Eosinophil cationic protein and histamine after intestinal challenge in patients with cow's milk intolerance.
ABSTRACT Mast cells and eosinophils are key cells in the development of active symptoms in allergic diseases and other inflammatory conditions, and they mediate their action through the release of very potent granule constituents.
Five patients with milk-related gastrointestinal symptoms diagnosed by double-blind placebo-controlled milk challenges, but with negative responses to skin prick tests and RASTs with milk, and eight healthy control subjects were investigated. Repeated perfusion studies were performed with a two-balloon, six-channel tube by using milk, casein, and whey as antigens. Luminal eosinophil cationic protein, histamine, and albumin were measured by radioimmunoassay.
Luminal cow's milk induced a pronounced increase in intestinal secretion of histamine and eosinophil cationic protein in patients, but not control subjects, during the first 20 minutes after challenge (histamine from 123 +/- 12 to 543 +/- 175 ng/cm, hr; eosinophil cationic protein from 80 +/- 23 to 686 +/- 262 ng/cm, hr). Albumin, as a marker of plasma leakage, was also significantly increased.
These data indicate that mast cells and eosinophils are effector cells not only in patients with allergic disease but also in patients intolerant to foods and lacking circulating antibodies. The underlying mechanisms may be a reaction mediated by locally appearing antibodies or an immunologic activation resembling that found in intestinal disorders such as celiac disease.
- SourceAvailable from: Celso Eduardo Olivier
Article: Food Allergy[Show abstract] [Hide abstract]
ABSTRACT: Adverse reactions to food may be produced by several mechanisms and present a great diversity of symptoms, which may be reproducible or not reproducible (occasional adverse food reactions). The reproducible adverse food reactions to minimal or usual amounts of food are classified as hypersensitivity reactions, which may be derived from immune disorders (food allergies) or derived from non-immune conditions (food intolerance). Here, we review the clinical presentations of food allergies according to the underlying mechanisms and causative agents in order to put perspectives over the treatment possibilities.Journal of Allergy & Therapy. 03/2013; S3:4.
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ABSTRACT: BACKGROUND/PURPOSE:: The aim was to determine the clinical significance of an incidental finding of eosinophilia (EOS) and chronic inflammatory infiltrate (CINF) in rectal biopsies of children investigated for suspected Hirschsprung's disease (HSCR). METHODS:: A retrospective study (2000-2010) of children incidentally found to have EOS and CINF was performed. HSCR cases were excluded. Presence of gastro-intestinal symptoms and nutritional status (weight-for-age Z-score) were investigated and compared with a matched cohort with normal biopsy. RESULTS:: Of 364 children undergoing rectal biopsy for suspected HSCR, 109 had confirmed HSCR whereas 255 children had normal ganglia. 44/255 (17%) had EOS and/or CINF incidentally reported and are the subject of this study. In 13/44 (29%), the biopsy was performed neonatally. At follow-up [4.6 months (1-22)], 21 (48%) had food and/or milk allergy, 30 (68%) had constipation and/or other gastro-intestinal symptoms. There was no change in weight-for-age Z-score (p = 0.85) at follow-up and 8 (20%) had failure to thrive. Only 10/44 (p = 0.0001 vs. patients with EOS and/or CINF) children with normal biopsy had persistent constipation at follow-up [9.7 months (0.5-84.7)] and 1 patient had atopy. Patients with normal biopsy exhibited an increase in weight-for-age Z-score at follow-up (p = 0.003) and only 3 patients (7%) had failure to thrive. CONCLUSIONS:: EOS and CINF are found in 17% of rectal biopsy in children who had rectal biopsies negative for HSCR. Half of these children will need further medical input for the presence of persisting G-I symptoms, food/milk allergy and failure to thrive and the possibility to develop inflammatory bowel disease later in life.Journal of pediatric gastroenterology and nutrition 04/2012; · 2.18 Impact Factor
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ABSTRACT: Majority of the patients with perceived food hypersensitivity have irritable bowel syndrome (IBS), and a significant proportion of IBS patients also attribute their gastrointestinal complaints to food items. Different factors such as disturbed intestinal fermentation, enteric dysmotility, post-infectious changes and altered microbial flora in the colon as well as psychological disturbances likely play a role in the pathophysiology and symptoms generation in patients with food hypersensitivity. In addition, a number of studies in these patient groups indicate that local, systemic and mucosal immune systems are activated. The question now is no longer intestinal immune activation, but how the immune system is activated in these patients. In the following review, the potential pathogenetic role of the immune system and evidence of immune activation are reported in patients with perceived food hypersensitivity.Digestive Diseases and Sciences 11/2013; · 2.26 Impact Factor