Severe upper gastrointestinal hemorrhage due to milk protein allergy: A case report

BACKGROUND Upper gastrointestinal hemorrhage is a life-threatening manifestation of cow’s milk protein allergy(CMPA).We analyze the clinical characteristics of a case of milk protein allergy manifested as severe upper gastrointestinal hemorrhage.CASE SUMMARY The hospital admitted a 2-month-old male infant due to“melena for 6 days,he-matemesis twice”.The main symptom was melena,initially occurring once or twice per day,then gradually increasing to five or six times per day at their peak.During the course of the illness,the infant vomited blood,but there were no re-ports of vomiting,fever,pale complexion,dyspnea,wheezing,or difficulty brea-thing.Laboratory tests showed hemoglobin level of 87 g/L,platelet count of 349×109/L,and eosinophil percentage of 0.031.Coagulation studies were normal.After avoiding certain foods and feeding with an amino acid formula for 2 weeks,a repeat gastroscopy revealed less bleeding.After six weeks,a positive oral food challenge test confirmed a severe CMPA.At the 4-month follow-up,there was no gastrointestinal bleeding,and the infant was growing and developing well.CONCLUSION The manifestations of milk protein allergy are diverse and nonspecific,with gas-trointestinal bleeding being less common,especially in infants.When infants present with unexplained massive hematemesis,it’s critical to investigate the possibility of CMPA.

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.

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.

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.

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.

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.

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.

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.

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.

Comparative Study of the Flavor Compounds in two Different Milk with SPME-GCMS

The flavor is very important in the dairy industry because it decides on the acceptance of milk and other dairy products. And the flavor compounds in two different milk were analyzed with SPME-GCMS. At present, the milking mode includes automatic milking and manual milking in cat- tle farm. Milk samples, collected from six healthy early/mid-lactation Holstein cows, were analyzed by static headspace （SH） and solid phase microextraction （SPME） combined with gas-chromatogra- phy and mass spectrometry （GCMS） in this paper. The result showed that the aroma compounds in milk （automatic milking） were more than that of milk （manual milking）, but the off-flavor com- pounds in milk （automatic milking） were less than that of milk （manual milking）. So to preserve the good flavor, the milk should be extruded with the automate milking.

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.

傅里叶变换红外光谱的牛乳中α_(s)1-酪蛋白和κ-酪蛋白含量的快速检测

为了找到一种能够对牛乳中的两种主要过敏原(αs1和κ-酪蛋白)含量快速检测的方法,以河南、湖北、宁夏和内蒙古四省区的211份中国荷斯坦牛牛乳样本为研究对象,建立了基于傅里叶变换中红外光谱技术的牛乳中αs1和κ-酪蛋白含量的无损快速检测模型。首先对牛乳的原始光谱进行预分析,发现水对牛乳的光谱吸收具有很强的干扰,对水的两个主要吸收区域1597~1712和3024~3680 cm^(-1)进行分析,发现水的吸收区域1597~1712 cm^(-1)和蛋白的部分吸收区域1558~1705 cm^(-1)(酰胺Ⅰ)基本重合,通过对比去除1597~1712 cm^(-1)前后的效果,最终选择925.92~3005.382 cm^(-1)的光谱区域作为敏感波段用于后续分析。选取的全光谱经手动降维,利用MCCV剔除异常样本,分别采用标准正态变量变换(SNV)、多元散射校正(MSC)等8种预处理算法和竞争性自适应重加权算法(CARS)、无信息变量消除法(UVE)等3种特征选择算法联合建立支持向量机回归模型(SVR)。经检验,对于αs1-酪蛋白,一阶导数和CARS算法结合建立的SVR模型效果最优,训练集相关系数Rc和测试集相关系数R p分别为0.8827和0.8998,训练集均方根误差RMSEC和测试集均方根误差RMSEP分别为1.1363和1.3726;对于κ-酪蛋白,一阶差分和UVE算法结合建立的SVR模型效果最优,训练集相关系数R_(c)和测试集相关系数R_(p)分别为0.8808和0.8903,训练集均方根误差RMSEC和测试集均方根误差RMSEP分别为0.5345和0.5354。研究结果表明,基于傅里叶变换中红外光谱技术建立的SVR模型可以对牛乳中的过敏原α_(s)1和κ-酪蛋白含量进行无损检测,预测效果良好,此研究弥补了国内利用光谱技术对牛乳中的酪蛋白进行无损快速检测的空白。

