Macrophages and their products in mucosal immunopathology

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ЭФФЕКТИВНОСТЬ СМЕСЕЙ, ОСНОВАННЫХ НА АМИНОКИСЛОТАХ, В ОБЛЕГЧЕНИИ СИМПТОМОВ АЛЛЕРГИИ К КОРОВЬЕМУ МОЛОКУ: СИСТЕМАТИЧЕСКИЙ ОБЗОР

In the given systematic review, the authors evaluated the efficiency of the amino acid based mixtures among the patients, suffering from the cow's milk protein allergy. They have studied the electronic and bibliographic databases. The researchers accounted for the patients of any age, suffering from the cow's milk protein allergy or similar symptoms. The task was to compare the aminoacid based mixtures with highly hydrolyzed mixtures, soy mixtures and cow's milk/cow's milk based mixtures. They showed that the use of the amino acid based mixtures is safe and efficient among the infants with the confirmed or suspected cow's milk protein allergy. The data of the randomized controlled studies, comparing amino acid based mixtures with highly hydrolyzed mixtures, witnesses that both types of mixtures are equally efficient in reducing the symptoms of the cow's milk protein allergy in the confirmed or alleged allergy cases. This review demonstrates the clinical impact of the amino acid based mixtures both upon certain symptoms and growth of the infants and children with the cow's milk protein allergy, who have zero tolerance towards the highly hydrolyzed mixtures.Key words: aminoacid-based mixtures, cow's milk protein allergy, highly hydrolyzed mixtures, soy mixtures, systematic review.В представленном систематическом обзоре авторы оценили эффективность смесей, основанных на аминокислотах у пациентов с аллергией на коровье молоко. Исследовались электронные и библиографические базы данных. В обработку включались пациенты любого возраста с аллергией на коровье молоко или сходными симптомами. Задачей было сравнить смеси, основанные на аминокислотах, с высокогидролизированными смесями, соевыми смесями и коровьим молоком/смесями на основе коровьего молока. Показано, что у грудных детей с подтверждённой или подозреваемой аллергией на коровье молоко использование смесей, основанных на аминокислотах, является безопасным и эффективным. Данные рандомизированных контролируемых исследований, сравнивающие смеси, основанные на аминокислотах, с высокогидролизированными смесями свидетельствуют о том, что оба вида смесей одинаково эффективно уменьшают симптомы аллергии на коровье молоко в подтвержденных или предполагаемых случаях аллергии. Этот обзор показывает клиническое влияние использования смесей на основе аминокислот как на отдельные симптомы, так и на рост младенцев и детей с аллергией на коровье молоко, которые не переносят высокогидролизированные смеси.Ключевые слова: смеси на основе аминокислот, аллергия к коровьему молоку, высоко гидролизированные смеси, соевые смеси, систематический обзор. (Педиатрическая фармакология. – 2008;5(3):32-38

EFFICIENCY OF THE AMINOACID-BASED MIXTURES IN BRINGING RELIEF FOR THE SYMPTOMS OF THE COW'S MILK PROTEIN ALLERGY: SYSTEMATIC REVIEW

In the given systematic review, the authors evaluated the efficiency of the amino acid based mixtures among the patients, suffering from the cow's milk protein allergy. They have studied the electronic and bibliographic databases. The researchers accounted for the patients of any age, suffering from the cow's milk protein allergy or similar symptoms. The task was to compare the aminoacid based mixtures with highly hydrolyzed mixtures, soy mixtures and cow's milk/cow's milk based mixtures. They showed that the use of the amino acid based mixtures is safe and efficient among the infants with the confirmed or suspected cow's milk protein allergy. The data of the randomized controlled studies, comparing amino acid based mixtures with highly hydrolyzed mixtures, witnesses that both types of mixtures are equally efficient in reducing the symptoms of the cow's milk protein allergy in the confirmed or alleged allergy cases. This review demonstrates the clinical impact of the amino acid based mixtures both upon certain symptoms and growth of the infants and children with the cow's milk protein allergy, who have zero tolerance towards the highly hydrolyzed mixtures.Key words: aminoacid-based mixtures, cow's milk protein allergy, highly hydrolyzed mixtures, soy mixtures, systematic review

EFFICIENCY OF THE AMINOACID-BASED MIXTURES IN BRINGING RELIEF FOR THE SYMPTOMS OF THE COW'S MILK PROTEIN ALLERGY: SYSTEMATIC REVIEW

