15 ANTICEN ABSORPTION IN CHILDREN WITH COW'S MILK PROTEIN INTOLERANCE

Abstract

Intestinal absorption of exogenous proteins was studied in infants with cow's milk protein intolerance (CMPI) during the initial period of diagnosis, at the age of 3 ± 1 months and one year later just before and after a milk challenge. Peroral biopsies were mounted in an Ussing chamber for simultaneous measurement of mucosal to serosal transport of Horseradish peroxidase (HRP) in its intact and degraded forms and electrical parameters including short circuit current (Isc) and conductance (G). No modification in HRP absorption was noted in healthy children aged from 2 months to 11 years indicating that gut closure to non-immunoglobulin proteins probably occurred earlier in life. During the initial period of CMPI, transepithelial HRP fluxes rose siginificantly (J intact HRP = 48.5 ± 15.2 versus 5.9 ± 1.5 pinoles.h−1 .cm−2 in control children and J degraded HRP = 471 ± 236 versus 37.5 ± 7.7 pmoles.h−1 .cm−2), Isc was increased but G unchanged. After several months on a milk free diet, J HRP and Isc returned to control values. Just after the late milk challenge and independently of the clinical issue, J HRP and Isc remained within control values. These results suggest that increased permeability to proteins is probably not constitutive in CMPI but rather secondary to an abnormal immunological response to cow's milk proteins.