Multi‑omics reveals that the host‑microbiome metabolism crosstalk of differential rumen bacterial enterotypes can regulate the milk protein synthesis of dairy cows

Background Dairy cows’lactation performance is the outcome of the crosstalk between ruminal microbial metabo-lism and host metabolism.However,it is still unclear to what extent the rumen microbiome and its metabolites,as well as the host metabolism,contribute to regulating the milk protein yield(MPY).Methods The rumen fluid,serum and milk of 12 Holstein cows with the same diet(45%coarseness ratio),parity(2–3 fetuses)and lactation days(120–150 d)were used for the microbiome and metabolome analysis.Rumen metabolism(rumen metabolome)and host metabolism(blood and milk metabolome)were connected using a weighted gene co-expression network(WGCNA)and the structural equation model(SEM)analyses.Results Two different ruminal enterotypes,with abundant Prevotella and Ruminococcus,were identified as type1 and type2.Of these,a higher MPY was found in cows with ruminal type2.Interestingly,[Ruminococcus]gauvreauii group and norank_f_Ruminococcaceae(the differential bacteria)were the hub genera of the network.In addition,differential ruminal,serum and milk metabolome between enterotypes were identified,where the cows with type2 had higher L-tyrosine of rumen,ornithine and L-tryptophan of serum,and tetrahydroneopterin,palmitoyl-L-carnitine,S-lactoylglutathione of milk,which could provide more energy and substrate for MPY.Further,based on the identi-fied modules of ruminal microbiome,as well as ruminal serum and milk metabolome using WGCNA,the SEM analysis indicated that the key ruminal microbial module1,which contains the hub genera of the network([Ruminococcus]gauvreauii group and norank_f_Ruminococcaceae)and high abundance of bacteria(Prevotella and Ruminococcus),could regulate the MPY by module7 of rumen,module2 of blood,and module7 of milk,which contained L-tyrosine and L-tryptophan.Therefore,in order to more clearly reveal the process of rumen bacterial regulation of MPY,we established the path of SEM based on the L-tyrosine,L-tryptophan and related components.The SEM based on the metabolites suggested that[Ruminococcus]gauvreauii group could inhibit the energy supply of serum tryptophan to MPY by milk S-lactoylglutathione,which could enhance pyruvate metabolism.Norank_f_Ruminococcaceae could increase the ruminal L-tyrosine,which could provide the substrate for MPY.Conclusion Our results indicated that the represented enterotype genera of Prevotella and Ruminococcus,and the hub genera of[Ruminococcus]gauvreauii group and norank_f_Ruminococcaceae could regulate milk protein synthesis by affecting the ruminal L-tyrosine and L-tryptophan.Moreover,the combined analysis of enterotype,WGCNA and SEM could be used to connect rumen microbial metabolism with host metabolism,which provides a fundamental understanding of the crosstalk between host and microorganisms in regulating the synthesis of milk composition.

Very early onset perinatal constipation:Can it be cow’s milk protein allergy?

Delayed passage of meconium or constipation during the perinatal period is traditionally regarded as a signal to initiate further work up to evaluate for serious diagnoses such as Hirschsprung’s disease(HD),meconium ileus due to Cystic Fibrosis,etc.The diagnosis of HD particularly warrants invasive testing to confirm the diagnosis,such as anorectal manometry or rectal suction biopsy.What if there was another etiology of perinatal constipation,that is far lesser known?Cow’s milk protein allergy(CMPA)is often diagnosed in infants within the first few weeks of life,however,there are studies that show that the CMPA allergen can be passed from mother to an infant in-utero,therefore allowing symptoms to show as early as day one of life.The presentation is more atypical,with perinatal constipation rather than with bloody stools,diarrhea,and vomiting.The diagnosis and management would be avoidance of cow's milk protein within the diet,with results and symptom improvement in patients immediately.Therefore,we discuss whether an alternative pathway to address perinatal constipation should be further discussed and implemented to potentially avoid invasive techniques in patients.This entails first ruling out CMPA with safe,noninvasive techniques with diet modification,and if unsuccessful,then moving forward with further diagnostic modalities.

