Increased IFN‐γ secretion from duodenal biopsy samples in delayed‐type cow's milk allergy

Abstract

A delayed and local gastrointestinal hypersensitivity to cow's milk (CM) protein is difficult to diagnose and there are limited data on this disorder. The aim of this study was to investigate local intestinal cytokine secretion in the upper small intestine in children with delayed-type cow's milk allergy (CMA). Duodenal biopsy samples from 31 children with delayed CMA, 14 with celiac disease (CD), and 14 healthy controls were studied for the spontaneous release of IFN-gamma, TNF-alpha, IL-2, IL-4, IL-5, and IL-10, measured by cytometric bead array, and of TGF-beta and IL-6 measured by ELISA. The children with delayed CMA secreted more IFN-gamma than the controls (p = 0.006) and the children with CD (p = 0.006). The children with CD secreted more IL-6 compared to the controls (p = 0.008) and the children with delayed CMA (p = 0.002). The children with delayed CMA who had continuously been exposed to CM secreted less TGF-beta than the children with delayed CMA who avoided CM (p = 0.050), and showed a tendency towards lower secretion compared to the controls (p = 0.078). Secretions of TNF-alpha, IL-2, IL-4, IL-5, and IL-10 were low in general; however, the children with delayed CMA who did not avoid CM secreted more IL-4 and IL-10 than the controls (p = 0.016, 0.059). In conclusion, the children with delayed CMA showed up-regulation of IFN-gamma. Interestingly, TGF-beta secretion was up-regulated in those children with delayed CMA who avoided CM suggesting recovery of regulation mechanisms.

TLR4 receptor and selected cytokines in development of food allergy in infants and small children

“…Our study showed that levels of IFN-γ were higher in children from the IgEindependent group than in children from the IgE-dependent group. Paajanen et al observed an increased level of IL-4, IL-5 and IFN-γ from duodenal biopsy in children with delayed cow's milk allergy when an elimination diet was not introduced [32]. The results of our study showed lower concentration of IL-2 in allergic groups (especially in children with IgE-dependent allergy).…”

Asthmatic Response to Milk Ingestion Challenge in Adults: A Comparison of the Open and Double-Blind Challenges

“…The LAR to foods has also been reported, but its immunological mechanism has not yet been sufficiently clarified [2,9,10,14,17,18,23,26,27,38]. In the DYAR to food challenge that we described previously [26,27], which is analogical to the DYAR induced by inhalant allergens [49], an involvement of the cell-mediated hypersensitivity mechanism could be presumed [13,15,16,18,19,20,21,22,23,24,26,27,49]. However, there is still a dearth of structural information concerning the immunological mechanisms underlying the particular food-induced AR types investigated in large groups of well-defined patients [1,2,3,6,7,8,17,23,25,26,27,30,37,38,39,41,42].…”

“…Food allergy was previously classically attributed to the involvement of the immediate (IgE-mediated) hypersensitivity mechanism [1,2,3,4,5,6,7,8,9,10,11,17,22,23,25,26,27,28,29,30,31,32,33,34]. However, evidence has been found for the possible involvement of other, so-called non-IgE-mediated, hypersensitivity types, such as late (immune-complex-mediated) and delayed (cell-mediated) types of hypersensitivity in food allergy [1,3,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30]. Food allergy can also be a factor in disorders of the respiratory tract, such as bronchial asthma [1,2,3,4,8,9,10,11,21,23,24,25,26,27,28,29,30,31,34,35,36].…”

“…Food allergy is a multifaceted clinical manifestation of an immunological process in which foods or their components act as antigens, stimulating the production of specific antibodies or sensitizing the particular T lymphocyte subsets and subsequently interacting with them [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30]. Food allergy was previously classically attributed to the involvement of the immediate (IgE-mediated) hypersensitivity mechanism [1,2,3,4,5,6,7,8,9,10,11,17,22,23,25,26,27,28,29,30,31,32,33,34].…”

“…Food-induced IAR, LAR, DAR and DYAR differ from each other with respect to their clinical features, their association with other diagnostic parameters and to the possible underlying immunological mechanisms [1,2,3,4,9,12,13,14,15,16,17,18,19,23,25,26,27,30,32,34,40,42,43]. The provocation tests with foods should be considered to be the definite confirmation of the contribution of a certain food to the patient’s complaints, e.g.…”