Microbact^TM 24E system identification and antimicrobial sensitivity pattern of bacterial flora from raw milk of apparently healthy lactating cows in Gwagwalada, Nigeria

Objective: To determine the prevalence of bacterial organisms from raw milk of cows in Gwagwalada and determine their susceptibility to commonly used antimicrobial agents. Methods: A total of 120 samples of milk were obtained from lactating cows that were at different stages of postpartum from six different locations in Gwagwalada metropolis. Samples were subjected to Microbact? 24E system identification, isolation and characterization of isolates, and antibiotics susceptibility test. Results: The most prevalent organisms were Staphylococcus aureus (34.1%), Escherichia coli (27.3%) and Bacillus species (18.2%) while the least isolated were Salmonella species (11.4%) and Pseudomonas aeruginosa (9.0%). The highest resistance patterns were shown by Staphylococcus aureus which displayed resistance to five drugs: amoxicillin, ampiclox, levofloxacin, norfloxacin, chloramphenicol and streptomycin. The least resistance was displayed by Bacillus species which were resistant to only two drugs, norfloxacin and chloramphenicol. Pseudomonas aeroginosa dissipated the highest pattern susceptibility to ciprofloxacin, norfloxacin, gentamicin and streptomycin while Salmonella species showed the lowest pattern of susceptibility to ciprofloxacin only. Other microorganisms dissipated susceptibility patterns ranging from 16.6%–100.0%. Conclusions: This study documented the occurrence of bacterial flora in raw milk of apparently healthy lactating cows in the Gwagwalada area. The variation in patterns of multidrug resistance and susceptibilities in our studies may lead to possibility of transfer of antibiotic resistance from raw milk consumers. More studies are required using higher molecular techniques to expose different species of microorganisms causing milk borne illness and their antibiotic resistant genes.

广西南宁兴宁区不同季节水牛和娟姗牛乳中As和Hg重金属元素含量的研究

使用原子荧光光度计对广西南宁兴宁区水牛和娟姗牛生乳、水源、饲料中As和Hg元素进行检测与统计分析。结果表明:(1)两个牛场不同季节的生乳和饲料中As和Hg元素含量存在显著性差异,但均未超过国标限定值,无安全风险。(2)水牛场与娟珊牛场使用相同的水源,不同季节As含量均非常低,且含量水平非常接近,Hg元素均未被检出,对本地区牛奶生乳中As及Hg含量影响较小。(3)饲料中As及Hg元素含量与生乳中As及Hg元素含量的相关性分析表明,生乳中As元素含量与精饲料中As元素含量有一定的相关性,而Hg元素与精饲料中Hg元素含量有显著相关性(P<0.05)。精饲料的批次及产地变化可能是水牛及娟珊牛生乳As及Hg元素含量在不同季节存在的差异性的主要原因。

芝士风味牛奶的配方研究

以生牛乳、稀奶油、芝士粉为原料制备芝士风味牛奶。以产品感官评定为评价指标,在单因素试验的基础上进行正交试验,分析稀奶油、芝士粉、稳定剂的添加量对芝士风味牛奶品质的影响,并进行产品稳定性测定。试验结果表明,稀奶油、芝士粉、稳定剂的添加量分别为13.5 g·L^(-1)、1.5 g·L^(-1)、2.0 g·L^(-1)时,产品顺滑细腻,香甜可口,颜色呈乳白色,奶香味浓郁,具有独特的芝士风味,在保质期可安全储存。

