Cytokine profile after oral food challenge in infants with food protein-induced enterocolitis syndrome

Kimura, Mitsuaki; Ito, Yasunori; Shimomura, Masaki; Morishita, Hideaki; Meguro, Takaaki; Adachi, Yuichi; Seto, Shiro

doi:10.1016/j.alit.2016.12.001

Cited by 40 publications

(41 citation statements)

References 26 publications

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“…showed that AEC decreased 6 h after OFC in patients with FPIES. We also observed a similar phenomenon . In the present study, a mild decrease in AEC was also seen in negative OFC.…”

Section: Discussionsupporting

confidence: 89%

“…For statistical purposes, if the value was less than the minimum limit of detection, a provisional figure of 0 was assigned in some instances. An allergen‐specific lymphocyte stimulation test (ALST) was performed using a method previously described …”

Section: Methodsmentioning

confidence: 99%

“…We have also reported that peripheral blood eosinophils increased in many cases of FPIES . Absolute eosinophil count (AEC), however, has been shown to decrease during OFC . Although the reason for the eosinopenia after OFC is not clear, cortisol, which causes eosinopenia, is a likely factor to explain this phenomenon…”

mentioning

confidence: 97%

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Increased serum cortisol on oral food challenge in infants with food protein‐induced enterocolitis syndrome

Shimomura

Ito

Tanaka

et al. 2018

Pediatrics International

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Background: An increase in absolute neutrophil count (ANC) is seen after oral food challenge test (OFC) in patients with food protein-induced enterocolitis syndrome (FPIES). Although it has been suggested that interleukin (IL)-8 is involved in this phenomenon, a possible role for cortisol has not yet been studied. Methods: Six positive OFC in five patients with FPIES due to cows' milk (CM) proteins, and two negative OFC in two patients with suspected FPIES were analyzed. Absolute neutrophil count, serum IL-8, and serum cortisol were measured before OFC, 6 and 24 h after the ingestion of CM formula.Results: For the positive OFC, ANC measured 6 h after the ingestion of CM formula was significantly higher than that measured before the OFC (median, 8,761 versus 2,297/lL; P < 0.05). Significant increases in serum cortisol and IL-8 were observed 6 h after OFC (cortisol, median 1,119 pg/mL before versus 2,141 pg/mL after, P < 0.05; IL-8, median 15.5 pg/mL before versus 165.3 pg/mL after, P < 0.05). The change ratio (i.e. ratio of that after OFC to that before OFC) of ANC was significantly correlated not only with that of serum IL-8 (r = 0.90, P < 0.01) but also with that of serum cortisol (r = 0.76, P < 0.05). Moreover, the serum cortisol change ratio was significantly higher in subjects with vomiting than in those without (median, 2.5 versus 1.0, P < 0.05).Conclusions: Serum cortisol, in combination with IL-8, affects the increase in ANC after OFC.

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“…showed that AEC decreased 6 h after OFC in patients with FPIES. We also observed a similar phenomenon . In the present study, a mild decrease in AEC was also seen in negative OFC.…”

Section: Discussionsupporting

confidence: 89%

Section: Methodsmentioning

confidence: 99%

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Increased serum cortisol on oral food challenge in infants with food protein‐induced enterocolitis syndrome

Shimomura

Ito

Tanaka

et al. 2018

Pediatrics International

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“…These observations are not altogether unexpected as the cytokine release syndrome following the first dose of biologics that activate T cells is also associated with elevation of interleukin‐2 over a similar time‐course . Elevation in plasma interleukin‐2 has also been reported after oral food challenge in infants with food protein‐induced enterocolitis syndrome . Interestingly, high‐dose interleukin‐2 therapy and cytokine release syndromes are often associated with digestive symptoms, in particular nausea and vomiting …”

Section: Discussionmentioning

confidence: 99%

Elevated serum interleukin‐2 after gluten correlates with symptoms and is a potential diagnostic biomarker for coeliac disease