Milk fat globule membrane supplementation protects againstβ-lactoglobul-ininduced food allergy in mice via upregulation of regulatory T cells and enhancement of intestinal barrier in a microbiota-derived short-chain fatty acids manner

Milk fat globule membrane(MFGM),which contains abundant glycoproteins and phospholipids,exerts beneficial effects on intestinal health and immunomodulation.The aim of this study was to evaluate the protective effects and possible underlying mechanisms of MFGM on cow’s milk allergy(CMA)in aβ-lactoglobulin(BLG)-induced allergic mice model.MFGM was supplemented to allergic mice induced by BLG at a dose of 400 mg/kg body weight.Results demonstrated that MFGM alleviated food allergy symptoms,decreased serum levels of lipopolysaccharide,pro-inflammatory cytokines,immunoglobulin(Ig)E,Ig G1,and Th2 cytokines including interleukin(IL)-4,while increased serum levels of Th1 cytokines including interferon-γand regulatory T cells(Tregs)cytokines including IL-10 and transforming growth factor-β.MFGM modulated gut microbiota and enhanced intestinal barrier of BLG-allergic mice,as evidenced by decreased relative abundance of Desulfobacterota,Rikenellaceae,Lachnospiraceae,and Desulfovibrionaceae,while increased relative abundance of Bacteroidetes,Lactobacillaceae and Muribaculaceae,and enhanced expressions of tight junction proteins including Occludin,Claudin-1 and zonula occludens-1.Furthermore,MFGM increased fecal short-chain fatty acids(SCFAs)levels,which elevated G protein-coupled receptor(GPR)43 and GPR109A expressions.The increased expressions of GPR43 and GPR109A induced CD103+dendritic cells accumulation and promoted Tregs differentiation in mesenteric lymph node to a certain extent.In summary,MFGM alleviated CMA in a BLG-induced allergic mice model through enhancing intestinal barrier and promoting Tregs differentiation,which may be correlated with SCFAs-mediated activation of GPRs.These findings suggest that MFGM may be useful as a promising functional ingredient against CMA.

Correlation between the Insertion/Deletion Mutations of Prion Protein Gene and BSE Susceptibility and Milk Performance in Dairy Cows

Objective To investigate the 23 bp and 12 bp insertion/deletion(indel)mutations within the bovine prion protein(PRNP)gene in Chinese dairy cows,and to detect the associations of two indel mutations with BSE susceptibility and milk performance.Methods Based on bovine PRNP gene sequence,two pairs of primers for testing the 23 bp and 12 bp indel mutations were designed.The PCR amplification and agarose electrophoresis were carried out to distinguish the different genotypes within the mutations.Moreover,based on previous data from other cattle breeds and present genotypic and allelic frequencies of two indels mutations in this study,the corrections between the two indel mutations and BSE susceptibility were tested,as well as the relationships between the mutations and milk performance traits were analyzed in this study based on the statistical analyses.Results In the analyzed Chinese Holstein population,the frequencies of two"del"alleles in 23 bp and 12 bp indel muations were more frequent.The frequency of haplotype of 23del-12del was higher than those of 23del-12ins and 23ins-12del.From the estimated r2and D’values,two indel polymorphisms were linked strongly in the Holstein population(D’=57.5%,r2=0.257).Compared with the BSE-affected cattle populations from the reported data,the significant differences of genotypic and allelic frequencies were found among present Holstein and some BSE-affected populations(P<0.05 or P<0.01).Similarly,there were significant frequency distribution differences of genotypes and alleles among Chinese Holstein and several previous reported healthy dairy cattle(P<0.05 or P<0.01).Moreover,association of genotype and combined genotypes of two indel polymorphisms with milk performance and resistant mastitis traits were analyzed in Holstein population,but no significant differences were found(P>0.05).Conclusions These observations revealed that the influence of two indel mutations within the bovine PRNP gene on BSE depended on the breed and they did not affect the milk production traits,which layed the foundation for future selection of resistant animals,and for improving health conditions for dairy breeding against BSE in China.

