AIM:To study the association between serum levels of milk protein IgG and IgA antibodies and milk-related gastrointestinal symptoms in adults.METHODS:Milk protein IgG and IgA antibodies were determined in serum sample...AIM:To study the association between serum levels of milk protein IgG and IgA antibodies and milk-related gastrointestinal symptoms in adults.METHODS:Milk protein IgG and IgA antibodies were determined in serum samples of 400 subjects from five outpatient clinics in Southern Finland.Subjects were randomly selected from a total of 1900 adults undergoing laboratory investigations in primary care.All 400 participants had completed a questionnaire on abdominal symptoms and dairy consumption while waiting for the laboratory visit.The questionnaire covered the nature and frequency of gastrointestinal problems,the provoking food items,family history and allergies.Twelve serum samples were disqualifi ed due to insuff icient amount of sera.The levels of specif ic milk protein IgG and IgA were measured by using the ELISA technique.The association of the milk protein-specific antibody level was studied in relation to the milk-related gastrointestinal symptoms and dairy consumption.RESULTS:Subjects drinking milk(n=265) had higher levels of milk protein IgG in their sera than non-milk drinkers(n=123,P<0.001).Subjects with gastrointestinal problems related to milk drinking(n=119) consumed less milk but had higher milk protein IgG levels than those with no milk-related gastrointestinal symptoms(n=198,P=0.02).Among the symptomatic subjects,those reporting dyspeptic symptoms had lower milk protein IgG levels than non-dyspeptics(P<0.05).However,dyspepsia was not associated with milk drinking(P=0.5).The association of high milk protein IgG levels with constipation was close to the level of statistical signif icance.Diarrhea had no association with milk protein IgG level(P=0.5).With regard to minor symptoms,flatulence and bloating(P=0.8),were not associated with milk protein IgG level.Milk protein IgA levels did not show any association with milk drinking or abdominal symptoms.The levels of milk protein IgA and IgG declined as the age of the subjects increased(P<0.004).CONCLUSION:Milk protein IgG but not milk IgA seems to be associated with self-reported milk-induced gastrointestinal symptoms.展开更多
目的了解儿童牛乳蛋白过敏(cowmilk protein allergy,CMPA)现状,为CMPA的防治和致敏食物的监管提供科学依据。方法以自编问卷、皮肤点刺试验、德国敏筛试纸实验作为初步诊断依据,对哈尔滨市5840名6～10岁学龄儿童进行筛查,分析牛乳蛋白...目的了解儿童牛乳蛋白过敏(cowmilk protein allergy,CMPA)现状,为CMPA的防治和致敏食物的监管提供科学依据。方法以自编问卷、皮肤点刺试验、德国敏筛试纸实验作为初步诊断依据,对哈尔滨市5840名6～10岁学龄儿童进行筛查,分析牛乳蛋白过敏的影响因素。结果在有效答卷5720份中,自诉牛乳蛋白过敏的学生196例,其中47例皮肤点刺实验、德国敏筛试纸均呈阳性,CMPA发生率为0.82%。牛乳蛋白过敏多为皮疹,其次为胃肠过敏。除对牛乳蛋白过敏外,同时也对其他食物过敏。喂养方式、其他食物过敏情况、父母过敏情况是CMPA发生的影响因素。结论应采取母乳喂养、推荐食用低致敏婴儿配方粉等综合措施预防和治疗CMPA。展开更多
Background This study aimed to develop an expert consensus regarding the epidemiology,diagnosis,and management of cow’s milk protein allergy(CMPA)in the Middle East.Methods A three-step modified Delphi method was uti...Background This study aimed to develop an expert consensus regarding the epidemiology,diagnosis,and management of cow’s milk protein allergy(CMPA)in the Middle East.Methods A three-step modified Delphi method was utilized to develop the consensus.Fifteen specialized pediatricians participated in the development of this consensus.Each statement was considered a consensus if it achieved an agreement level of>80%.Results The experts agreed that the double-blind placebo-controlled oral challenge test(OCT)should be performed for 2-A weeks using an amino acid formula(AAF)in formula-fed infants or children with suspected CMPA.Formula-fed infants with confirmed CMPA should be offered a therapeutic formula.The panel stated that an extensively hydrolyzed formula(eHF)is indicated in the absence of red flag signs.At the same time,the AAF is offered for infants with red flag signs,such as severe anaphylactic reactions.The panel agreed that infants on an eHF with resolved symptoms within 2-4 weeks should continue the eHF with particular attention to the growth and nutritional status.On the other hand,an AAF should be considered for infants with persistent symptoms;the AAF should be continued if the symptoms resolve within 2-4 weeks,with particular attention to the growth and nutritional status.In cases with no symptomatic improvements after the introduction of an AAF.other measures should be followed.The panel developed a management algorithm,which achieved an agreement level of 90.9%.Conclusion This consensus document combined the best available evidence and clinical experience to optimize the management of CMPA in the Middle East.展开更多
