Serum thymus and activation‐regulated chemokine level as a potential biomarker for food protein–induced enterocolitis syndrome

Hamano, Sho; Yamamoto, Akira; Fukuhara, Daisuke; Kou, Yan

doi:10.1111/pai.13030

Cited by 10 publications

(6 citation statements)

References 9 publications

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“…It was recently reported that some patients with FPIES showed an increase in TARC about 24 h after being exposed to the trigger food, whether accidentally or during OFC. This increase only appears alongside gastrointestinal symptoms, suggesting that changes in serum TARC levels are likely linked to allergy reactions in intestinal epithelium cells [157,158]. This study is an example of how the measurement of cytokines and changes in their levels following OFC may help in the diagnosis of non IgE-mediated FA.…”

Section: Novel and Future Diagnostic Tests For Non Ige-mediated Food Allergymentioning

confidence: 95%

Non–IgE- or Mixed IgE/Non–IgE-Mediated Gastrointestinal Food Allergies in the First Years of Life: Old and New Tools for Diagnosis

et al. 2021

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non-IgE and mixed gastrointestinal food allergies present various specific, well-characterized clinical pictures such as food protein-induced allergic proctocolitis, food protein-induced enterocolitis and food protein-induced enteropathy syndrome as well as eosinophilic gastrointestinal disorders such as eosinophilic esophagitis, allergic eosinophilic gastroenteritis and eosinophilic colitis. The aim of this article is to provide an updated review of their different clinical presentations, to suggest a correct approach to their diagnosis and to discuss the usefulness of both old and new diagnostic tools, including fecal biomarkers, atopy patch tests, endoscopy, specific IgG and IgG4 testing, allergen-specific lymphocyte stimulation test (ALST) and clinical score (CoMiss).

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Section: Novel and Future Diagnostic Tests For Non Ige-mediated Food Allergymentioning

confidence: 95%

Non–IgE- or Mixed IgE/Non–IgE-Mediated Gastrointestinal Food Allergies in the First Years of Life: Old and New Tools for Diagnosis

et al. 2021

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“…A recent report has demonstrated that serum levels of TARC elevate after oral food challenge (OFC) in two patients with FPIES, suggesting that serum TARC levels are potential biomarker of the disease. 3 We defined TARC ratio as the ratio of post-OFC to pre-OFC TARC levels. To validate the utility of TARC in the diagnosis of FPIES, we examined TARC ratio in a larger number of patients with FPIES.…”

mentioning

confidence: 99%

Usefulness of thymus and activation‐regulated chemokine in solid food protein‐induced enterocolitis syndrome

Okura

Shimomura

Takahashi

et al. 2021

Pediatric Allergy Immunology

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Food protein-induced enterocolitis syndrome (FPIES) is a non-IgEmediated food allergy that predominantly affects infants and is characterized by repetitive vomiting 1-4 h after causative food ingestion which often leads to diarrhea, lethargy, and pallor. Although the involvement of cellular immunity is suggested, comprehensive mechanisms of the disorder have been poorly understood. Diagnosis is often hampered by delayed onset of non-specific symptoms after allergen exposure and lack of awareness of FPIES. In addition, reliable objective biomarkers are absent, although acute FPIES attack is accompanied by neutrophilia, thrombocytosis, methemoglobinemia, and metabolic acidosis. 1 Thymus and activation-regulated chemokine (TARC), a member of the CC chemokine family, recruits CC chemokine receptor 4 + Th2-polarized memory/effector T cells into inflamed tissues. A serum TARC level serves as a reliable biomarker of atopic dermatitis severity in clinical practice. Although high levels of serum TARC discriminate FPIES from vomiting associated with infectious gastroenteritis, 2 TARC levels are influenced by several factors such as age and presence of eczema, which make it difficult to evaluate FPIES by a single measurement of TARC level. A recent report has demonstrated that serum levels of TARC elevate after oral food challenge (OFC) in two patients with FPIES, suggesting that serum TARC levels are potential biomarker of the disease. 3 We defined TARC ratio as the ratio of post-OFC to pre-OFC TARC levels. To validate the utility of TARC in the diagnosis of FPIES, we examined TARC ratio in a larger number of patients with FPIES.

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“…In particular, the usefulness of TARC in the diagnosis and evaluation of atopic dermatitis has been reported [4]. However, few studies have examined the relationship between food allergies and TARC [3]. In this study, we compared post-emetic TARC levels between patients with solid-food FPIES and those with infectious gastroenteritis and found significantly higher TARC levels in patients with FPIES.…”

Section: Discussionmentioning

confidence: 98%

“…Therefore, diagnosing FPIES at the first episode is difficult in the absence of disease-specific biomarkers; in particular, solid-food FPIES often develops in infancy after the age of 5–6 months [1], which is a period when infants are more likely to have infectious gastroenteritis. Notably, thymus and activation-regulated chemokine (TARC), a Th2 chemokine, was found to be elevated in allergic diseases, such as atopic dermatitis [2], and a case report showed increased serum TARC levels after appearance of FPIES symptoms [3]. However, no studies have assessed TARC levels for the differential diagnosis of FPIES and other diseases, such as infectious gastroenteritis.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Diagnostic Accuracy of Thymus and Activation-Regulated Chemokine to Discriminate Food Protein-Induced Enterocolitis Syndrome from Infectious Gastroenteritis

Makita

Kuroda

Itabashi

et al. 2020

Int Arch Allergy Immunol

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Background: Post-emetic elevation in thymus and activation-regulated chemokine (TARC) levels has been reported in patients with food protein-induced enterocolitis syndrome (FPIES); however, no studies have investigated differences in TARC levels between FPIES and other diseases. Objectives: We evaluated the clinical usefulness of TARC measurement in differentiating between FPIES and infectious gastroenteritis. Methods: This study included 8 patients with solid-food FPIES (FPIES group; hen’s egg [n = 6], rice [n = 1], and short-neck clam [n = 1]; a total of 11 episodes necessitating emergency department visit or positive result of oral food challenge test) and 17 patients with infectious gastroenteritis (control group), and all patients had no eczema. Post-emetic serum TARC levels and modified TARC levels (serum TARC value – normal mean for each age) were compared between the 2 groups. Results: The median (range) ages for the FPIES and control groups were 0.7 (0.5–6.2) and 1.8 (0.1–4.4) years, respectively (p > 0.05). In the FPIES and control groups, median (range) TARC levels were 2,911 (1,062–7,816) and 600 (277–2,034) pg/mL, and median (range) modified TARC levels were 2,204 (355–7,109) and 129 (0–1,314), respectively. The TARC and modified TARC levels were significantly higher in the FPIES group than in the control group (p < 0.001 for both). Conclusion: In the absence of eczema, post-emetic serum TARC levels might be a potential diagnostic biomarker for distinguishing FPIES from infectious gastroenteritis.

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Serum thymus and activation‐regulated chemokine level as a potential biomarker for food protein–induced enterocolitis syndrome

Cited by 10 publications

References 9 publications

Non–IgE- or Mixed IgE/Non–IgE-Mediated Gastrointestinal Food Allergies in the First Years of Life: Old and New Tools for Diagnosis

Non–IgE- or Mixed IgE/Non–IgE-Mediated Gastrointestinal Food Allergies in the First Years of Life: Old and New Tools for Diagnosis

Usefulness of thymus and activation‐regulated chemokine in solid food protein‐induced enterocolitis syndrome

Evaluation of the Diagnostic Accuracy of Thymus and Activation-Regulated Chemokine to Discriminate Food Protein-Induced Enterocolitis Syndrome from Infectious Gastroenteritis

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