Bacillus subtilis Co-transfected with a Lysine-rich and a Methionine-rich Protein Gene and Its Effect on Cow Milk Production

The probiotic Bacillus subtilis （B. subtilis） was widely applied in animal production as feed additive. Lysine （Lys） and methionine （Met） were the two most important limiting amino acids in livestock animal feed. Raising Lys and Met contents in B. subtilis would provide better effects for animal production and save Lys and Met supplements. We still didn＇t know whether Lys- rich and Met-rich protein genes from plants could be transfected into B. subtilis and expressed at a high level so as to improve animal production, such as milk production as an additional diet. The Lys-rich protein gene （Cflr） and Met-rich 10 ku-δ Zein were cloned from pepper anther and maize endosperm, respectively. Then they were constructed into plasmids individually and successfully cotransfected into B. subtilis. Upon IPTG induction, mRNAs and protein expressions could be observed. Lys and Met contents in the fermentation broth were raised by 65.92% and 46.39%, respectively. After feeding 200 g and 400 g· cow^-1· d^-1, transgenic B. subtilis fermentation broth, the milk yield, milk protein and milk fat contents all significantly increased. The Lys-rich protein gene （Cflr） and Met-rich 10 ku-δ Zein were successfully transfected into B. subtilis. Contents of Lys and Met in the transgenic B. subalis obviously raised and the fermentation broth of the transgenic bacteria could effectively improve milk yield and quality.

Feeding Protected Lysine and Methionine Modifies Milk Protein Profile in Grazing Dairy Cows

The experiment was designed to determine the effect of protected lysine (Lys) and methionine (Met) supply on milk protein profile in grazing dairy cows specifically in the caseins (CNs) and α-lactalbumin fractions. Twelve multiparous mid lactation Holstein cows producing 24 (±4.76) kg of milk were assigned to one of two treatments (six cows per treatment) during an experimental period of 21 days. In the control (C) group, cows grazed a Pennisetum clandestinum pasture and were supplemented with a commercial concentrate according to milk production. In the Met-Lys treatment, cows received the same ration supplemented with protected Lys and Met. Milk yield and composition and milk protein profile were measured at the start and the end (21st day) of the experimental period. The Tricine-SDS-PAGE and the Gel-Quant Express Analysis (Invitrogen) software were used to determine milk protein composition. Statistical analysis was performed using the SAS’s PROC MIXED procedure through a mixed model that included the animal as a random effect and the treatments as a fixed effect adjusted by covariables. Milk production averaged 23.7 (±2.0) kg cow-1 day-1 without differences between treatments (P P -1 day-1) compared to C (24.2 kg cow-1 day-1). Milk protein content (g/kg) did not differ (C = 30.4;Met-Lys = 31.1) and lactose content tended (P P β-CN also increased (P < 0.05) after protected aminoacid supply (C = 9.58;Met-Lys = 10.35). It can be concluded that milk protein composition was improved by protected Lys-Met supply without altering other compositional parameters of milk composition. Milk nutritional quality and its potential yield for cheese-making were positively enhanced.

Milk protein IgG and IgA:The association with milk-induced gastrointestinal symptoms in adults

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.

Cow’s milk-induced gastrointestinal disorders:From infancy to adulthood

Milk is related to many gastrointestinal disorders from the cradle to the grave due to the many milk ingredients that can trigger gastrointestinal discomfort and disorders.Cow’s milk protein allergy(CMPA)is the most common food allergy,especially in infancy and childhood,which may persist into adulthood.There are three main types of CMPA;immunoglobulin E(IgE)-mediated CMPA,non-IgEmediated CMPA,and mixed type.CMPA appears before the first birthday in almost all cases.Symptoms may start even during the neonatal period and can be severe enough to simulate neonatal sepsis.CMPA(often non-IgE mediated)can present with symptoms of gastroesophageal reflux,eosinophilic esophagitis,hemorrhagic gastritis,food protein-induced protein-losing enteropathy,and food protein-induced enterocolitis syndrome.Most CMPAs are benign and outgrown during childhood.CMPA is not as common in adults as in children,but when present,it is usually severe with a protracted course.Lactose intolerance is a prevalent condition characterized by the development of many symptoms related to the consumption of foods containing lactose.Lactose intolerance has four typical types:Developmental,congenital,primary,and secondary.Lactose intolerance and CMPA may be the underlying pathophysiologic mechanisms for many functional gastrointestinal disorders in children and adults.They are also common in inflammatory bowel diseases.Milk consumption may have preventive or promoter effects on cancer development.Milk may also become a source of microbial infection in humans,causing a wide array of diseases,and may help increase the prevalence of antimicrobial resistance.This editorial summarizes the common milk-related disorders and their symptoms from childhood to adulthood.

