clair088

Food protein-induced enterocolitis syndrome (FPIES) is a type of food allergy in which children who eat milk, soy, or other foods develop repetitive vomiting and sometimes diarrhea.  This can lead to dehydration, and, in the longer run, failure to thrive.  But unlike more typical food allergies, FPIES isn’t mediated by IgE antibodies.  In fact, what causes FPIES is still a bit of a mystery.  In this month’s issue of JACI, Caubet and colleagues discuss results of their study on the immune responses seen in FPIES due to cow milk (CM-FPIES) ( J Allergy Clin Immunol 2017; 139(2): 572-583 ). To do this, they looked that the levels of antibodies, cytokines (chemical messengers), cell counts, and tryptase levels in 38 patients with active and resolved CM-FPIES.  Oral food challenges (OFCs) were performed, and the results from positive OFCs were compared to those from negative OFCs. What they found is that neutrophils could be responsible cells, which were found to be h...

The immune system is very complicated, and sometimes, a mutation in a single protein can cause major problems.  One such protein is Phosphoinositide 3-kinase (PI3Kδ), which, may interfere with the body’s ability to fight off disease upon activation.  In this month’s issue of JACI, Coulter and colleagues look at 53 patients with Activated PI3Kδ Syndrome (APDS) ( J Allergy Clin Immunol 2017; 139(2): 597-606 ). These 53 patients were found worldwide, and the diagnosis was confirmed by genetic sequencing.  They then looked at the laboratory findings, radiographs, and other clinical features to better understand the presentation of APDS.  All in all, the presentation of APDS was highly variable.  Some were asymptomatic through adulthood while others developed infections early in childhood, leading to death.  Three required a bone marrow transplantation.  The most common infectious complication was recurrent respiratory tract infections.  Much like othe...

In the gut, there are millions of bacteria and other micro-organisms, collectively called the gut microbiome.  Microbes in the gut are known to be important modulators of the developing immune system.   In this month’s issue of JACI, Sordillo and colleagues look at predictors of the gut microbiome in infancy ( J Allergy Clin Immunol 2017; 139(2): 482-491 ).  Microbes present in this early life window may ultimately affect the risk of allergic disease later in childhood.  They looked at stool samples in over 300 infants born to mothers in the Vitamin D Antenatal Asthma Reduction Trial (VDAART), a trial in which pregnant women took vitamin D to see how it would impact their children’s health.  In the stool, they looked at the bacterial genes to see what bacteria were present. They found that race, mode of delivery, and formula-feeding are associated with different composition of gut bacteria.  Black race and caesarean section were independent predic...