目的分析婴幼儿牛奶蛋白过敏(cow′s milk protein allergy,CMPA)的临床特点与危险因素,为婴幼儿CMPA防治提供依据。方法回顾性分析2017年1月至2018年12月在本院儿童保健科门诊首诊的CMPA患儿93例,另选取同期排除CMPA的体检婴幼儿186例...目的分析婴幼儿牛奶蛋白过敏(cow′s milk protein allergy,CMPA)的临床特点与危险因素,为婴幼儿CMPA防治提供依据。方法回顾性分析2017年1月至2018年12月在本院儿童保健科门诊首诊的CMPA患儿93例,另选取同期排除CMPA的体检婴幼儿186例为对照组。统计患儿特征、家族史以及实验室检查如血嗜酸性粒细胞和血清牛奶蛋白特异性sIgE水平等,应用Logistic多元逐步回归法确定CMPA危险因素。结果CMPA组与对照组婴幼儿性别、年龄与对照组差异无统计学意义(P>0.05)。单因素分析显示两组剖宫产、纯母乳喂养、部分母乳喂养、人工喂养、维生素D不足、维生素D缺乏、家族过敏性疾病史、血嗜酸性粒细胞增多及血清牛奶蛋白sIgE阳性差异有统计学意义(P<0.05)。多因素分析显示剖宫产、纯母乳喂养、维生素D不足、家族过敏史、血嗜酸性粒细胞增多、血清牛奶蛋白sIgE阳性是婴幼儿CMPA的危险因素;纯母乳喂养、维生素D缺乏是重度婴幼儿CMPA的危险因素。结论剖宫产、纯母乳喂养、维生素D不足、家族过敏史、血嗜酸性粒细胞增多、血清牛奶蛋白sIgE阳性是婴幼儿CMPA危险因素;纯母乳喂养、维生素D缺乏是重度婴幼儿CMPA危险因素,对危险因素的干预可能有助改善患儿病情。展开更多
目的应用高通量测序技术探讨IgE介导的牛乳蛋白过敏(cow′s milk protein allergy,CMA)婴幼儿肠道菌群结构和组成的变化。方法回顾性分析2012年6月-2013年6月入组食物过敏患儿,选择出IgE介导的CMA(IgE-CMA)患儿4例,非IgE介导的CMA(non-I...目的应用高通量测序技术探讨IgE介导的牛乳蛋白过敏(cow′s milk protein allergy,CMA)婴幼儿肠道菌群结构和组成的变化。方法回顾性分析2012年6月-2013年6月入组食物过敏患儿,选择出IgE介导的CMA(IgE-CMA)患儿4例,非IgE介导的CMA(non-IgE-CMA)患儿4例,采集粪便样本进行454焦磷酸测序分析,血清样本进行细胞因子检测。结果与non-IgE-CMA患儿相比较,IgECMA患儿肠道菌群多样性Shannon指数(t=-2.996,P=0.010)和Simpson指数(t=-1.786,P=0.036)显著改变,菌群多样性下降,菌群丰富度指数ACE(t=0.406,P=0.021)显著升高。β-多样性PCA分析可显著区分两组,提示IgE-CMA患儿肠道菌群发生显著改变。LEfSe组成差异分析发现肠道菌群中硬壁菌门和拟杆菌门的改变与CMA的不同表型无关,IgE-CMA婴儿中链球菌、肠球菌、鞘氨醇单胞菌、双歧杆菌、罗思氏菌属、红球菌和梭菌属第Ⅺ簇等减少,而厌氧杆菌和狭义梭菌属增加,可用于鉴别诊断CMA表型。结论IgE可决定CMA患儿肠道菌群的改变,这为开展以肠道菌群为靶点的不同表型CMA诊疗提供了新策略。展开更多
BACKGROUND Allergy to cow’s milk is the most frequent allergy occurring in infants and young children.The dietary management of these patients consists of the elimination of any cow’s milk proteins from the diet,and...BACKGROUND Allergy to cow’s milk is the most frequent allergy occurring in infants and young children.The dietary management of these patients consists of the elimination of any cow’s milk proteins from the diet,and for formula-fed infants,the substitution of the usual infant formula with an adapted formula that is generally based on extensively hydrolyzed cow’s milk proteins.The American Academy of Pediatrics has established specific criteria to confirm the hypoallergenicity of a formula intended for these children.AIM To assess the hypoallergenicity of a new thickened extensively hydrolyzed casein-based formula (TeHCF) in children with cow’s milk allergy (CMA).METHODS Children diagnosed with CMA through a double-blind placebo-controlled food challenge (DBPCFC) were randomly administered increased doses of a placebo formula or the TeHCF [Allernova,new thickener including fibres (Novalac)] under double-blind conditions and medical surveillance on two separate days.Otherwise,both of these formulas and a cow’s milk-based formula were randomly introduced to children who were highly suspected of having CMA on three separate days.Immediate and late reactions occurring after the introduction of any of these formulas were thoroughly recorded by the physician at the hospital and reported by parents to the physician after hospital discharge,respectively.If the children tolerated the TeHCF during the DBPCFC,they were exclusively fed this formula during a 3-mo period where potential allergic symptoms,anthropometric parameters,as secondary outcomes,and adverse events were registered.The Cow’s Milk-related Symptoms Score (CoMiSSTM) was assessed and anthropometric parameters were compared to World Health Organization (WHO) reference data.RESULTS Of the 30 children included in the study,the CMA diagnosis of 29 (mean age: 8.03 ± 7.43 mo) patients was confirmed by a DBPCFC.The children all tolerated the TeHCF during both the challenge and the subsequent 3-mo feeding period,which they all completed.During the latter p展开更多
