The Frequency of Development of Cow’s Milk Protein Allergy Post Gastrointestinal Tract Surgery among Infants and Children

Our aim is to assess the efficacy of fecal calprotectin (fCP) and fecal eosinophil-derived neurotoxin (fEDN) as diagnostic markers of cow’s milk protein allergy (CMPA) and for monitoring the infants’ response to a non-IgE mediated cow’s milk protein (CMP)-free diet. We prospectively recruited infants aged 0 to 9 months. Stool samples were taken from 30 infants with CMPA, 19 with mild functional gastrointestinal disorders, 28 healthy infants, and 28 children who presented mild infections. Despite the fact that levels of fCP and fEDN in CMPA infants were higher than in healthy infants at month 0, differences for both parameters did not reach statistical significance (p-value 0.119 and 0.506). After 1 month of an elimination diet, no statistically significant differences in fCP with basal levels were found (p-values 0.184) in the CMPA group. We found a high variability in the fCP and fEDN levels of young infants, and discrepancies in individual behavior of these markers after a CMP-free diet was started. It seems that neither fCP nor fEDN levels are helpful to discriminate between healthy infants and those with signs or symptoms related to non-IgE-mediated CMPA. Additionally, it is debatable if on an individual basis, fCP or fEDN levels could be used for clinical follow-up and dietary compliance monitoring. However, prospective studies with larger populations are needed to draw robust conclusions.

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Differential Cytokine Expression in the Duodenum and Rectum of Children with Non-Immunoglobulin E-Mediated Cow’s Milk Protein Allergy

Digestive Diseases and Sciences ◽

10.1007/s10620-020-06743-z ◽

2021 ◽

Author(s):

Erick M. Toro-Monjaraz ◽

Gabriela Fonseca-Camarillo ◽

Flora Zárate-Mondragón ◽

Ericka Montijo-Barrios ◽

José Cadena-León ◽

...

Keyword(s):

Milk Protein ◽

Immunoglobulin E ◽

Cytokine Expression ◽

Cow’S Milk ◽

Cow's Milk ◽

Cow’S Milk Protein

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The Effectiveness of Probiotic Lactobacillus rhamnosus and Lactobacillus casei Strains in Children with Atopic Dermatitis and Cow’s Milk Protein Allergy: A Multicenter, Randomized, Double Blind, Placebo Controlled Study

Nutrients ◽

10.3390/nu13041169 ◽

2021 ◽

Vol 13 (4) ◽

pp. 1169

Author(s):

Bożena Cukrowska ◽

Aldona Ceregra ◽

Elżbieta Maciorkowska ◽

Barbara Surowska ◽

Maria Agnieszka Zegadło-Mylik ◽

...

Keyword(s):

Atopic Dermatitis ◽

Lactobacillus Casei ◽

Milk Protein ◽

Lactobacillus Rhamnosus ◽

Cow’S Milk ◽

Controlled Study ◽

Symptom Improvement ◽

Cow's Milk ◽

Probiotic Preparation ◽

Cow’S Milk Protein

Probiotics seem to have promising effects in the prevention and treatment of allergic conditions including atopic dermatitis (AD) and food allergy. The purpose of this multicenter randomized placebo-controlled trial was to evaluate the effectiveness of a probiotic preparation comprising Lactobacillus rhamnosus ŁOCK 0900, Lactobacillus rhamnosus ŁOCK 0908, and Lactobacillus casei ŁOCK 0918 in children under 2 years of age with AD and a cow’s milk protein (CMP) allergy. The study enrolled 151 children, who—apart from being treated with a CMP elimination diet—were randomized to receive the probiotic preparation at a daily dose of 109 bacteria or a placebo for three months, with a subsequent nine-month follow-up. The primary outcomes included changes in AD symptom severity assessed with the scoring AD (SCORAD) index and in the proportion of children with symptom improvement (a SCORAD score decreased by at least 30% in comparison with that at baseline). After the three-month intervention, both the probiotic and placebo groups showed a significant (p < 0.0001) decrease in SCORAD scores, which was maintained nine months later. The percentage of children who showed improvement was significantly higher in the probiotic than in the placebo group (odds ratio (OR) 2.56; 95% confidence interval (CI) 1.13–5.8; p = 0.012) after three months. Probiotics induced SCORAD improvement mainly in allergen sensitized patients (OR 6.03; 95% CI 1.85–19.67, p = 0.001), but this positive effect was not observed after nine months. The results showed that the mixture of probiotic ŁOCK strains offers benefits for children with AD and CMP allergy. Further research is necessary to assess the effect of probiotic supplementation on the development of immune tolerance. (ClinicalTrials.gov NCT04738565)

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