IMMUNOLOGIC BASIS OF COW MILK-INDUCED HYPERSENSITIVITIES

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 研究中心，而研究中心不一定是研究者所在的机构。 牛奶是出生后第一年食物过敏的最常见原因，大约2.5%的新生儿在这段时间内对牛奶过敏。 大多数儿童在3-4年内“长大”[变得耐受]他们的牛奶过敏。最常见的过敏症状涉及皮肤和胃肠道。 IgE介导和非IgE介导的机制似乎各占幼儿牛奶过敏性疾病的一半左右，其中大多数IgE介导的反应涉及皮肤，大多数细胞介导的反应涉及胃肠道。 两种形式的IgE介导的皮肤反应与牛奶过敏有关。 急性荨麻疹是由于过敏原诱导的肥大细胞膜结合IgE的交联。 释放预先形成的介质，即组胺，导致局部血管舒张和血管通透性增加，这导致红斑和水肿。 特应性皮炎也与IgE介导的肥大细胞活化有关，释放预先形成的介质和新产生的细胞因子。 此外，皮肤淋巴细胞抗原阳性[CLA+]淋巴细胞被食物过敏原摄入激活，这可能是湿疹性皮疹发生的原因。 已经描述了各种牛奶诱导的非IgE介导的[推测为细胞介导的]胃肠道超敏反应。 牛奶引起的小肠结肠炎综合征最常见于1周至6个月大的幼儿，表现为持续性呕吐和腹泻，经常导致脱水。 牛奶引起的过敏性嗜酸性胃肠炎[AEG]患者通常表现为餐后恶心和腹痛、早饱或拒食、呕吐或干呕、胃食管反流和体重减轻或发育不良。 这两种疾病的免疫病理学知之甚少。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Cow milk is the most common cause of food allergy in the first year of life, with approximately 2.5% of newborns experiencing allergic reactions to cow milk during this time. The majority of children "outgrow" [become tolerant] their milk allergy in 3-4 years. The most common allergic symptoms involve the skin and gastrointestinal tract. IgE- and non-IgE-mediated mechanisms each appear to account for about one-half of milk hypersensitivity disorders in young children, with the majority of IgE-mediated reactions involving the skin and the majority of cell-mediated reactions involving the gastrointestinal tract. Two forms of IgE-mediated skin reactions have been associated with milk allergy. Acute urticaria is due to allergen-induced cross-linkage of mast cell membrane-bound IgE. Preformed mediators are released, i.e. histamine, leading to localized vasodilation and increased vasopermeability, which results in erythema and edema. Atopic dermatitis also has been associated with IgE-mediated mast cell activation with release of preformed mediators and newly generated cytokines. In addition, cutaneous lymphocyte antigen positive [CLA+] lymphocytes are activated by food allergen ingestion, which probably accounts for the development of the eczematous rash. A variety of cow milk-induced, non-IgE-mediated [presumably cell-mediated] gastrointestinal hypersensitivities have been described. Milk-induced Enterocolitis Syndrome most commonly presents in young infants between 1 week and 6 months of age as protracted vomiting and diarrhea, which not infrequently results in dehydration. Patient with milk-induced Allergic Eosinophilic Gastroenteritis [AEG] generally present with post-prandial nausea and abdominal pain, early satiety or food refusal, vomiting or retching, gastroesophageal reflux and weight loss or failure to thrive. The immunopathology of these two disorders is poorly understood.