基金Supported by Helsinki University Research FundsHelsinki University Central Hospital Grant and The Research Foundation for Allergy, FinlandThe Foundation for Promoting Occupational Medicine in Finland, Helsinki, Finland
文摘AIM:To study the association between serum levels of milk protein IgG and IgA antibodies and milk-related gastrointestinal symptoms in adults.METHODS:Milk protein IgG and IgA antibodies were determined in serum samples of 400 subjects from five outpatient clinics in Southern Finland.Subjects were randomly selected from a total of 1900 adults undergoing laboratory investigations in primary care.All 400 participants had completed a questionnaire on abdominal symptoms and dairy consumption while waiting for the laboratory visit.The questionnaire covered the nature and frequency of gastrointestinal problems,the provoking food items,family history and allergies.Twelve serum samples were disqualifi ed due to insuff icient amount of sera.The levels of specif ic milk protein IgG and IgA were measured by using the ELISA technique.The association of the milk protein-specific antibody level was studied in relation to the milk-related gastrointestinal symptoms and dairy consumption.RESULTS:Subjects drinking milk(n=265) had higher levels of milk protein IgG in their sera than non-milk drinkers(n=123,P<0.001).Subjects with gastrointestinal problems related to milk drinking(n=119) consumed less milk but had higher milk protein IgG levels than those with no milk-related gastrointestinal symptoms(n=198,P=0.02).Among the symptomatic subjects,those reporting dyspeptic symptoms had lower milk protein IgG levels than non-dyspeptics(P<0.05).However,dyspepsia was not associated with milk drinking(P=0.5).The association of high milk protein IgG levels with constipation was close to the level of statistical signif icance.Diarrhea had no association with milk protein IgG level(P=0.5).With regard to minor symptoms,flatulence and bloating(P=0.8),were not associated with milk protein IgG level.Milk protein IgA levels did not show any association with milk drinking or abdominal symptoms.The levels of milk protein IgA and IgG declined as the age of the subjects increased(P<0.004).CONCLUSION:Milk protein IgG but not milk IgA seems to be associated with self-reported milk-induced gastrointestinal symptoms.
文摘目的了解儿童牛乳蛋白过敏(cowmilk protein allergy,CMPA)现状,为CMPA的防治和致敏食物的监管提供科学依据。方法以自编问卷、皮肤点刺试验、德国敏筛试纸实验作为初步诊断依据,对哈尔滨市5840名6～10岁学龄儿童进行筛查,分析牛乳蛋白过敏的影响因素。结果在有效答卷5720份中,自诉牛乳蛋白过敏的学生196例,其中47例皮肤点刺实验、德国敏筛试纸均呈阳性,CMPA发生率为0.82%。牛乳蛋白过敏多为皮疹,其次为胃肠过敏。除对牛乳蛋白过敏外,同时也对其他食物过敏。喂养方式、其他食物过敏情况、父母过敏情况是CMPA发生的影响因素。结论应采取母乳喂养、推荐食用低致敏婴儿配方粉等综合措施预防和治疗CMPA。
基金Medical writing support in the development of this manuscript was provided by Dr.Ahmed Elgebaly of Clinart MENA and funded by Nutricia Middle East.
文摘Background This study aimed to develop an expert consensus regarding the epidemiology,diagnosis,and management of cow’s milk protein allergy(CMPA)in the Middle East.Methods A three-step modified Delphi method was utilized to develop the consensus.Fifteen specialized pediatricians participated in the development of this consensus.Each statement was considered a consensus if it achieved an agreement level of>80%.Results The experts agreed that the double-blind placebo-controlled oral challenge test(OCT)should be performed for 2-A weeks using an amino acid formula(AAF)in formula-fed infants or children with suspected CMPA.Formula-fed infants with confirmed CMPA should be offered a therapeutic formula.The panel stated that an extensively hydrolyzed formula(eHF)is indicated in the absence of red flag signs.At the same time,the AAF is offered for infants with red flag signs,such as severe anaphylactic reactions.The panel agreed that infants on an eHF with resolved symptoms within 2-4 weeks should continue the eHF with particular attention to the growth and nutritional status.On the other hand,an AAF should be considered for infants with persistent symptoms;the AAF should be continued if the symptoms resolve within 2-4 weeks,with particular attention to the growth and nutritional status.In cases with no symptomatic improvements after the introduction of an AAF.other measures should be followed.The panel developed a management algorithm,which achieved an agreement level of 90.9%.Conclusion This consensus document combined the best available evidence and clinical experience to optimize the management of CMPA in the Middle East.
