Abstract
Background: Cow's milk protein (CMP) sensitisation in preterm (PT) infants with necrotising enterocolitis (NEC), and associated inflammatory and the regulatory components were described (1, 2). This study aimed to follow the evolution of this phenomenon in relation to the natural history of NEC.
Methods: ELISPOTs was used to detect numbers of peripheral blood mononuclear cells (PBMCs) secreting interferon-y (IFN-y), interleukin (IL)-4, IL-10, and transforming growth factor-β1 (TGF-β1), in response to stimulation with CMPs (casein and β-lactoglobulin [β-lg]) in the acute-stage NEC, compared to septic and healthy controls, then at recovery, and at full feeding in PT infants with NEC stage II and III on the modified Bell's score
Results: During acute NEC, a pattern of higher levels of cytokine secretion to CMPs (for IFN-γ, IL-4 and IL-10) than in septic and healthy controls was noted, with a minimal TGF-β1 response. Responses to β-lg and casein were significantly enhanced at recovery for IFN-γ (p=0.01, 0.06), IL-4 (0.02, 0.009) and IL-10 (p=0.005, 0.002) but less marked at full feeding to β-lg than to casein: IFN-γ (p=0.03, 0.002), IL-4 (0.03, 0.002) and IL-10 (p=0.11, 0.007). TGF-β1 secretion was only slightly enhanced at presentation but progressively enhanced at recovery (p=0.002, 0.01) and at full feeding (p=0.002, 0.002).
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References
Chuang et al (2009). CMP-specific T-helper type I/II cytokine responses in infants with necrotizing enterocolitis. Pediatr Allergy Immunol; 20 ( 1): 45–52.
Abdelhamid et al (2011). In vitro CMP-specific inflammatory and regulatory cytokine responses in preterm infants with necrotizing enterocolitis and sepsis. Pediatr Res; 69 ( 2): 165–9.
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Abdelhamid, A., Chuang, SL., Hays, P. et al. Evolution of In-Vitro Sensitisation to Cow's Milk Proteins Among Preterm Infants with Necrotising Enterocolitis. Pediatr Res 70 (Suppl 5), 598 (2011). https://doi.org/10.1038/pr.2011.823
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DOI: https://doi.org/10.1038/pr.2011.823