title: Dysregulated Th1 and Th2 responses in food-allergic children--does elimination diet contribute to the dysregulation?
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.
authors.affiliation: Division of Pediatrics, Department of Clinical and Experimental Medicine, and Unit of Clinical Experimental Research, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
authors.forename: Sara
authors.initials: S
authors.lastname: Tomicić
authors.forename: Karin
authors.initials: K
authors.lastname: Fälth-Magnusson
authors.forename: Malin Fagerås
authors.initials: MF
authors.lastname: Böttcher
mesh_terms: D000485:Allergens / Q000276:immunology / Q000378:metabolism; D000818:Animals; D002478:Cells, Cultured; D002675:Child, Preschool; D016207:Cytokines / Q000378:metabolism*; D004485:Eczema; D004531:Eggs / Q000009:adverse effects*; D005247:Feeding Behavior; D005260:Female; D005500:Follow-Up Studies; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000178:diet therapy / Q000276:immunology* / Q000503:physiopathology; D006801:Humans; D007108:Immune Tolerance / Q000276:immunology; D007223:Infant; D007782:Lactoglobulins / Q000276:immunology / Q000378:metabolism; D007963:Leukocytes, Mononuclear / Q000276:immunology / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008892:Milk / Q000009:adverse effects*; D011446:Prospective Studies; D058408:Th1-Th2 Balance
chemical_list: D000485:Allergens; D016207:Cytokines; D007782:Lactoglobulins