Bisphenol A in Fluid and Powdered Milk Samples and Associated Child Dietary Exposures

Bisphenol A (BPA) is a synthetic chemical found in a wide range of consumer products and consumables that humans are exposed to. The aim of this study was to determine BPA contamination levels in 51 milk samples sold in the Rio de Janeiro Metropolitan Region, Brazil. Bisphenol A was detected (≥limit of detection, LOD) in five of the analyzed samples (9.8%) and quantified (≥limit of quantification, LOQ) in two (3.8%). The estimated daily intake (EDI) for children aged up to 12 months ranged from 24.95 to 97.72 ng/kg body weight/day, lower than the established European Union tolerable daily intake value. Recent evidence, however, suggests that even low doses of endocrine disruptors such as BPA may pose potential health risks, even more so when exposure occurs at such an early life stage.

Assessment of a Precaution Index for Environmental Evaluation: An Example of Application to the Cow’s Milk Production

The paper presents a Precaution Index (P) developed to create an instrument to assess the potential risk related to the presence of pollution sources next to milk production farms. The methodology starts from the inventory and geo-referencing of all pollution sources in an area, with the help of the multi-criteria decision analysis. Results are represented in a map of P, which highlights which areas are most at risk and need monitoring, and which pollutants may be involved. This may help in the early identification of emerging hazards to food safety. P was calculated for the milk production in an Italian region. Results show that 97% of the area is in a condition of minimum precaution that would be needed in controlling the safety of dairy products.

Dietary polyphenols reduced the allergenicity ofβ-lactoglobulin via non-covalent interactions:a study on the structure-allergenicity relationship

Studies showed that complexation of polyphenols with milk allergens reduced their immunogenic potential.However,the relationship between structures of polyphenols and their hypoallergenic effects on milk allergens in association with physiological and conformational changes of the complexes remain unclear.In this study,polyphenols from eight botanical sources were extracted to prepare non-covalent complexes withβ-lactoglobulin(β-LG),a major allergen in milk.The dominant phenolic compounds bound toβ-LG with a diminished allergenicity were identified to investigate their respective role on the structural and allergenic properties ofβ-LG.Extracts from Vaccinium fruits and black soybeans were found to have great inhibitory effects on the IgE-and IgG-binding abilities ofβ-LG.Among the fourteen structure-related phenolic compounds,flavonoids and tannins with larger MWs and multi-hydroxyl substituents,notably rutin,EGCG,and ellagitannins were more potent to elicit changes on the conformational structures ofβ-LG to decrease the allergenicity of complexedβ-LG.Correlation analysis further demonstrated that a destabilized secondary structure and protein depolymerization caused by polyphenol-binding were closely related to the allergenicity property of formed complexes.This study provides insights into the understanding of structure-allergenicity relationship ofβ-LG-polyphenol interactions and would benefit the development of polyphenol-fortified matrices with hypoallergenic potential.

Effects of Cow’s Milk on Reproduction in ICR Male Mice

Objective To study the effects of Cow＇s milk on the reproduction in male mice. Methods Twenty-four male mice were divided randomly into two groups： milk group （M） and control group （C）. Each mouse was given 10 mL milk per day from 4 to 16 weeks in the group M. At the age of 17 weeks, all the mice were sacrificed. Results Serum testosterone was decreased in the group M （P=0.037）. No significant difference was found in weight of testes, seminal vesicle or adrenal gland of mice between the groups C and M. However, the weight of seminal vesicle decreased when expressed in g/100 g body weight in the group M. Epididymal sperm concentration, motility, morphology, and sperm head number were not affected by milk. Conclusion Cow＇s milk has adverse effects on the reproductive system in ICR male mice. Further studies are needed to clarify the specific effects of milk on reproductive health.

Molecularly defined adult-type hypolactasia in school-aged children with a previous history of cow's milk allergy

AIM： To assess the role of lactase non-persistence/per- sistence in school-aged children and their milk-related symptoms. METHODS： The genotypes for the C/T-13910 variant associated with lactase non-persistence/ persistence were determined using PCR-minisequencing in a group of 172 children with a mean age of 8.6 years （SE = 0.02, 93 boys） participating in a follow-up study for cow＇s milk allergy. The parents were asked to assess their children＇s milk consumption and abdominal symptoms. RESULTS： The presence of allergy to cow＇s milk was not associated with the C/C-13910 genotype related with a decline of lactase enzyme activity during childhood （lactase non-persistence）. The frequency of the C/C-13910 genotype （16%） was similar to published figures for the prevalence of adult-type hypolactasia in Finland. The majority of the children （90%） in this series consumed milk but 26% of their families suspected that their children had milk-related symptoms. Forty-eight percent of the children with the C/C-13910 genotype did not drink milk at all or consumed a low lactose containing diet prior to the genotyping （P〈 0.004 when compared to the other genotypes）. CONCLUSION： Analysis of the C/T-13910 polymorphism is an easy and reliable method for excluding adult-type hypolactasia in children with milk-related symptoms. Genotyping for this variant can be used to advise diets for children with a previous history of cow＇s milk allergy.

