Antigen‐induced Lymphoblast Transformation in the Diagnosis of Cow's Milk Allergic Diseases in Infancy and Early Childhood

Endre, L; Osváth, P

doi:10.1111/j.1398-9995.1974.tb02694.x

Cited by 12 publications

(2 citation statements)

References 17 publications

(17 reference statements)

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“…Several reports suggest that T-cell mediated reactions play a role in deeluyed reactions to CMP, mainly gastrointestinal and skin reacttions (33). Cellular tests for type IV reactions include in vitro lymphoblast transformation test (172,173), lymphoblastic stimulation test (174,175), and leucocyte migration inhibition test (33,(176)(177)(178)(179). Hill et al (1988) demonstrated an increased production of leucocyte migration inhibitor factor (LIF) in response to ALA, BLG and alpha-CAS in clinically well-defined late reactors, but not in immediate reactors and controls (33).…”

Section: Type IV Cellular Immune Reactionmentioning

confidence: 99%

Cow's milk protein allergy and intolerance in infancy Some clinical, epidemiological and immunological aspects

Høst

1994

Pediatric Allergy Immunology

259

140

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Reproducible clinically abnormal reactions to cow's milk protein (CMP) may be due to the interaction between one or more milk proteins and one or more immune mechanisms, possibly any of the four basic types of hypersensitivity reactions. At present, evidence for type I, III and IV reactions against CMP has been demonstrated. Immunologically mediated reactions, mainly immediate IgE‐mediated reactions are defined as cow's milk protein allergy (CMPA). Non immunologically reactions against CMP are defined as cow's milk protein intolerance (CMPI). Many studies on “cow's milk allergy” have not investigated the immunological basis of the clinical reactions. It is not possible to differentiate between CMPA and CMPI solely on clinical symptoms. No single laboratory test is diagnostic of CMPA/CMPI. Therefore, the diagnosis still has to be based on strict well‐defined elimination and milk challenge procedures. Before 1950 CMPA/CMPI was rarely diagnosed. Since 1970 widely varying estimates of the incidence from 1.8% to 7.5% have been reported, mainly reflecting differences in diagnostic criteria and study design. Based on strict diagnostic criteria the incidence of confirmed CMPA/CMPI in infancy seems to be about 2–5% in developed countries. Symptoms suggestive of CMPA/CMPI may be encountered in about 5–15% of infants emphasizing the importance of controlled elimination/milk challenge. In breastfed infants reproducible clinical reactions to CMP in human milk have been reported in about 0.5%. Most infants with CMPA/CMPI develop symptoms before one month of age, often within one week after introduction of cow's milk based formula. The majority have ≥ 2 symptoms and symptoms from ≥ 2 organ systems. About 50%–70% have cutaneous symptoms, 50–60% gastrointestinal symptoms, and about 20–30% respiratory symptoms. In exclusively breast‐fed infants with CMPA/CMPI severe atopic eczema is a predominant symptom. Debut of CMPA/CMPI after 12 months is extremely rare. The basic treatment is complete avoidance of CMP. In infancy a proven hypoallergenic CM substitute is needed. Due to clinically important residual allergenicity in some hypoallergenic formulae controlled clinical testing is necessary in each case before use. Goat's milk proteins share identity with CMP. Raw untreated cow's milk and unhomogenized cow's milk is as allergenic as normal pasteurized and homogenized milk products. The prognosis of CMPA/CMPI is good with a remission rate about 45–50% at one year, 60–75% at two years, and 85–90% at three years. Associated adverse reactions to other foods develop in about 50%, and allergy against inhalants in 50–80% before puberty. High levels of IgE to CMP are associated with an increased risk of persisting CMPA, persisting allergy to other foods and inhalant allergy. The degree of antibody response to CMP exposure is a better predictor of persisting CMPA than a single finding of an elevated antibody level which can occur in normal infants without CMPA/CMPI. Cow's milk proteins are absorbed from the gut and can be measured in the bloo...

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Section: Type IV Cellular Immune Reactionmentioning

confidence: 99%

Cow's milk protein allergy and intolerance in infancy Some clinical, epidemiological and immunological aspects

Høst

1994

Pediatric Allergy Immunology

259

140

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“…A kórkép diagnózisában a klinikai tünetek mellett a széklet-okkultvérzés kimutatása, a szérum-IgE-szintmeghatározás, későbbi életkorban a nutritív Prick-teszt a leggyakrabban alkalmazott vizsgálati módszerek; ritkáb-ban lymphocytatranszformációs tesztet végeznek az allergia kimutatására [7].…”

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A gyermekkori tehéntejfehérje-allergia diagnosztikai kihívásai

Lendvai-Emmert

Emmert²,

Fusz

et al. 2019

Orvosi Hetilap

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Introduction and aim: The aim of our research is to evaluate and compare commonly performed diagnostic tests, and to examine the psychological disorders induced by this food allergy. Children with symptoms suggesting cow’s milk protein allergy were included in this study (n = 47). Blood and saliva samples were collected from the participants. Parents were asked to fill in a questionnaire constructed by the research team (containing the DSM-5 symptoms checklist about attention deficit hyperactivity disorder). Method: One of the most widely used diagnostic tool is the skin allergy test, which was performed in 47 subjects (n = 47, mean age: 7.36 years); only 2 children showed positive test result for cow’s milk. Lymphocyte transformation test was observed to be positive in 8 children (17%), 4 subjects demonstrated questionable results. In our sub-study about psychological symptoms (n = 43, mean age: 7.88 years), the score was according to the attention deficit hyperactivity disorder symptom checklist before the diet (6.88, SD: 4.43) and showed significant decrease after 3 months of the elimination diet (4.48, SD: 3.69, p = 0.001). Scores of children with sleep disorder (10.62, SD: 4.23) also represented a significant reduction after 3 months of the diet (6.69, SD: 4.59, p = 0.009). Salivary cortisol levels did not show significant changes before and after elimination diet. Results: According to our data, skin allergy testing and lymphocyte transformation test are not reliable diagnostic tools for establishing the diagnosis. Conclusion: We conclude that a significant improvement in clinical symptoms can only be achieved with a strict elimination diet. Orv Hetil. 2019; 160(33): 1311–1318.

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Allergic Diseases of the Lung Parenchyma

Osváth¹

1976

Immunological Aspects of Allergy and Allergic Diseases

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Antigen‐induced Lymphoblast Transformation in the Diagnosis of Cow's Milk Allergic Diseases in Infancy and Early Childhood

Cited by 12 publications

References 17 publications

Cow's milk protein allergy and intolerance in infancy Some clinical, epidemiological and immunological aspects

Cow's milk protein allergy and intolerance in infancy Some clinical, epidemiological and immunological aspects

A gyermekkori tehéntejfehérje-allergia diagnosztikai kihívásai

Allergic Diseases of the Lung Parenchyma

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