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Clinical and Translational Allergy
Published in: Clinical and Translational Allergy 1/2018

Open Access 01-12-2018 | Research

Deep analysis of immune response and metabolic signature in children with food protein induced enterocolitis to cow’s milk

Authors: Karine Adel-Patient, Guillaume Lezmi, Florence Anne Castelli, Sibylle Blanc, Hervé Bernard, Pascale Soulaines, Pascale Dumond, Sandrine Ah-Leung, Florence Lageix, Delphine de Boissieu, Naima Cortes-Perez, Stéphane Hazebrouck, François Fenaille, Christophe Junot, Christophe Dupont

Published in: Clinical and Translational Allergy | Issue 1/2018

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Abstract

Background

Food Protein-Induced Enterocolitis Syndrome (FPIES) is considered to be a non-IgE mediated food allergy. However, its pathogenesis remains poorly understood and biomarkers are lacking. We aimed to perform in-depth characterization of humoral and cellular immune responses in children with cow’s milk (CM)-FPIES and investigated whether there is a FPIES metabolomic signature.

Methods

Children with CM-FPIES and control subjects with an IgE-mediated CM allergy (IgE-CMA), both avoiding CM, were recruited on the day of an oral food challenge. Blood samples were collected before the challenge. Total and specific levels of IgE, IgG1-4, IgA, IgM and IgD to various whey and casein allergens and to their gastroduodenal digestion products were measured in plasma, using plasma from CM-tolerant peanut allergic patients (IgE-PA, not avoiding CM) as additional controls. Cytokine secretion and cellular proliferation were analyzed after stimulation of PBMC with different CM allergens. Metabolomic profiles were obtained for plasma samples using liquid chromatography coupled to high-resolution mass spectrometry.

Results

Nine children with CM-FPIES and 12 control subjects (6 IgE-CMA and 6 IgE-PA) were included. In children with CM-FPIES, total Ig concentrations were lower than in control subjects, specific Ig against CM components were weak to undetectable, and no specific IgE against CM digestion products were detected. Moreover, in CM-FPIES patients, we did not find any Th cell proliferation or associated cytokine secretion after allergen reactivation, whereas such responses were clearly found in children with IgE-CMA. Plasma metabolic profiles were different between CM allergic patients, with significantly lower concentrations of various fatty acids and higher concentrations of primary metabolites such as amino acids in CM-FPIES compared to IgE-CMA patients.

Conclusions

In CM-FPIES, both humoral and cellular specific immune responses are weak or absent, and this is not related to CM avoidance. A metabolomic signature was identified in patients with CM-FPIES that may be useful for the diagnosis and management of this disease.
Appendix
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Metadata
Title
Deep analysis of immune response and metabolic signature in children with food protein induced enterocolitis to cow’s milk
Authors
Karine Adel-Patient
Guillaume Lezmi
Florence Anne Castelli
Sibylle Blanc
Hervé Bernard
Pascale Soulaines
Pascale Dumond
Sandrine Ah-Leung
Florence Lageix
Delphine de Boissieu
Naima Cortes-Perez
Stéphane Hazebrouck
François Fenaille
Christophe Junot
Christophe Dupont
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Clinical and Translational Allergy / Issue 1/2018
Electronic ISSN: 2045-7022
DOI
https://doi.org/10.1186/s13601-018-0224-9

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