title: Serum interleukin--4 and tumor necrosis factor alpha concentrations in children with primary acid gastroesophageal reflux and acid gastroesophageal reflux secondary to cow's milk allergy.
abstract: OBJECTIVE
  The possible role of serum interleukin 4 (IL-4) and tumor necrosis factor alpha (TNF- α) in pathogenesis of the reflux symptoms in children with primary acid gastroesophageal reflux (GER) and acid GER secondary to cow's milk allergy (CMA).
  
  
  METHODS
  Out of 264 children, 76 (28.8%) patients with primary GER and 62 (23.5%) patients with GER secondary to CMA (pH - monitoring) serum IL-4 and TNF- α concentrations were assessed before treatment, 1 and 2 years after the initiation of the periodically administered pharmacotherapy.
  
  
  RESULTS
  Children with primary GER had mean IL-4 concentrations 0.17 ± 0.06 pg/ml before treatment, 0.08 ± 0.07 pg/ ml after 1-year and 0.07 ± 0.06 pg/ml after 2-years of treatment. The mean IL-4 concentrations were 1.07 ± 0.24, 0.5 ± 0.22 and 0.44 ± 0.19 pg/ml respectively in children with GER secondary to CMA. The mean serum TNF- α concentrations was 3.62 ± 1.30 pg/ml before treatment , 2.16 ± 1,35 pg/ ml after 1 year and 1.65 ± 1.16 pg/ml after 2 years of treatment in children with primary GER. In group with GER secondary to CMA mean serum TNF- α concentrations were 4.95 ± 1.88, 2.53 ± 0.80 and 2.02 ± 0.78 pg/ml respectively. Statistical analysis of the concentration of both cytokines showed their differentiation between them and in the study groups.
  
  
  CONCLUSIONS
  The highest mean serum IL-4 and TNF-α concentrations were observed in children with GER secondary to CMA and in children in control group (with cow's milk allergy and/or other food allergy diagnosed - CMA/FA) before the treatment administration.
authors: Department of Pediatrics, Pediatric Gastroenterology and Allergology, Medical University of Bialystok, Poland. Janexik@poczta.onet.pl
authors: J
authors: J
authors: Semeniuk
authors: J
authors: J
authors: Wasilewska
authors: M
authors: M
authors: Kaczmarski
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005764:Gastroesophageal Reflux / Q000209:etiology* / Q000276:immunology* / Q000628:therapy; D006801:Humans; D007223:Infant; D015847:Interleukin-4 / Q000097:blood*; D008297:Male; D016269:Milk Hypersensitivity / Q000150:complications* / Q000276:immunology* / Q000628:therapy; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: C508598:IL4 protein, human; D014409:Tumor Necrosis Factor-alpha; D015847:Interleukin-4