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

• Published in: Pediatric allergy and immunology Vol. 21; no. 4p1; pp. 649 - 655
• Main Authors: Tomičić, Sara, Fälth-Magnusson, Karin, Böttcher, Malin Fagerås
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-06-2010; Blackwell
• Subjects: Age; Allergens; Allergens - immunology; Allergens - metabolism; Allergic diseases; Animals; b-lactoglobulin; Biological and medical sciences; Cell culture; Cells, Cultured; Child, Preschool; Children; Cytokines; Cytokines - secretion; Diets; Digestive allergic diseases; Eczema; Eggs - adverse effects; elimination diet; Enzyme-linked immunosorbent assay; Feeding Behavior; Female; Follow-Up Studies; Food; food allergy; Food hypersensitivity; Food Hypersensitivity - diagnosis; Food Hypersensitivity - diet therapy; Food Hypersensitivity - immunology; Food Hypersensitivity - physiopathology; Food intolerance; Fundamental and applied biological sciences. Psychology; Fundamental immunology; g-Interferon; General aspects; Helper cells; Humans; Immune response; Immune Tolerance - immunology; Immunopathology; Infant; Infants; Interleukin 4; Interleukin 5; Lactoglobulins - immunology; Lactoglobulins - metabolism; Leukocytes, Mononuclear - immunology; Leukocytes, Mononuclear - metabolism; Leukocytes, Mononuclear - pathology; Lymphocytes T; Male; Medical sciences; MEDICIN; MEDICINE; Milk; Milk - adverse effects; Ovalbumin; Peripheral blood mononuclear cells; Prospective Studies; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Skin; Tetanus; Th1-Th2 Balance; tolerance; Human; Food allergy; Immunopathology; Pediatrics; Deficient diet; elimination diet; Cytokine; Th1 lymphocyte; Tolerance; Feeding; Immunology; children; T-Lymphocyte; Digestive diseases; Th2 lymphocyte; cytokines; Child; Food; food allergy; tolerance
• ISSN: 0905-6157; 1399-3038; 1399-3038
• DOI: 10.1111/j.1399-3038.2009.00937.x

Tomičić S, Fälth‐Magnusson K, Fagerås Böttcher M. Dysregulated Th1 and Th2 responses in food‐allergic children – does elimination diet contribute to the dysregulation?
Pediatr Allergy Immunol 2010: 21: 649–655.
© 2010 John Wiley & Sons A/S
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 4½ 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 4½ 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 4½ yr of age. Ovalbumin, β‐lactoglobulin and tetanus toxoid‐induced IL‐4, ‐5, ‐10, ‐13 and IFN‐γ production from PBMC were analyzed with enzyme‐linked immunosorbent assay. The IFN‐γ and IL‐5 secretion induced by food allergen at 4½ 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‐γ and IL‐5 were higher at 4½ 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.