towards viruses, live attenuated vaccines, and certain autoantigens. A low responder group had much weaker responses overall, including against vaccines. The serum antibody screen also identifies individuals with IgG responses to less common infections (West Nile virus, parvovirus, tuberculosis). The characterization of the antibody responses in combination with the identification of genetic risk alleles provides an opportunity to identify children with increased risk of clinical disease. Supplementary Information The online version contains supplementary material available at 10.1007/s10875-021-00993-w.

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“…However, this hypothesis would not explain the presence of FPIAP in exclusive formula-fed infants. The possibility of an autoimmune mechanism has been raised by one study that detected perinuclear antineutrophil cytoplasmic (p-ANCA) antibodies in 24 of 25 infants with FPIAP compared to 0 of 18 controls [ 45 ].…”

Section: Research Agendamentioning

confidence: 99%

To Diet or Not to Diet This Is the Question in Food-Protein-Induced Allergic Proctocolitis (FPIAP)—A Comprehensive Review of Current Recommendations

Salvatore,

Folegatti,

Ferrigno

et al. 2024

Nutrients

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Food-protein-induced allergic proctocolitis (FPIAP) is an increasingly reported transient and benign form of colitis that occurs commonly in the first weeks of life in healthy breastfed or formula-fed infants. Distal colon mucosal inflammation is caused by a non-IgE immune reaction to food allergens, more commonly to cow’s milk protein. Rectal bleeding possibly associated with mucus and loose stools is the clinical hallmark of FPIAP. To date, no specific biomarker is available, and investigations are reserved for severe cases. Disappearance of blood in the stool may occur within days or weeks from starting the maternal or infant elimination diet, and tolerance to the food allergen is typically acquired before one year of life in most patients. In some infants, no relapse of bleeding occurs when the presumed offending food is reassumed after a few weeks of the elimination diet. Many guidelines and expert consensus on cow’s milk allergy have recently been published. However, the role of diet is still debated, and recommendations on the appropriateness and duration of allergen elimination in FPIAP are heterogeneous. This review summarizes and compares the different proposed nutritional management of infants suffering from FPIAP, highlighting the pros and cons according to the most recent literature data.

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High Prevalence of Neutrophil Cytoplasmic Autoantibodies in Infants with Food Protein-Induced Proctitis/Proctocolitis: Autoimmunity Involvement?

Cited by 6 publications

References 32 publications

Proctocolite Alérgica Em Lactentes: Fatores De Risco E Evolução Clínica

Proctocolite Alérgica Em Lactentes: Fatores De Risco E Evolução Clínica

Serum IgG Profiling of Toddlers Reveals a Subgroup with Elevated Seropositive Antibodies to Viruses Correlating with Increased Vaccine and Autoantigen Responses

To Diet or Not to Diet This Is the Question in Food-Protein-Induced Allergic Proctocolitis (FPIAP)—A Comprehensive Review of Current Recommendations

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