Time Course Until Tolerance for Food Protein–Induced Allergic Proctocolitis Varies by the Causal Food

IF 6.6 1区医学 Q1 ALLERGY

Journal of Allergy and Clinical Immunology-In Practice Pub Date : 2025-09-01 DOI:10.1016/j.jaip.2025.06.010

Nagihan İskender MD , Nefise Nezihe Uluç MD , Ismail Ozanli MD , Belkis Ipekci MD , Taha Yasin Akın MD , Mujde Tuba Cogurlu MD , Aysen Uncuoğlu MD , Nihal Uyar Aksu MD , Sibel Balcı MD , Isıl Eser Simsek MD , Metin Aydoğan MD

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引用次数: 0

Abstract

Background

For food protein–induced allergic proctocolitis (FPIAP), published information on the time until tolerance for each causal food and their combinations remains scarce.

Objective

To determine time until tolerance for individual causal foods, causal foods in combination, and factors affecting tolerance development.

Methods

Of the 91 patients diagnosed with FPIAP between March 2019 and March 2020, 84 patients with at least 3 years of follow-up were evaluated in this prospective cohort.

Results

The median age of the patients was 50 months at last evaluation (interquartile range [IQR]: 47-54 months), and 52.4% were male. The tolerance development rate was 36.6% in the first year, 88.9% in the second year, 96.4% in the third year, and 97.6% after the age of 3 years. The overall median tolerance development time was 15.5 (IQR: 12-22.5) months. For each causal food, cow’s milk (CM), beef, wheat, eggs, and nuts, median times until tolerance were 13 (IQR: 12-18), 13 (IQR: 12-18), 14 (IQR: 10.7-16), 16 (IQR: 12-24), and 24 (IQR: 22.5-36.5) months, respectively. In multiple food allergies (MFA), the presence of eggs significantly prolonged the time until tolerance, whereas the presence of beef did not. Multivariate regression analysis revealed that MFA presence (odds ratio [OR]: 12.11, 95% confidence interval [CI]: 1.23-118.12, P = .03), atopic dermatitis (AD) at onset (OR: 4.04, 95% CI: 1.15-14.25, P = .03), and the absence of a pet at home (OR: 0.23, 95% CI: 0.06-0.87, P = .03) were associated with delayed tolerance. The presence of IgE-mediated food allergy at onset was also associated with delayed tolerance (P = .02).

Conclusions

Tolerance development times to egg and nuts were longer than those to CM, beef, and wheat in FPIAP. Delayed tolerance appears to be due to the specific food combinations rather than multiple foods.

查看原文本刊更多论文

对食物蛋白引起的过敏性直结肠炎的耐受时间因引起的食物而异。

背景：关于食物蛋白诱导的过敏性直结肠炎（FPIAP），关于对每种致病食物及其组合耐受的时间的公开信息仍然很少。目的：确定对单个因果食品、组合因果食品产生耐受性的时间，以及影响耐受性发展的因素。方法：在2019年3月至2020年3月期间诊断为FPIAP的91例患者中，84例患者进行了至少三年的随访。结果：最后一次评估时中位年龄为50个月（四分位间距[IQR]: 47 ~ 54），男性占52.4%。耐受性发育率第一年为36.6%，第二年为88.9%，第三年为96.4%，3岁以后为97.6%。总体中位耐受性发展时间为15.5个月（IQR: 12-22.5个月）。对于每种因果食品，牛奶（CM）、牛肉、小麦、鸡蛋和坚果，达到耐受的中位数时间分别为13 （IQR: 12-18）、13 （IQR: 12-18）、14 （IQR: 10.7-16）、16 （IQR: 12-24）和24 （IQR: 22.5-36.5）个月。在多种食物过敏（MFA）中，鸡蛋的存在显著延长了耐受时间，而牛肉的存在则没有。多因素回归分析显示，MFA的存在（优势比[OR]: 12.11, 95%可信区间[CI]: 1.23-118.12, p=0.03）、发病时的特应性皮炎（OR: 4.04, 95% CI: 1.15-14.25, p=0.03）和家中没有宠物（OR: 0.23, 95% CI: 0.06-0.87, p=0.03）与延迟耐受相关。发病时存在ige介导的食物过敏也与延迟耐受相关（p=0.02）。结论：FPIAP对鸡蛋和坚果的耐受性发育时间长于对CM、牛肉和小麦的耐受性发育时间。延迟耐受似乎是由于特定的食物组合，而不是多种食物。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Allergy and Clinical Immunology-In Practice ALLERGYIMMUNOLOGY-IMMUNOLOGY

CiteScore

11.10

自引率

9.60%

发文量

683

审稿时长

50 days

期刊介绍： JACI: In Practice is an official publication of the American Academy of Allergy, Asthma & Immunology (AAAAI). It is a companion title to The Journal of Allergy and Clinical Immunology, and it aims to provide timely clinical papers, case reports, and management recommendations to clinical allergists and other physicians dealing with allergic and immunologic diseases in their practice. The mission of JACI: In Practice is to offer valid and impactful information that supports evidence-based clinical decisions in the diagnosis and management of asthma, allergies, immunologic conditions, and related diseases. This journal publishes articles on various conditions treated by allergist-immunologists, including food allergy, respiratory disorders (such as asthma, rhinitis, nasal polyps, sinusitis, cough, ABPA, and hypersensitivity pneumonitis), drug allergy, insect sting allergy, anaphylaxis, dermatologic disorders (such as atopic dermatitis, contact dermatitis, urticaria, angioedema, and HAE), immunodeficiency, autoinflammatory syndromes, eosinophilic disorders, and mast cell disorders. The focus of the journal is on providing cutting-edge clinical information that practitioners can use in their everyday practice or to acquire new knowledge and skills for the benefit of their patients. However, mechanistic or translational studies without immediate or near future clinical relevance, as well as animal studies, are not within the scope of the journal.