Evaluation of the Physicochemical Parameters of Cow’s Fresh Milk in Shkodra

Milk is universally recognized as complete food, which contains essential components for human nutrition. Physicochemical analysis constitutes an important device that monitors its quality. The purpose of this study was to determine the physicochemical characteristics of fresh cow milk in samples taken in the region of Shkodra and Lezha and compare it to European quality standards. Results of the analyses were statistically processed by the Minitab 17 statistical program. Results showed that there is no significant difference (P > 0.05) in fat, protein, lactose and density value, while there is significant difference (P < 0.05) in pH, ash% without fat, freezing point and water value. The results show a stability of physicochemical parameters of milk, with variation according to the region where samples were gathered.

Cow milkα_(s1)-casein induces allergic responses in a mouse model of atopy

α_(s1)-Casein is a potential allergen to induce hypersensitivity in cow milk.We had identifiedα_(s1)-casein and its epitopes in previous studies.The present study aimed to evaluate the allergic mechanism ofα_(s1)-casein in a BALB/c mouse model.The levels of specific IgE,mast cell proteinase,histamine and cytokines in sensitized mice were determined,and the clinical and pathological observation were evaluated.Results showed that the levels of specific IgE,mast cell proteinase,histamine,IL-4,IL-5,IL-10 increased significantly with a dose-dependent trend.The local alveolar septum collapsed or thickened,and lymphatic foci were produced in the spleen and thymus,and the inflammatory cells infiltrated in small intestinal mucosa mesenchyme.In conclusion,the levels of specific IgE,mast cell proteinase,histamine,IL-4,IL-5,IL-10 and some inflammatory factors could possibly serve as allergic biomarkers ofα_(s1)-casein,however,additional studies on signal transduction and gene expression are necessary in future.

Preparation of Polyclonal Antisera of Dairy Cow S100A12 Protein

[Objective] This study aimed to prepare dairy cow anti-S100A12 antisem and develop a highly effective and sensitive immunological detection reagent for further investigation of the functions of dairy cow S100A12. [Method] Purified S100A12 protein was respectively emulsified with Freund＇s complete adjuvant and Freund＇s incomplete adjuvant as the antigen for immunizing New Zealand white rabbits to prepare the polyclonal antisera. The titer was detected using agar double diffusion assay and indirect enzyme-linked immunoserbent assay （ELISA） and the specificity was determined with Western Blot. [ Result ] The titer of anti- S100A12 antisera was 1： 8 as determined by agar double diffusion assay and over 1：409 600 by ELISA. Western Blot result showed that the polyclonal antisera could be specifically combined with S100A12 protein. [ Conclusion] The results indicated that anti-S100A12 polyclonal antibody with high fiter and high specificity was successfully obtained, which provided a novel tool for further investigation of the functions of S100A12 gene.

Milk Consumption and Lactose Intolerance in Adults

Objective To investigate relations between milk consumption and lactose intolerance （LI） in adults and to explore the effect of milk consumption on lactase activity.Methods Total of 182 subjects aged 20‐70 years were recruited and interviewed by questionnaires,and their accumulative cow＇s milk intake （AMI） was calculated.LI was evaluated by hydrogen breath test （HBT）.Results A negative correlation was found between AMI and severity of observed LI symptom （r=-0.2884;P0.05）.Binary logistic regression analysis showed a negative correlation between LI and duration and frequency of milk consumption （OR,0.317 and 0.465,respectively;both P0.05） and a positive correlation between LI and amount of milk consumed per sitting （OR,6.337;P0.05）.Conclusion LI is related to various milk consumption behaviors.Most Chinese adults with LI may tolerate moderate milk consumption 160 mL.

