Value of lymphoblast transformation test in cow's milk protein intestinal intolerance

Scheinmann, P.; Gendrel, D.; Charlas, J; Paupe, J

doi:10.1111/j.1365-2222.1976.tb01936.x

Cited by 56 publications

(20 citation statements)

References 11 publications

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“…Significant reactivity was noted in 14 samples from 33 cases (101), reactivity being even more frequent in two other series (6, 25). The stimulation indices in the tests were not affected by the length of the CM-free diet or by recent feeding with CM (6,101). After CM challenge a positive result was associated equally often with acute and with chronic symptoms.…”

Section: Cell-mediated Reaction To CM (Type Iv Reaction (I 7))mentioning

confidence: 93%

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Cow's Milk Allergy

Savilahti

1981

Allergy

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By the end of the last century prevention of waterborne infections by chlorination of water supplies, pasteurization of cow's milk (CM) and production of suitable, easily cleaned bottles and nipples for infants had made artificial infant feeding a relatively safe procedure. But in the early years of the present century unexplained difficulties were reported in infants fed with cow's milk; some of them had continuous diarrhoea and failed to thrive (103). It was speculated that such infants had difficulty in digesting foreign proteins, although they could readily assimilate those in breast milk. In the following years cases of anaphylactic shock caused by CM were described, one of them with a fatal outcome (29). Animal studies showed that one species produced precipitins to proteins of milk from another species, and this type of reaction to the foreign structure of CM proteins was presumed to account for the symptoms seen in infants (29). In 1906, precipitins to CM were found in blood from a marasmic infant fed with CM (80). A year later reports appeared describing successful desensitization: injections of small quantities of cow serum cured and prevented hypersensitivity to oral CM and its symptoms (102). This was not a solution to the problem, however, as treatment with serum caused severe reactions (95). The mechanism and components of C M causing these reactions were debated. Wernstedt suggested that the symptoms were due to altered reactivity to CM because of earlier contact with it, and proposed that it should be called allergy (119). Subsequently, the intestinal symptoms were shown to be caused by the whey fraction of CM (42). They were noted to vary in severity and disappeared with increasing age. A decade later (1921) urticaria was described as a symptom of CM hypersensitivity (104). By the 1930's and 40's however, CMA was considered a rare disease ( I 12), but the decrease in breast feeding in most developed countries has made cow's milk allergy (CMA) an important cause of infant morbidity and one of the best known and most frequently encountered problems in current infant feeding practices. DEFINITIONThe majority of infants can be reared on CM formulas without untoward effects. However, sensitive immunochemical methods show that they do react to the foreign proteins in CM. When the immunologic reactions to CM are associated with clinical symptoms, the child can be said to be allergic to CM (89). Obviously, the simplest and the most convincing way to verify cow's milk allergy (CMA) would be to demonstrate this either abnormally strong or qualitatively altered immune reaction to C M proteins. As yet, however, this cannot be done by any single test or combination of tests. Therefore the diagnosis of CMA has to be based on the clinical response to CM. In most cases it is enough to observe a favourable response to elimination of CM, reappearance of symptoms during one challenge test and their -disappearance on renewed elimination. When symptoms are severe it is unethical to perform more than one challenge.Ot...

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Section: Cell-mediated Reaction To CM (Type Iv Reaction (I 7))mentioning

confidence: 93%

“…After CM challenge a positive result was associated equally often with acute and with chronic symptoms. In the control group the test was positive in 9.3% of samples (101).…”

Section: Cell-mediated Reaction To CM (Type Iv Reaction (I 7))mentioning

confidence: 99%

Cow's Milk Allergy

Savilahti

1981

Allergy

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“…In addition, in creased levels of antibodies to cow's milk protein are of some value in the diagnosis of gastrointestinal cow's milk protein intoler ance. For such a purpose the lymphocyte transformation test has also been suggested indicating some cases with cell mediated reactivity to cow's milk proteins [21]. Fur thermore, the possibility that heated or de graded cow's milk proteins should be pre ferred as antigens in immunological studies of cases with cow's milk intolerance must be analyzed.…”

Section: Discussionmentioning

confidence: 99%

Specific Antibodies in Infants with Gastrointestinal Intolerance to Cow’s Milk Protein

Sp¹,

Ahlstedt²,

La³

1978

Int Arch Allergy Immunol

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Antibodies of various immunoglobulin classes against cow’s milk proteins were studied in infants and children with cow’s milk protein intolerance, gluten-sensitive enteropathy and acute gastroenteritis. Their IgE, IgG, IgM and IgA antibody levels determined with the enzyme-linked immunosorbent assay (ELISA) and the IgE antibodies also determined with RAST, were compared with reference groups of children and adults. IgE, IgG or IgA antibodies against unseparated cow’s milk proteins, α-lactalbumin, β-lactoglobulin, α-casein and β-casein were present in many of the studied samples, but did not discriminate between the individuals with and without intolerance symptoms. As a group, the infants with late reactions to cow’s milk showed increased levels of IgE and IgG antibodies detected with the ELISA, while patients with gluten-sensitive enteropathy had significantly increased levels of IgG and IgA antibodies to cow’s milk proteins compared to the reference group. By combining the findings of antibody increases in various immunoglobulin classes, an individual discrimination could be reached. Thus, 8 of 9 of the patients with late reactions to cow’s milk had increased levels of IgE or IgG + IgA antibodies as compared to 3 of 22 in the reference group. Serodiagnosis with the ELISA may, therefore, be of some use in patients with a suspicion of cow’s milk protein intolerance.

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“…IgE-mediated hypersensitivity is the most frequent type and clinically and immunologically best rec ognized (1)(2)(3)10]. Non-IgE-mediated hypersensitivity re actions to CMP have been suspected because of clinical signs, course of symptoms and indirect in vitro evidence, but have not been proven conclusively [2,4,5]. The reasons for food antigens to cause hypersensitivity or to induce immunological tolerance in man are poorly understood 11 1 ].…”

Section: Discussionmentioning

confidence: 99%

Delayed-Type Hypersensitivity to Cow’s Milk Protein in Melkersson-Rosenthal Syndrome: Coincidence or Pathogenetic Role?

1996

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Background: Intolerance to cow’s milk protein is frequently seen in children and rarely in adults. Non-IgE-mediated hypersensitivity to cow’s milk protein has been suspected in children based on in vitro evidence. Food intolerance may play a pathogenetic role in some cases of Melkersson-Rosenthal syndrome, which is often of unknown origin. Objective: We describe an adult female patient who developed a Melkersson-Rosenthal syndrome and at the same time was found to have in vivo and in vitro evidence of a delayed-type hypersensitivity to cow’s milk protein. Methods: Allergic and immunologic examinations, including skin prick tests, patch tests, serology, lymphocyte transformation tests and biopsies were performed. Results: A positive patch test to alpha-lactalbumin, a positive lymphocyte transformation test to whole cow’s milk and an immunohistology with infiltration of CD4+ and CD8+ T cells were found. Conclusions: There is a possible pathogenetic relation between delayed-type hypersensitivity to cow’s milk protein and Melkersson-Rosenthal syndrome in the patient presented.

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Value of lymphoblast transformation test in cow's milk protein intestinal intolerance

Cited by 56 publications

References 11 publications

Cow's Milk Allergy

Cow's Milk Allergy

Specific Antibodies in Infants with Gastrointestinal Intolerance to Cow’s Milk Protein

Delayed-Type Hypersensitivity to Cow’s Milk Protein in Melkersson-Rosenthal Syndrome: Coincidence or Pathogenetic Role?

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