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FOXP3 expression, vitamins D and C in the prediction of tolerance acquisition in infants with cow’s milk allergy

Sardecka I1, Łoś-Rycharska E2, Gawryjołek J2, Toporowska – Kowalska E1, Krogulska A2

1Department of Paediatrics, Allergology, Gastroenterology and Nutrition, Medical University of Lodz, Poland
2Department of Paediatrics, Allergology and Gastroenterology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Torun, Poland

J Investig Allergol Clin Immunol 2020; Vol. 30(3)
doi: 10.18176/jiaci.0422

Background: Treg cells and dietetic factors may play a significant role in the natural acquisition of tolerance in children with cow’s milk allergy (CMA). The best marker for Treg lymphocytes is the transcription factor-forkhead boxP3 (FOXP3).
Objective: The paper examines the relationship between Foxp3mRNA expression and serum concentration of vitamins D and C, and the development of different phenotypes of tolerance in children with CMA.
Material and methods: The study group comprised 138 infants with CMA and 101 healthy infants. All children underwent oral food challenge, first with an extensively-heated milk product and then with unheated products. FOXP3mRNA expression and serum vitamin C and D concentration were evaluated.
Results: At two years of life, 54 (39.1%) children still displayed CMA, 43 (31.2%) were unheated milk-reactive and heated milk-tolerant, while 41 (29.7%) were classified as outgrown. The mean level of FOXP3 expression in the studied group was 2.07±1.23; this was lower than the control group value of 2.98±1.52 (p<0.001). A value below 1.45 indicated allergy. The mean serum level of vitamin D in the study group (29.67±7.09 ng/ml) was lower than in the control group, 33.35±4.13 ng/ml (p<0.001). No significant differences in mean serum vitamin C content were found.
Conclusions: Increased Foxp3mRNA expression can predict faster acquisition of tolerance in infants with CMA. These children have lower serum vitamin D levels than healthy children. No relationship was found between the natural history of CMA and serum vitamin C concentration.

Key words: Food allergy, FOXP3, Tolerance, Children, Vitamin D, Vitamin C, Cow’s milk

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