Assessment of Inflammatory Markers in Children with Cow’s Milk Allergy Treated with a Milk-Free Diet

Abstract

Background: The aim of the study was to establish whether the use of a strict milk-free diet in children with cow’s milk allergy, resulting in the resolution of clinical symptoms of the disease, also extinguishes the inflammatory reaction induced by the allergy. Methods: We examined 64 children (aged 3–6 years) with a diagnosed cow’s milk allergy who had been treated with an elimination diet for at least six months and showed remission of the disease’s clinical symptoms as a result of the treatment. The control group consisted of 30 healthy children of the same age following an unrestricted age-appropriate diet. Concentrations of cytokines, calprotectin, and adipokines (leptin, resistin, chemerin, neutrophilic lipocalin associated with gelatinase—NGAL) were determined in the serum samples obtained from the studied children by immunoenzymatic assays. Results: Patients with CMA had significantly higher median values of serum IL-6, TNF-α, resistin, chemerin and NGAL in comparison to the healthy children (p < 0.05, p < 0.001, p < 0.05, p < 0.01, p < 0.001, respectively). Serum concentrations of IL-10, leptin, calprotectin and CRP as well as in WBC count were in the same range in both studied groups. We observed direct statistically significant correlations between levels of IL-10 and CRP (p = 0.005), IL-10 and WBC (p = 0.045), TNF-α and WBC (p = 0.038), calprotectin and WBC (p < 0.001), chemerin and CRP (p < 0.001) as well as between NGAL and WBC (p = 0.002) in children with CMA. Conclusion: The use of a strict milk-free diet by children with CMA, resulting in the resolution of clinical symptoms of the disease, does not seem to extinguish the inflammation induced by the allergy. The findings of this study—elevated IL-6, TNF-α, resistin, chemerin and NGAL levels in patients with CMA—suggest that these parameters seem to be involved in the generation of a low-grade proinflammatory environment observed in cow‘s milk allergy and could be used to monitor the effectiveness of treatment.

Fecal Calprotectin in Children with Cow’s Milk Protein Allergy: A Systematic Review and Meta-Analysis

“…The review concluded that no sufficient evidence could confirm the value of FC in CMPA, which may be due to the small size and different people. There were three additional studies that reported contradictory results on FC levels in CMPA patients this year [10,16,17]. Qiu et al [17] conducted a prospective case-control trial and found a significantly higher FC level in the milk-allergic infants than in the nonallergic group IgE (median: 410 vs. 141 μg/g, p < 0.001).…”

“…Nineteen pieces of literature were selected for full-text revision, 7 of those were also excluded with no complete information. Finally, 12 pieces of literature were included in the meta-analysis [4,7,8,[10][11][12][13][14][15][16][17][18].…”

“…CMPA are classified into 3 groups: IgE-mediated, non-IgE-mediated allergy, and mixed type. IgE-mediated CMPA was differentiated from non-IgE-mediated in two studies [8,15,16]. For the detection method, ELISA was the most common method.…”

Gut Inflammation Markers, Diet, and Risk of Islet Autoimmunity in Finnish Children – A Nested Case-Control Study

“…This is because cow milk allergy in young children has gastrointestinal inflammatory manifestations including enteropathy, increased inflammatory cell infiltration, and cytotoxic expression [ [33] , [34] , [35] ]. Cow milk allergy is also associated with elevated fecal calprotectin concentrations [ [36] , [37] , [38] ] and has been linked with higher risk of type 1 diabetes [ 39 ].…”

Food allergy to cow’s milk proteins and meat

“…Сходство симптоматики и сочетание патогенетических механизмов затрудняет её диагностику. В подобных случаях ис-пользуют методы определения маркеров аллергического воспаления, а также вспомогательные методы выявления аллергической гиперчувствительности к пищевым продуктам [61].…”