牛乳β-酪蛋白基因分型及A1β-酪蛋白对人体健康的潜在影响

长期以来,牛奶为人们提供优质蛋白质和钙等微量元素。β-酪蛋白作为牛乳蛋白质的重要组成部分,具有多种分型,其中最常见的是A1型和A2型,且因与人体健康密切相关而受到广泛关注。BCM-7是A1β-酪蛋白消化产生的一种生物活性肽,具有阿片样性质,推测其可能与胃肠功能紊乱、I型糖尿病、心血管疾病和神经系统疾病等慢性非传染性疾病密切相关,而也有少数文献报道,A1β-酪蛋白对机体是有益的。因此,该文从β-酪蛋白的基因分型及其与人体健康的关系等方面进行阐述,为阐明A1和A2型β-酪蛋白牛奶对人体健康的具体影响以及各自发挥作用的机理奠定基础,并为A1和A2型β-酪蛋白牛奶的消费选择提供一定的理论参考。

徐州地区0~3岁婴幼儿牛奶蛋白过敏的临床特征及影响因素分析

目的了解徐州地区0~3岁婴幼儿牛奶蛋白过敏(CMPA)的临床特征及影响因素分析,为临床诊断和治疗提供参考。方法选取2019年10月至2022年10月徐州地区0~3岁婴幼儿为研究对象,采用问卷调查的形式收集所有对象的临床特征,评估其营养水平并开展实验室检查。根据皮肤点刺试验和牛奶回避/激发试验结果确诊CMPA患儿。评估病情严重程度并分析CMPA患儿的临床特征及影响因素。根据皮肤点刺试验和IgE检查结果将患儿分为免疫球蛋白E(IgE)介导型和非IgE介导型,比较不同类型患儿临床症状和实验室检查结果。结果共纳入4983例0~3岁婴幼儿进行研究。4983例婴幼儿中共检出CMPA患儿124例,发病率为2.49%。不同年龄婴幼儿,CMPA发病率比较,差异有统计学意义(χ^(2)=10.065,P=0.002),且1~2岁和>2岁婴幼儿的CMPA发病率均高于<1岁的婴幼儿(χ^(2)=5.258,P=0.022;χ^(2)=8.055,P=0.005)。早产儿及父母有过敏史的婴幼儿CMPA发病率显著高于非早产儿及父母无过敏史者,差异均有统计学意义(χ^(2)=6.881,P=0.009;χ^(2)=9.753,P=0.002)。124例CMPA患儿中IgE介导型26例(20.97%),非IgE介导型98例(79.03%)。IgE介导型发生呕吐/胃食管反流的发生率显著低于非IgE介导型(χ^(2)=11.668,P=50.001),而发生湿疹/风团/红斑、流涕/咳嗽/喘息、口周红肿和累及2个及以上系统的发生率显著高于非IgE介导型(χ^(2)=32.975,P<0.001;χ^(2)=10.000,P=0.002;χ^(2)=17.293,P<0.001;χ^(2)=4.908,P=0.027)。IgE介导型患儿总IgE阳性比例和牛奶蛋白sIgE阳性比例均显著高于非IgE介导型(χ^(2)=19.855,P<0.001;χ^(2)=50.077,P<0.001)。多因素Logistic回归分析结果显示,年龄<1岁(OR=4.674,95%CI:2.890~7.560)、早产(OR=3.077,95%CI:1.669~5.674)、父母有过敏史(OR=3.908,95%CI:2.236~6.830)是婴幼儿发生CMPA的危险因素(P<0.05)。结论徐州地区0~3岁婴幼儿CMPA发病率随年龄升高而降低,早产儿和父母有过敏史可导致发病率升高,且不同类型CMPA患儿的临床症状差异较大。