Search

Gastro-allergic anisakiasis has been reported as an entity in which an acute parasitism by Anisakis simplex is accompanied by an immunoglobulin (Ig)E-mediated systemic allergic reaction. Serum samples were obtained from 24 patients within 24 h after the onset of symptoms (day 0) and after 1 month (day 30) and in 13 patients after 6 months. Total IgE was assessed by the Imx method. Specific IgE was assessed by CAP-FEIA. Specific IgM, IgG, IgG4 and IgA antibodies were assessed by enzyme-linked immunosorbent assay against crude extract (CE) and excretory-secretory products (ESP). IgE immunoblotting (IB) was directed against CE or ESP (day 0 and day 30). We found a rise of total IgE, specific IgE, number of bands in IgE-IB, IgG and IgG4 between day 0 and day 30 with a fall to near basal levels after 6 months. IgM levels were highest at day 0, falling over the next 6 months and IgA levels remained almost unchanged. Correlation studies revealed a parallel stimulation of nearly all Ig isotypes, except IgM anti-ESP, whose antibody levels correlated negatively with specific IgG levels. We found an extension of the IgE antibody repertoire in IB. We conclude that the allergic IgE-mediated reaction in the course of gastro-allergic anisakiasis involves a parallel secondary Th2 type memory response and a primary immunologic stimulation of both Th2 and Th1 lymphocyte subsets against previously unrecognized antigens.

Background: Hydrolysate formulas are safe for most infants who are allergic to cow's milk. The purpose of this study was to assess the clinical tolerance and safety of an extensively hydrolyzed casein-whey protein formula in a homogeneous group of patients with immediate cow's milk hypersensitivity., Methods: The study population consisted of 33 infants in whom immediate cow's milk protein allergy had been diagnosed by clinical data, evidence of specific immunoglobulin E antibodies, and positive results in a controlled challenge test with cow's milk proteins., Results: The hydrolysate was well tolerated in 31 of the 33 patients, which represented a 94% effectiveness. Using 95% confidence intervals generated for a binomial outcome (reaction-no reaction), the casein-whey protein formula is tolerated by 84.4% to 99% of infants with immediate immunoglobulinE-mediated cow's milk protein allergy. These figures are in the range of values recommended for this type of product., Conclusions: This extensively hydrolyzed casein-whey protein formula is generally safe to feed children with immediate hypersensitivity to cow's milk. However. it is advisable that the first intakes be given under direct medical supervision, in that the occurrence of adverse reactions in highly sensitive infants cannot be unequivocally excluded.