Physico-chemical and Microbiological Analysis of Algerian Raw Camel＇s Milk and Identification of Predominating Thermophilic Lactic Acid Bacteria

The dromedary camel （Camelus dromedarius） is a significant socioeconomic importance in several arid and semi-arid regions of North Africa and Middle East, and its milk constitutes an important component of human diets in these regions. The camel milk plays a vital role in the food of the Algerian nomads in the Sahara. During February and September, 20 samples of the raw camel＇s milk were taken starting from different livestock of camels from three different Sahariennes regions （Bechar, EI-Bayadh and Naama）. These 20 collected samples were analyzed by physico-chemical and microbiological methods. The results of physicochemical analyze obtained from two hot and cold seasons are respectively the following： T ~C （35.83 and 33.95）, pH （6.36 and 6.49）, density （1.031 and 1.032）, dornic acidity （18.6 and 18.3 ~D）, dry matter （93.4 and 144.8 g/L）, fat contents （30 and 52.1 g/L）, total protein （26.3 and 33.1 g/L） and ashes （7.46 and 8.66 g/L）. The protein profile obtained by electrophoretic analysis （SDS-PAGE） showed that camel milk contains several types of proteins and some have a molecular weight identical to major proteins of the cow＇s milk. The final results showed that camel milk has generally a comparable composition to that of bovine milk. The microbiological analysis, of these samples, detected a significant number of the total microflora, Staphylococcus aureus and total coliforms. The absence of Clostridium and fecal coliforms was observed. Several species of lactic acid bacteria were detected such as Lactococcus lactis subsp, lactis, Lactococcus lactis subsp, lactis biovar, diacetylactis, Weissella cibaria and Enteroccocusfeacalis.

孕期因素与婴儿牛奶蛋白过敏的关系

目的:初步探讨孕期因素与婴儿牛奶蛋白过敏的关系。方法:数据来自一项“中国儿童对牛奶蛋白过敏的遗传易感性研究”的子队列,包括2020年3月1日至12月31日在北京大学人民医院出生的婴儿,根据随访至1岁时有无牛奶蛋白过敏(cow’s milk protein allergy,CMPA),分为病例组(CMPA组)和对照组。回顾性收集婴儿及其母亲孕前和孕期的临床资料,分析孕期多因素与婴儿牛奶蛋白过敏的相关性。结果:共纳入278例婴儿,CMPA患儿52例,对照组226例;男性婴儿143例,女性婴儿135例,其中男性婴儿在CMPA组比例(69.2%)高于对照组(47.3%),差异有统计学意义(P=0.004);CMPA患儿和对照组在出生体质量、出生胎龄、低出生体重儿、早产、脐带绕颈、新生儿窒息分布上差异无统计学意义(P>0.05)。母亲孕期合并免疫性疾病、贫血者以及孕期存在抗生素暴露者在CMPA组比例均高于对照组,两组之间差异有统计学意义(P<0.05);其他妊娠期合并症,如子痫/子痫前期、慢性高血压/妊娠期高血压、糖尿病/妊娠期糖尿病、甲状腺疾病等在两组分布差异无统计学意义(P>0.05)。CMPA组与对照组孕期多项血常规指标总体分布差异无统计学意义(P>0.05)。多因素Logistic回归分析发现男性婴儿、母亲妊娠合并免疫性疾病、妊娠合并贫血以及孕期抗生素暴露是CMPA发生的独立危险因素。结论:男性婴儿、母亲妊娠合并免疫性疾病、妊娠合并贫血以及孕期抗生素暴露是CMPA发生的独立危险因素。

《新生儿牛奶蛋白过敏诊断与管理专家共识(2023)》要点解读

新生儿牛奶蛋白过敏(cow's milk protein allergy,CMPA)临床表现不典型,可导致多器官和系统受累,并且可能影响新生儿体格生长和中枢神经系统发育,造成机体功能障碍,还会增加其他家庭成员的焦虑和压力。由于缺乏特异性临床表现和诊断方法,新生儿CMPA的诊断和管理仍然是目前非常重要的临床挑战。为促进新生儿CMPA规范化诊治,由中华医学会儿科学分会新生儿学组、中华儿科杂志编辑委员会组织制定了《新生儿牛奶蛋白过敏诊断与管理专家共识(2023)》,该文对该共识新生儿CMPA饮食和营养管理部分重点内容进行介绍和解读。