牛奶过敏
医学
食物过敏
肠道菌群
口服免疫疗法
过敏
口服食物挑战赛
双歧杆菌
粪便
免疫学
牛奶过敏
免疫球蛋白E
安慰剂
胃肠病学
内科学
生理学
食品科学
生物
抗体
乳酸菌
病理
微生物学
发酵
替代医学
作者
Ryosuke Shibata,Naoka Itoh,Yumiko Nakanishi,Tamotsu Kato,Wataru Suda,Mizuho Nagao,Tadahisa Iwata,Hideo Yoshida,Masahira Hattori,Takao Fujisawa,Naoki Shimojo,Hiroshi Ohno
标识
DOI:10.1016/j.alit.2023.10.001
摘要
Oral immunotherapy (OIT) can ameliorate cow's milk allergy (CMA); however, the achievement of sustained unresponsiveness (SU) is challenging. Regarding the pathogenesis of CMA, recent studies have shown the importance of gut microbiota (Mb) and fecal water-soluble metabolites (WSMs), which prompted us to determine the change in clinical and gut environmental factors important for acquiring SU after OIT for CMA. We conducted an ancillary cohort study of a multicenter randomized, parallel-group, delayed-start design study on 32 school-age children with IgE-mediated CMA who underwent OIT for 13 months. We defined SU as the ability to consume cow's milk exceeding the target dose in a double-blind placebo-controlled food challenge after OIT followed by a 2-week-avoidance. We longitudinally collected 175 fecal specimens and clustered the microbiome and metabolome data into 29 Mb- and 12 WSM-modules. During OIT, immunological factors improved in all participants. However, of the 32 participants, 4 withdrew because of adverse events, and only 7 were judged SU. Gut environmental factors shifted during OIT, but only in the beginning, and returned to the baseline at the end. Of these factors, milk- and casein-specific IgE and the Bifidobacterium-dominant module were associated with SU (milk- and casein-specific IgE; OR for 10 kUA/L increments, 0.67 and 0.66; 95%CI, 0.41–0.93 and 0.42–0.90; Bifidobacterium-dominant module; OR for 0.01 increments, 1.40; 95%CI, 1.10–2.03), and these associations were observed until the end of OIT. In this study, we identified the clinical and gut environmental factors associated with SU acquisition in CM-OIT.
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