Dysregulated Th1 and Th2 responses in food-allergic children--does elimination diet contribute to the dysregulation?

Pediatr Allergy Immunol. 2010 Jun;21(4 Pt 1):649-55. doi: 10.1111/j.1399-3038.2009.00937.x.

Abstract

Infants with eczema and sensitization to foods are recommended skin care and, if food allergy is proven, an elimination diet. Although most of these children tolerate foods before 3 yr of age, some children experience prolonged food allergy. To our knowledge, no prospective study has investigated the cytokine profile in food-sensitized eczematous children with prolonged food intolerance. The aim of the study was to prospectively investigate the development of cytokine production induced by food allergen in food-sensitized eczematous children who, at 4(1/2) yr of age, were allergic or tolerant to egg or milk. Twenty-one eczematous infants, [age 5 (3-10) months; median and range], sensitized to egg and/or milk were included, put on elimination diet and followed prospectively. At 4(1/2) yr of age, the children were defined as tolerant or allergic to egg and/or milk based on open or double-blind placebo-controlled food challenges. Peripheral blood mononuclear cells (PBMC) were isolated from the children on inclusion, after 6 wk of elimination diet, and at 3 and 4(1/2) yr of age. Ovalbumin, beta-lactoglobulin and tetanus toxoid-induced IL-4, -5, -10, -13 and IFN-gamma production from PBMC were analyzed with enzyme-linked immunosorbent assay. The IFN-gamma and IL-5 secretion induced by food allergen at 4(1/2) yr was higher in cell cultures from children who were allergic to egg or milk than in tolerant children. In food-allergic children, the levels of IFN-gamma and IL-5 were higher at 4(1/2) yr compared with inclusion levels, but this increase was generally not observed in the tolerant children who consumed milk and egg. In conclusion, immune cells from food-allergic children on an elimination diet respond with up-regulated T helper 1 and T helper 2 cytokine secretion induced by food allergen. We hypothesize that allergen elimination may influence the regulatory mechanisms maintaining balanced immune responses to innocuous food antigens.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Allergens / immunology
  • Allergens / metabolism
  • Animals
  • Cells, Cultured
  • Child, Preschool
  • Cytokines / metabolism*
  • Eczema
  • Eggs / adverse effects*
  • Feeding Behavior
  • Female
  • Follow-Up Studies
  • Food Hypersensitivity / diagnosis
  • Food Hypersensitivity / diet therapy
  • Food Hypersensitivity / immunology*
  • Food Hypersensitivity / physiopathology
  • Humans
  • Immune Tolerance / immunology
  • Infant
  • Lactoglobulins / immunology
  • Lactoglobulins / metabolism
  • Leukocytes, Mononuclear / immunology
  • Leukocytes, Mononuclear / metabolism*
  • Leukocytes, Mononuclear / pathology
  • Male
  • Milk / adverse effects*
  • Prospective Studies
  • Th1-Th2 Balance

Substances

  • Allergens
  • Cytokines
  • Lactoglobulins