In the given systematic review, the authors evaluated the efficiency of the amino acid based mixtures among the patients, suffering from the cow's milk protein allergy. They have studied the electronic and bibliographic databases. The researchers accounted for the patients of any age, suffering from the cow's milk protein allergy or similar symptoms. The task was to compare the aminoacid based mixtures with highly hydrolyzed mixtures, soy mixtures and cow's milk/cow's milk based mixtures. They showed that the use of the amino acid based mixtures is safe and efficient among the infants with the confirmed or suspected cow's milk protein allergy. The data of the randomized controlled studies, comparing amino acid based mixtures with highly hydrolyzed mixtures, witnesses that both types of mixtures are equally efficient in reducing the symptoms of the cow's milk protein allergy in the confirmed or alleged allergy cases. This review demonstrates the clinical impact of the amino acid based mixtures both upon certain symptoms and growth of the infants and children with the cow's milk protein allergy, who have zero tolerance towards the highly hydrolyzed mixtures.Key words: aminoacid-based mixtures, cow's milk protein allergy, highly hydrolyzed mixtures, soy mixtures, systematic review

Proteolytic degradation of intestinal mucosal extracellular matrix after lamina propria T cell activation

BACKGROUND: Proteoglycans, consisting of glycosaminoglycan (GAG) side chains covalently linked to a protein core, are a major component of the extracellular matrix of the intestinal lamina propria. AIMS: This study investigated the effects of lamina propria T cell activation on the proteoglycan component of the matrix. METHODS: The high degree of sulphation of GAGs means that they are polyanionic and thus can be visualised in tissue sections by means of colloidal-gold labelled cationic probes. RESULTS: In human fetal small intestine there is a dense meshwork of anionic residues in the lamina propria and basement membrane. When explants of human fetal small intestine are cultured ex vivo, and resident lamina propria T cells are activated with pokeweed mitogen, mucosal destruction occurs within three days. This is associated with the rapid loss of anionic sites from the lamina propria. Dermatan sulphate proteoglycan is lost from the tissue and is present at increased concentrations in the organ culture supernatants, indicating that T cell activation has led to solubilisation of lamina propria proteoglycans. Tissue destruction and loss of anionic residues are inhibited in a dose dependent fashion by dexamethasone, and by the protease inhibitor, alpha 2 macroglobulin. CONCLUSIONS: Proteolytic degradation of the lamina propria may therefore be a mechanism by which T cell hypersensitivity injures the intestinal mucosa

Management guidelines of eosinophilic esophagitis in childhood

Objectives: Eosinophilic esophagitis (EoE) represents a chronic, immune/antigen-mediated esophageal disease characterized clinically by symptoms related to esophageal dysfunction and histologically by eosinophil-predominant inflammation. With few exceptions, 15 eosinophils per high-power field (peak value) in ≥1 biopsy specimens are considered a minimum threshold for a diagnosis of EoE. The disease is restricted to the esophagus, and other causes of esophageal eosinophilia should be excluded, specifically proton pump inhibitor-responsive esophageal eosinophilia. This position paper aims at providing practical guidelines for the management of children and adolescents with EoE. METHODS: Relevant literature from searches of PubMed, CINAHL, and recent guidelines was reviewed. In the absence of an evidence base, recommendations reflect the expert opinion of the authors. Final consensus was obtained during 3 face-to-face meetings of the Gastroenterology Committee and 1 teleconference. RESULTS: The cornerstone of treatment is an elimination diet (targeted or empiric elimination diet, amino acid-based formula) and/or swallowed, topical corticosteroids. Systemic corticosteroids are reserved for severe symptoms requiring rapid relief or where other treatments have failed. Esophageal dilatation is an option in children with EoE who have esophageal stenosis unresponsive to drug therapy. Maintenance treatment may be required in case of frequent relapse, although an optimal regimen still needs to be determined. CONCLUSIONS: EoE is a chronic, relapsing inflammatory disease with largely unquantified long-term consequences. Investigations and treatment are tailored to the individual and must not create more morbidity for the patient and family than the disease itself. Better maintenance treatment as well as biomarkers for assessing treatment response and predicting long-term complications is urgently needed. © 2013 by European Society for Pediatric Gastroenterology,Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition