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Low-grade inflammation in gut mucosa linked to GI allergy to cow’s milk protein
Researchers identified low-grade inflammation in gut mucosa, indicating a potentially novel pathophysiology behind the symptoms associated with gastrointestinal allergy to cow’s milk protein, according to recent study data.
“The increase in calprotectin was independent of cow’s milk elimination or provocation,” Laura Merras-Salmio, MD, of Children’s Hospital, division of gastroenterology at Helsinki University in Finland, and colleagues wrote. “This finding may indicate a novel pathophysiology behind the symptoms associated with [gastrointestinal allergy to cow’s milk protein], but fecal calprotectin cannot be used in the diagnostic process due to the high degree of variation in the levels.”
Investigators also found that the dietary elimination of cow’s milk protein results in levels of cow’s milk specific IgA, total IgG and IgG4.
The prospective study included 57 infants and children aged younger than 4 years (median age, 8.7 months) with gastrointestinal complaints suspected of cow’s milk protein allergy (CMPA).
Data indicated that fecal calprotectin levels were higher in the challenge positive group (n=18) compared with the negative group (n=37), with geometric means of 55 mcg/g (95% CI, 38–81) and 29 mcg/g (95% CI, 24–36), respectively, during a cow milk-free diet.
No significant inter-group differences in the fecal beta-defensin and IgA levels were observed. The CMP-specific IgG and IgA levels were not elevated in patients with CMPA, researchers wrote, although levels of beta-lactoglobulin-IgG4 (P=.0118) and alpha-casein-IgG4 (P=.0044), and total alpha-casein-IgG (P=.0054) and –IgA (P=.005) in all samples appeared lower compared with controls administered dairy products.
“The findings address the importance of accurate diagnostics of GI-CMPA and emphasize that the need of strict cow’s milk elimination should be thoroughly considered,” the investigators wrote.
Disclosure: The researchers report no relevant financial disclosures.