Tye–Din

Daveson

et al. 2019

Aliment Pharmacol Ther

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Summary Background Coeliac disease patients on a gluten‐free diet experience reactions to gluten, but these are not well characterised or understood. Systemic cytokine release was recently linked to reactivation of gluten immunity in coeliac disease. Aim To define the nature and time‐course of symptoms and interleukin‐2 changes specific for coeliac disease patients. Methods 25 coeliac disease patients on a gluten‐free diet and 25 healthy volunteers consumed a standardised 6 gram gluten challenge. Coeliac Disease Patient‐Reported Outcome survey and global digestive symptom assessment were completed hourly up to 6 hours after gluten. Adverse events over 48 hours were recorded. Serum interleukin‐2 was measured at baseline, and 2, 4 and 6 hours. Results Serum interleukin‐2 was always undetectable in healthy controls, whereas it was undetectable at baseline and elevated >0.5 pg/ml at 4 hours in 92% of coeliac disease patients. All patient‐reported outcome severity scores increased significantly after gluten in coeliac disease patients (P < .001 Wilcoxon signed rank test), but not in controls. Symptoms began after 1 hour, and peaked in the third. Nausea and vomiting characterised severe reactions, but mild reactions were limited to headache and tiredness. Peak interleukin‐2 correlated with symptom severity, particularly for nausea and vomiting. Conclusions Serum interleukin‐2 elevations correlate with timing and severity of symptoms after gluten in coeliac disease. Standardised bolus gluten food challenge and interleukin‐2 assessment could provide a valuable clinical test to monitor and diagnose coeliac disease in patients established on a gluten‐free diet.

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“…Thus, the primary role of T cells is being questioned and needs to be elucidated, particularly T cell l role in the unique gastrointestinal manifestations compared to IgE‐mediated allergy . Regulatory T cells (CD4 + CD25 + ) have been incriminated in the mechanism of tolerance acquisition in FPIES, with a potential key role of IL‐10, but these data still need to be confirmed in a larger sample of patients . Humoral responses have been investigated in FPIES.…”

Section: Different Phenotypes Of Food Protein‐induced Enterocolitis Smentioning

confidence: 99%

Food protein‐induced enterocolitis syndrome

Caubet

Cianferoni

Groetch

et al. 2019

Clin Experimental Allergy

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Food protein‐induced enterocolitis syndrome (FPIES) is a non‐IgE‐mediated gastrointestinal food allergic disorder that has gained a major interest the past decade. FPIES prevalence, which still needs to be accurately determine in different populations, appears to be higher than previously thought (ie up to 0.7% in infants in the 1st year of life). FPIES to seafood in adults is also increasingly reported; limited data suggest that adult FPIES is most commonly triggered by shellfish, tends to affect females more than men, is characterized by a significant delay in diagnosis and a prolonged course. The first international consensus guidelines on diagnosis and management of FPIES have been published in 2017, proposing new diagnostic criteria as well as new criteria for a positive oral food challenge. However, there is a need to develop new biomarkers to improve the diagnosis and management of FPIES patients, and this requires a better understanding of the pathophysiology. Recently, the role of T cells has been questioned and a major role of innate immune cells has been suggested in acute FPIES. Regarding the treatment of acute FPIES reaction, ondansetron has emerged as an adjunct to intravenous rehydration in moderate‐severe reactions and as a first‐line treatment in mild reactions. Important information regarding the nutritional management of FPIES patients that might be complex has also been provided in the international guidelines. In this review, we discuss recent advances regarding all those different aspects.

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Cytokine profile after oral food challenge in infants with food protein-induced enterocolitis syndrome

Abstract: These results suggest that IL-2 and IL-8 are involved in the antigen-specific immune responses in most patients with FPIES. Further studies are needed to elucidate the significance of these cytokine in the pathogenesis of FPIES.

Cited by 40 publications

References 26 publications

Increased serum cortisol on oral food challenge in infants with food protein‐induced enterocolitis syndrome

Increased serum cortisol on oral food challenge in infants with food protein‐induced enterocolitis syndrome

Elevated serum interleukin‐2 after gluten correlates with symptoms and is a potential diagnostic biomarker for coeliac disease

Food protein‐induced enterocolitis syndrome

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