Abstract
Clinical manifestation of food allergy is characterized by polymorphic cutaneous, respiratory and gastrointestinal syndromes. Leukotrienes occupy a key place in the pathogenesis of a wide range of inflammatory diseases, including bronchial asthma, allergic rhinitis, atopic dermatitis, hives, allergic conjunctivitis, atherosclerotic cardio-vascular lesions system, inflammatory bowel disease, multiple sclerosis, cancer, etc. Better understanding of general pathophysiological mechanisms of allergic realization put the focus on the studying of cysteinyl leukotrienes biological effects in infants with atopic dermatitis and food-protein induced enterocolitis important. Aim. To optimize the diagnosis of allergic lesions of the gastrointestinal tract in children. Methods. The study was conducted in the allergy center and children clinic of the «Institute Pediatrics, Obstetrics and Gynecology named after academician O. Lukyanova of NAMS of Ukraine». Children were included from September 2017 to June 2018. We examined 60 patients aged from 3 months to 3 years old, including 22 patients with atopic dermatitis, 18 children with food-protein induced enterocolitis, 8 patients with bronchial asthma in the stage of aggravation and 12 practically healthy children (control group). Medical examination have been perfomed, general IG E and specific serum IG E were defined by ImmunoCAP (Phadia, 100), as well as concentrations of cysteinyl leukotrienes (LTB4, LTC4, LTE4) in biological liquids (serum, saliva, urine) using immunoenzyme method using the production sets of the "Enzolifescience" (USA) company on the analyzer-photometer Multiskan Plus "Labsystems". The results of the received data were processed statistically. The probability of differences was estimated with Student’s t-test and Tau Kendall rank correlation test. The difference was considered significant at p <0.05. Results. A significant increase in the concentrations of cysteinyl leukotrienes (C4, D4, E4) in the blood, urine and saliva was found in infants with allergic skin diseases, gastro-intestinal and respiratory tract surveyed during manifestation the disease compared with the control group. Comparison of concentrations of leukotrienes in urine and saliva of children with atopic dermatitis (AD), food-protein induced enterocolitis (FPIE) and asthma did not find credible. However, in the serum of patients with asthma, the concentration of cysteinyl leukotrienes was significantly higher (703.9±68.7) pg / ml than in children with enterocolitis induced by dietary proteins (509.3±57.4) pg / ml and significantly did not differ from patients with atopic dermatitis (695.2±46.3) pg / ml. According to the results of Kendall Tau correlation test, no significant Spearman rank correlation was found between the cysteinyl leukotrienes concentration in blood and urine – r=0.14 (p>0.05), blood and saliva r=0.07 (p>0.05), urine and saliva r=–0.52 (p>0.05). Conclusions. Increase in cysteinyl leukotrienes concentrations in serum, urine and saliva of children of early age with allergic skin diseases, respiratory and gastrointestinal tract was found. The absence of significant Spearman rank correlation between concentrations of leukotrienes in blood and urine, blood and saliva, saliva and urine shows that it is possible to select any biological fluid, saliva or urine, as a non-invasive way to determine the leukotriene concentrations for monitoring activity of allergic inflammation.
Highlights
In the last decade the rapid growth of allergic pathologies was noted around the world, which the manifestation of is often happens in early childhood as reactions to food [1, 2]
Clinical manifestation of food allergy (FA) is characterized by polymorphic cutaneous, respiratory and gastrointestinal syndromes [3, 4]. 50–70 % of children are diagnosed with atopic dermatitis (AD) during the first years of life [5]
Allergic inflammation could be develop in various areas of Gastrointestinal tract (GI) tract, so gastrointestinal form takes the second place in the overall structure of the clinical manifestations of the food allergy (48–67 %) [6, 7]
Summary
In the last decade the rapid growth of allergic pathologies was noted around the world, which the manifestation of is often happens in early childhood as reactions to food [1, 2]. Clinical manifestation of food allergy (FA) is characterized by polymorphic cutaneous, respiratory and gastrointestinal syndromes [3, 4]. Allergic inflammation could be develop in various areas of GI tract, so gastrointestinal form takes the second place in the overall structure of the clinical manifestations of the food allergy (48–67 %) [6, 7]. Allergic inflammation is a complex cascade reaction involving various inflammatory mediators produced by inflammatory effector cells [8]. Along with the leading role of histamine in the development of allergic diseases, lipid mediators leukotrienes (LT) take an extremely important place in early and late stages of allergic reactions [9, 10]
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