Humoral and cellular responses to casein in patients with food protein–induced enterocolitis to cow's milk

Caubet, Jean-Christoph Roger J-P; Bencharitiwong, Ramon; Ross, Andrew; Sampson, Hugh A.; Berin, M. Cecilia; Nowak‐Węgrzyn, Anna

doi:10.1016/j.jaci.2016.02.047

Cited by 83 publications

(102 citation statements)

References 55 publications

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“…However, IL-10 in the supernatant from the PBMC culture stimulated with casein was lower in children with active CM-FPIES compared with those whose CM-FPIES had resolved [6].…”

Section: Il-9mentioning

confidence: 80%

“…More recent study found no difference in proliferation of T cells and production of TH2 cytokines after casein stimulation in children with CM-FPIES and controls [6].…”

Section: Ip-10mentioning

confidence: 84%

“…There was a trend toward an increase of serum level of IP-10 in patients with active CM-FPIES and a positive OFC result [6].…”

Section: Ip-10mentioning

confidence: 85%

“…Casein-specific production of IL-9 was significantly higher in children with CM-FPIES compared to children with IgE-CM allergy (P<0.05) [6].…”

Section: Il-9mentioning

confidence: 87%

“…Little is known about the prevalence of FPIES, although the disease is a well-established and distinct clinical entity [2]. The pathophysiology of FPIES requires further investigation; current evidence indicates that cell-mediated responses may play an important role, whereas IgE antibodies to the offending foods have minimal or no significance in pathophysiology [6]. In the absence of definitive laboratory tests, diagnosis relies predominantly on clinical responses to elimination diets with resolution of symptoms, oral food challenges with reappearance of symptoms following ingestion of the offending food, endoscopy and biopsy findings, and exclusion of causes such as infections, inflammatory bowel disease, ischemia, and metabolic disorders.…”

Section: Introductionmentioning

confidence: 99%

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Food Protein–Induced Enterocolitis Syndrome

Nowak‐Węgrzyn

Jarocka-Cyrta

Castro

2017

J Investig Allergol Clin Immunol

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Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-, cell-mediated food allergy of unknown prevalence and pathophysiology. Onset is typically during the first year of life; seafood-induced FPIES may start in adulthood. Acute FPIES manifests within 1-4 hours after ingestion with repetitive emesis, pallor, and lethargy progressing to dehydration and hypovolemic shock in 15% of cases. Chronic FPIES manifests with intermittent emesis, watery diarrhea, and poor growth progressing to dehydration and hypovolemic shock over a period of days to weeks. Chronic FPIES has been only reported in infants aged less than 3 months fed with cow milk (CM) or soy formula. The most common triggers are CM, soy, rice, and oat. Diagnosis of FPIES relies on recognition of a pattern of clinical symptoms and may be missed owing to the absence of typical allergic symptoms (eg, urticaria, wheezing) and delayed onset in relation to food ingestion. Physician-supervised food challenge is recommended if diagnosis or the trigger food is not clear and to evaluate for resolution. Testing for food-specific IgE is usually negative, although a subset of patients, usually with CM-induced FPIES may develop sensitization to foods. Such atypical FPIES tends to have a more prolonged course. Despite the potential severity of the reactions, no fatalities have been reported, and FPIES has a favorable prognosis. In most cases, FPIES resolves by age 3-5 years, although persistence of CM-induced FPIES and soy FPIES into adulthood has been reported. The first international consensus guidelines on diagnosis and management of FPIES were published in 2017. Given that the pathophysiology of FPIES is poorly understood, there are no diagnostic biomarkers and no therapies to accelerate resolution. These unmet needs warrant future investigations to improve the care of patients with FPIES. Key words: FPIES. Food protein-induced enterocolitis syndrome. Non-IgE-mediated food allergy. Food allergy. Cow milk allergy. ResumenSEIOA es una alergia alimentaria con patofisiología y prevalencia desconocidas, que típicamente comienza en el primer año de vida, mientras que la producida por pescado suelo tener su comienzo en adultos. La forma aguda se manifiesta entre la hora y 4 horas tras la ingesta del alimento con emesis, palidez, letargia progresiva por deshidratación y shock hipovolémico en el 15% de los casos. La forma crónica se manifiesta con emesis intermitente, diarreas y crecimiento pobre con progresión hacia la deshidratación y shock hipovolémico en un periodo de días o semanas. La forma crónica se ha podido observar únicamente en niños menores de 3 años alimentados con leche de vaca o fórmula de soja. Los desencadenantes más frecuentes son la leche de vaca, la soja, el arroz y avena. El diagnóstico es clínico y puede ser difícil debido a la ausencia de síntomas alérgicos típicos (urticaria, asma…) y a la relación retardada con la ingesta. Es recomendable la provocación controlada si el diagnóstico clínico o el alimento implicado no son claros y tamb...

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“…However, IL-10 in the supernatant from the PBMC culture stimulated with casein was lower in children with active CM-FPIES compared with those whose CM-FPIES had resolved [6].…”

Section: Il-9mentioning

confidence: 80%

“…More recent study found no difference in proliferation of T cells and production of TH2 cytokines after casein stimulation in children with CM-FPIES and controls [6].…”

Section: Ip-10mentioning

confidence: 84%

“…There was a trend toward an increase of serum level of IP-10 in patients with active CM-FPIES and a positive OFC result [6].…”

Section: Ip-10mentioning

confidence: 85%

“…Casein-specific production of IL-9 was significantly higher in children with CM-FPIES compared to children with IgE-CM allergy (P<0.05) [6].…”

Section: Il-9mentioning

confidence: 87%

Section: Introductionmentioning

confidence: 99%

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Food Protein–Induced Enterocolitis Syndrome

Nowak‐Węgrzyn

Jarocka-Cyrta

Castro

2017

J Investig Allergol Clin Immunol

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Food protein‐induced enterocolitis syndrome: A large French multicentric experience

Lemoine¹,

Colas

et al. 2022

Clinical & Translational All

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Background Food protein‐induced enterocolitis syndrome (FPIES) is a non‐IgE‐mediated food allergy, with potential dehydration secondary to vomiting. Differences exist regarding culprit foods, and age of tolerance depending on the country of origin. We aimed at describing the characteristics of a French population of children with FPIES, and define risk factors for failure during challenge. Methods Data from 179 children who were referred for FPIES in two pediatric tertiary centers between 2014 and 2020 were retrospectively collected. The diagnosis of FPIES was based on international consensus guidelines. Clinical characteristics, culprit food, and age at resolution were assessed. Tolerance was defined as no adverse reaction after OFC or accidental exposure. Results In the 192 described FPIES, the age at first symptoms was 5.8 months old. The main offending foods were cow's milk (60.3%), hen's egg (16.2%), and fish (11.7%). Single FPIES was observed in 94.4% and multiple FPIES in 5.6% of cases. The age at resolution of FPIES was 2.2 years old, and resolution occurred later for fish than for milk (2.9 years vs. 2.0, p = 0.01). Severe acute FPIES was a risk factor for delayed resolution (RR: 3.3 [1.2–9.2]), but not IgE sensitization. Performing a food challenge within 12 months after the first reaction increased the risk of failure (OR: 2.6 [1.1–6.6]). Conclusion In this French cohort of children with FPIES, the main culprit foods were ubiquitous. Rice, oat, and soy were rarely or not involved. Multiple FPIES was infrequent. Our data confirmed the overall good prognosis of FPIES, the later resolution of FPIES to fish and in the case of severe acute FPIES.

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Recurrent Sepsis-Like Episodes

González-Delgado

Fernández

2019

Pediatric Allergy

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Humoral and cellular responses to casein in patients with food protein–induced enterocolitis to cow's milk

Cited by 83 publications

References 55 publications

Food Protein–Induced Enterocolitis Syndrome

Food Protein–Induced Enterocolitis Syndrome

Food protein‐induced enterocolitis syndrome: A large French multicentric experience

Recurrent Sepsis-Like Episodes

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