Abstract:Objective To study the association between maternal Th1/Th2 immune level at different pregnancy stages and cow's milk protein allergy (CMPA) in infants. Methods The healthy women with a singleton pregnancy, as well as their offspring, who attended Yidu Central Hospital of Weifang and Qingzhou Traditional Chinese Medicine Hospital from July 2016 to December 2018 were enrolled. The maternal levels of interleukin-2 (IL-2), interferon gamma (IFN-γ), interleukin-4 (IL-4), and interleukin-10 (IL-10) at the second and third trimesters of pregnancy were measured. A CMPA questionnaire survey was conducted within one year after birth. Food avoidance and cow's milk oral challenge tests were performed in infants suspected of CMPA. The 48 infants who met the diagnostic criteria for CMPA were included in the observation group, and the remaining 977 normal infants were included in the control group. A univariate analysis was performed on the infants with CMPA. A Poisson regression analysis was used to determine the association between maternal Th1/Th2 immune factors at different pregnancy stages and CMPA. Results The detection rate of CMPA was 4.68%. The clinical manifestations included the symptoms of the digestive system, skin, and respiratory system and other symptoms. The univariate analysis showed that compared with the control group, the observation group had significantly higher incidence rates of maternal food allergy and maternal history of allergic diseases (P < 0.05) and a significantly lower breastfeeding rate (P < 0.05). The observation group had significantly lower maternal levels of IL-2 (second and third trimesters) and IFN-γ (third trimester) than the control group (P < 0.05). Maternal low IFN-γ at the third trimester and maternal low IL-2 at the second and third trimesters were significantly associated with CMPA in infants (P < 0.05). After correction of the factors of breastfeeding, maternal food allergy, and maternal history of allergic diseases, it was found that maternal low IL-2 and IFN-γ at the third trimester were still significantly associated with CMPA in infants (P < 0.05). Conclusions The maternal decrease in Th1 level at the third trimester of pregnancy may lead to the change in fetal immunity and thus increase the risk of CMPA in offspring.
ZHANG Hai-Jun,DONG Xiao-Lei,ZHANG Yong-Fa et al. Effect of maternal immune level at different pregnancy stages on cow's milk protein allergy in infants[J]. CJCP, 2020, 22(11): 1221-1225.
Lieberman JA, Sicherer SH. Quality of life in food allergy[J]. Curr Opin Allergy Clin Immunol, 2011, 11(3):236-242.
[3]
Sardecka I, Łoś-Rycharska E, Ludwig H, et al. Early risk factors for cow's milk allergy in children in the first year of life[J]. Allergy Asthma Proc, 2018, 39(6):e44-e54.
Bonini M, Gramiccioni C, Fioretti D, et al. Asthma, allergy and the Olympics:a 12-year survey in elite athletes[J]. Curr Opin Allergy Clin Immunol, 2015, 15(2):184-192.
Yang M, Tan M, Wu J, et al. Prevalence, characteristics, and outcome of cow's milk protein allergy in Chinese infants:a population-based survey[J]. JPEN J Parenter Enteral Nutr, 2019, 43(6):803-808.
[9]
Host A, Halken S. Cow's milk allergy:where have we come from and where are we going?[J]. Endocr Metab Immune Disord Drug Targets, 2014, 14(1):2-8.
[10]
Walkner M, Warren C, Gupta RS. Quality of life in food allergy patients and their families[J]. Pediatr Clin North Am, 2015, 62(6):1453-1461.
Nissen SP, Kjaer HF, Høst A, et al. The natural course of sensitization and allergic diseases from childhood to adulthood[J]. Pediatr Allergy Immunol, 2013, 24(6):549-555.
[15]
von Berg A, Filipiak-Pittroff B, Krämer U, et al. Allergies in high-risk school children after early intervention with cow's milk protein hydrolysates:10-year results from the German Infant Nutritional Intervention (GINI) study[J]. J Allergy Clin Immunol, 2013, 131(6):1565-1573.
[16]
Clark H, Granell R, Curtin JA, et al. Differential associations of allergic disease genetic variants with developmental profiles of eczema, wheeze and rhinitis[J]. Clin Exp Allergy, 2019, 49(11):1475-1486.
[17]
Li AL, Meng XC, Huo GC, et al. The Th17/Treg imbalance in bovine β-lactoglobulin-sensitised mice[J]. Int Dairy J, 2014, 34(2):257-262.
[18]
Abell SK, De Courten B, Boyle JA, et al. Inflammatory and other biomarkers:role in pathophysiology and prediction of gestational diabetes mellitus[J]. Int J Mol Sci, 2015, 16(6):13442-13473.
[19]
Challis JR, Lockwood CJ, Myatt L, et al. Inflammation and pregnancy[J]. Reprod Sci, 2009, 16(2):206-215.
Gariboldi S, Palazzo M, Zanobbio L, et al. Low dose oral administration of cytokines for treatment of allergic asthma[J]. Pulm Pharmacol Ther, 2009, 22(6):497-510.
[22]
Carello R, Ricottini L, Miranda V, et al. Long-term treatment with low-dose medicine in chronic childhood eczema:a double-blind two-stage randomized control trial[J]. Ital J Pediatr, 2017, 43(1):78.