IMMUNOLOGIC BASIS OF COW MILK-INDUCED HYPERSENSITIVITIES

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。牛奶是生命第一年最常见的食物过敏原因，在此期间，大约2.5%的新生儿对牛奶发生过敏反应。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。免疫球蛋白E和非免疫球蛋白E介导的机制似乎各占幼儿牛奶过敏障碍的大约一半，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。有两种形式的IgE介导的皮肤反应与牛奶过敏有关。急性荨麻疹是由过敏原诱导的肥大细胞膜结合的IgE的交叉连接引起的。预形成的介质被释放，即组胺，导致局部血管扩张和血管通透性增加，从而导致红斑和水肿。特应性皮炎也与免疫球蛋白E介导的肥大细胞活化有关，释放预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的[CLA+]淋巴细胞被食物过敏原摄取激活，这可能是湿疹发生的原因。已经描述了各种由牛奶诱导的、非IgE介导的[可能是由细胞介导的]胃肠道过敏。乳源性小肠结肠炎综合征最常见于1周至6个月大的婴儿，表现为长期呕吐和腹泻，并不少见地导致脱水。牛奶诱导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、呕吐或呕吐、胃食道反流和体重减轻或无法茁壮成长。这两种疾病的免疫病理机制知之甚少。

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.