Publication: Papel de las células T reguladoras en la alergia a proteínas de leche de vaca no mediada por IGE en la infancia
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2019-11-12
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Universidad Complutense de Madrid
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Abstract
La fisiopatología de la alergia a proteínas de leche de vaca (APLV) no mediada por IgE es desconocida lo cual explica la falta de marcadores diagnósticos y pronósticos para esta entidad con un posible sobre diagnóstico. En el momento actual su incidencia está en aumento lo que conlleva un aumento de recursos sanitarios. Los estudios previos en alergias no mediadas por IgE, principalmente en enterocolitis alérgica, sugerían un mecanismo mediado por células T sin llegar a confirmarse en estudios posteriores. OBJETIVOS El objetivo del estudio es investigar los mecanismos inmunológicos, en especial el papel de las células T reguladoras (Treg), implicados en la fisiopatología de la proctocolitis alérgica. MATERIAL Y MÉTODOS Estudio prospectivo observacional realizado en un hospital terciario, desde enero de 2014 a enero de 2019, de lactantes con proctocolitis alérgica diagnosticados en consultas de Digestivo Infantil. Se recogieron variables clínicas y analíticas hasta la adquisición de tolerancia, poblaciones linfocitarias mediante citometría de flujo en sangre periférica en dos tiempos (“T0” en fase aguda o “Tres” en la resolución) y niveles de vitamina D. Se compararon las variables con un grupo control de lactantes sanos de edades similares. Se realizó estudio bivariante y curvas ROC, considerándose significativo una p<0,05...
The pathophysiology of non-IgE mediated cow`s milk allergy is unknown. That explains the lack of diagnostic and predictive markers for this entity with a possible over diagnosis. Actually, the incidence is increasing and so it does the cost of health expenditure. Previous studies in non-IgE mediated cow´s milk allergy, especially the ones that study allergic enterocolitis, suggested a mechanism mediated by T cells, but without confirmation in subsequent studies. OBJECTIVE The aim of this study is to investigate de immunological mechanisms, especially the role of regulatory-Tcells (Treg) involved in the pathophysiology of allergic proctocolitis. METHODS A prospective observational study was conducted in a tertiary hospital, including infants diagnosed with allergic proctocolitis in Infant´s Digestive consults. This study was conducted between January 2014 and January 2019. Clinical and analytical variables were collected until the infants acquired tolerance to cow`s milk proteins. These variables were compared with a control group of healthy infants with similar ages. The main analytical variables were lymphocyte populations, included T regulatory cells, extracted from peripheral blood and processed immediately by flow cytometry, in two times of the study: first one (“T0”) in acute phase and second one (“Tres”) in the clinical resolution. Levels of Vitamin D were also collected from both groups of study (proctocolitis and healthy group). Bivariate study and ROC curves were performed, considering p<0.05 as significant...
The pathophysiology of non-IgE mediated cow`s milk allergy is unknown. That explains the lack of diagnostic and predictive markers for this entity with a possible over diagnosis. Actually, the incidence is increasing and so it does the cost of health expenditure. Previous studies in non-IgE mediated cow´s milk allergy, especially the ones that study allergic enterocolitis, suggested a mechanism mediated by T cells, but without confirmation in subsequent studies. OBJECTIVE The aim of this study is to investigate de immunological mechanisms, especially the role of regulatory-Tcells (Treg) involved in the pathophysiology of allergic proctocolitis. METHODS A prospective observational study was conducted in a tertiary hospital, including infants diagnosed with allergic proctocolitis in Infant´s Digestive consults. This study was conducted between January 2014 and January 2019. Clinical and analytical variables were collected until the infants acquired tolerance to cow`s milk proteins. These variables were compared with a control group of healthy infants with similar ages. The main analytical variables were lymphocyte populations, included T regulatory cells, extracted from peripheral blood and processed immediately by flow cytometry, in two times of the study: first one (“T0”) in acute phase and second one (“Tres”) in the clinical resolution. Levels of Vitamin D were also collected from both groups of study (proctocolitis and healthy group). Bivariate study and ROC curves were performed, considering p<0.05 as significant...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Pediatría, leída el 06-09-2019