Abstract
To elucidate the pathogenic mechanisms underlying the development of different subtypes of CMA, cow's milk-induced eosinophil activation in vivo was studied. After 2-4 weeks on milk elimination, 25 children, aged from 6 to 44 months, with CMA manifested either with skin or gastrointestinal symptoms were challenged. Serum samples were drawn before the challenge (day 1), 27 (12) hours after commencing the challenge (day 2) and one week later. The levels of eosinophil cationic protein (ECP) were determined by human ECP-RIA Kit. Total IgE and cow's milk-specific RAST were measured before the challenge. Sixteen patients (64%) showed urticarial or eczematous skin eruptions during the challenge, 9 patients manifested gastrointestinal symptoms. The levels of ECP (μg /l) and total IgE [95% CI] and positive cow's milk-specific RAST (% of patients) are illustrated in the Table.
The group behaviour of these two subtypes of CMA was different; at successive measurements the level of ECP increased in patients with skin symptoms, but not in those with gastrointestinal symptoms, F=7.1, p=0.01 (ANOVA for repeated measures). The increased degranulation was shown to be transient. We conclude that eosinophil activation is an important part of the complex network of immunologic mechanisms leading lo allergic inflammation in CMA manifested with skin symptoms. Our results do not exclude eosinophil activation in patients with gastrointestinal symptoms, but lack of a systemic response suggests distinct regulation of hypersensitivity reaction.
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Suomalainen, H., Laine, S., Spppi, E. et al. EFFECT OF COW'S MILK CHALLENGE ON EOSINOPHIL DEGRANULATION IN DIFFERENT SUBTYPES OF COW'S MILK ALLERGY (CMA). Pediatr Res 32, 610 (1992). https://doi.org/10.1203/00006450-199211000-00034
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DOI: https://doi.org/10.1203/00006450-199211000-00034