文摘目的分析婴幼儿牛奶蛋白过敏(cow′s milk protein allergy,CMPA)的临床特点与危险因素,为婴幼儿CMPA防治提供依据。方法回顾性分析2017年1月至2018年12月在本院儿童保健科门诊首诊的CMPA患儿93例,另选取同期排除CMPA的体检婴幼儿186例为对照组。统计患儿特征、家族史以及实验室检查如血嗜酸性粒细胞和血清牛奶蛋白特异性sIgE水平等,应用Logistic多元逐步回归法确定CMPA危险因素。结果CMPA组与对照组婴幼儿性别、年龄与对照组差异无统计学意义(P>0.05)。单因素分析显示两组剖宫产、纯母乳喂养、部分母乳喂养、人工喂养、维生素D不足、维生素D缺乏、家族过敏性疾病史、血嗜酸性粒细胞增多及血清牛奶蛋白sIgE阳性差异有统计学意义(P<0.05)。多因素分析显示剖宫产、纯母乳喂养、维生素D不足、家族过敏史、血嗜酸性粒细胞增多、血清牛奶蛋白sIgE阳性是婴幼儿CMPA的危险因素;纯母乳喂养、维生素D缺乏是重度婴幼儿CMPA的危险因素。结论剖宫产、纯母乳喂养、维生素D不足、家族过敏史、血嗜酸性粒细胞增多、血清牛奶蛋白sIgE阳性是婴幼儿CMPA危险因素;纯母乳喂养、维生素D缺乏是重度婴幼儿CMPA危险因素,对危险因素的干预可能有助改善患儿病情。
文摘目的应用高通量测序技术探讨IgE介导的牛乳蛋白过敏(cow′s milk protein allergy,CMA)婴幼儿肠道菌群结构和组成的变化。方法回顾性分析2012年6月-2013年6月入组食物过敏患儿,选择出IgE介导的CMA(IgE-CMA)患儿4例,非IgE介导的CMA(non-IgE-CMA)患儿4例,采集粪便样本进行454焦磷酸测序分析,血清样本进行细胞因子检测。结果与non-IgE-CMA患儿相比较,IgECMA患儿肠道菌群多样性Shannon指数(t=-2.996,P=0.010)和Simpson指数(t=-1.786,P=0.036)显著改变,菌群多样性下降,菌群丰富度指数ACE(t=0.406,P=0.021)显著升高。β-多样性PCA分析可显著区分两组,提示IgE-CMA患儿肠道菌群发生显著改变。LEfSe组成差异分析发现肠道菌群中硬壁菌门和拟杆菌门的改变与CMA的不同表型无关,IgE-CMA婴儿中链球菌、肠球菌、鞘氨醇单胞菌、双歧杆菌、罗思氏菌属、红球菌和梭菌属第Ⅺ簇等减少,而厌氧杆菌和狭义梭菌属增加,可用于鉴别诊断CMA表型。结论IgE可决定CMA患儿肠道菌群的改变,这为开展以肠道菌群为靶点的不同表型CMA诊疗提供了新策略。
文摘BACKGROUND Allergy to cow’s milk is the most frequent allergy occurring in infants and young children.The dietary management of these patients consists of the elimination of any cow’s milk proteins from the diet,and for formula-fed infants,the substitution of the usual infant formula with an adapted formula that is generally based on extensively hydrolyzed cow’s milk proteins.The American Academy of Pediatrics has established specific criteria to confirm the hypoallergenicity of a formula intended for these children.AIM To assess the hypoallergenicity of a new thickened extensively hydrolyzed casein-based formula (TeHCF) in children with cow’s milk allergy (CMA).METHODS Children diagnosed with CMA through a double-blind placebo-controlled food challenge (DBPCFC) were randomly administered increased doses of a placebo formula or the TeHCF [Allernova,new thickener including fibres (Novalac)] under double-blind conditions and medical surveillance on two separate days.Otherwise,both of these formulas and a cow’s milk-based formula were randomly introduced to children who were highly suspected of having CMA on three separate days.Immediate and late reactions occurring after the introduction of any of these formulas were thoroughly recorded by the physician at the hospital and reported by parents to the physician after hospital discharge,respectively.If the children tolerated the TeHCF during the DBPCFC,they were exclusively fed this formula during a 3-mo period where potential allergic symptoms,anthropometric parameters,as secondary outcomes,and adverse events were registered.The Cow’s Milk-related Symptoms Score (CoMiSSTM) was assessed and anthropometric parameters were compared to World Health Organization (WHO) reference data.RESULTS Of the 30 children included in the study,the CMA diagnosis of 29 (mean age: 8.03 ± 7.43 mo) patients was confirmed by a DBPCFC.The children all tolerated the TeHCF during both the challenge and the subsequent 3-mo feeding period,which they all completed.During the latter p
