IgE And Lymphocyte Subsets In Children With Cow’s Milk Protein Allergy And Clinical Effect Analysis After Food Avoidance

ObjectiveCow’s milk protein allergy（CMPA）is an over-strong or abnormal immune reaction caused by eating Cow’s milk protein（CMP）in children.Can have long-term cough,repeated wheezing,nasal congestion and runny nose,vomiting,diarrhea,constipation,blood in the stool,abdominal pain,eczema,acute urticaria,facial edema and so on,if not timely intervention,can affect the normal growth and development of children.Avoidance of allergens and individualized diet management are the basic clinical treatment strategies.This paper mainly studied the changes of specific antibody IgE and lymphocyte subsets in children with milk protein allergy,as well as the short-term and long-term effects of food avoidance treatment on children.MethodsFifty children with confirmed milk allergy admitted to our Hospital from September 2021 to September 2022 were selected as case group.Fifty healthy children who came to hospital for physical examination during the same period were selected as the control group.IgE and lymphocyte subsets in the two groups were compared as well as the effects of food avoidance therapy on children with milk protein allergy.IgE,CD3⁺,CD3⁺CD4⁺,CD3⁺CD8⁺ and CD3^-CD19⁺ were statistically analyzed.The height and weight of case group and control group were recorded by physical measurement.The Z-score scoring method was used to calculate the Z-score of weight for age（WAZ）,Z-score of length/high for age（LAZ/HAZ）and Z-score of weight for length/high,WLZ/WHZ).To evaluate the physical development of children with milk protein.Three months after food avoidance treatment,the improvement of allergy symptoms and immune indexes and the changes of Z-values were observed 3 months after food avoidance treatment in the case group.P <0.05 was considered to have statistical difference.Results1.There was no significant difference in age between the two groups（Z=0.079,P >0.05）,and there was no significant difference in gender,feeding style and delivery mode（t₁=0.369,t₂=0.450,t₃=0.361,P > 0.05）.The values of WAZ,WHZ/WLZ and HAZ/LAZ in case group were lower than those in control group,and the differences were statistically significant（t₁=2.382,t₂=4.021,t₃=3.623,P < 0.05）.2.The clinical manifestations from 0 to 6 months were vomiting in 2 cases（33.3%）,diarrhea in 2 cases（33.3%）,eczema and urticaria in 1 case（16.7%）,and no weight gain in 1 case（16.7%）.From 6 to 12 months,vomiting in 2 cases（14.3%）,diarrhea in 6cases（42.9%）,wheezing in 1 case（7.1%）,eczema and urticaria in 3 cases（21.4%）,perioral red in 2 cases（14.3%）,difficulty in feeding in 1 case（7.1%）and 2 cases（14.3%）did not gain weight.From 12 to 24 months,vomiting in 1 case（5.6%）,diarrhea in 8cases（44.4%）,wheezing in 1 case（5.6%）,chronic cough in 1 case（5.6%）,eczema and urticaria in 3 cases（16.7%）,perioral red in 1 case（5.6%）,and difficulty in feeding in 2cases（11.1%）.2 cases（11.1%）did not gain weight;From 24 to 36 months,there were 3cases（16.7%）of diarrhea,2 cases（16.7%）of chronic cough,5 cases（41.7%）of eczema and urticaria.There was no statistical significance in the distribution of the above clinical manifestations among different age groups（P > 0.05）.3.All indexes of IgE and lymphocyte subsets in the case group and control group showed skewed distribution.Rank sum test analysis showed that IgE and CD3^-CD19⁺levels in the case group were higher than those in the control group,and the difference was statistically significant（P < 0.05）.The levels of CD3⁺,CD3⁺CD4⁺ and CD3⁺CD8⁺in control group were higher than those in case group,and the difference was statistically significant（P < 0.05）.4.After food avoidance treatment,the improvement of vomiting（Z=5.263,P=0.022）,diarrhea（Z=16.000,P < 0.001）and eczema and urticaria（Z=13.636,P <0.001）were statistically significant（P < 0.05）.Wheezing（Z=2.041,P=0.153）,chronic cough（Z=3.093,P=0.079）,perioral redness（Z=3.093,P=0.079）,feeding difficulties（Z=3.093,P=0.079）and no weight gain（Z=1.382,P=0.240）there was no significant difference before and after treatment（P > 0.05）.5.After treatment,the values of WAZ,LAZ/HAZ and WLZ/WHZ increased significantly compared with those before treatment,and the difference was statistically significant（P < 0.05）.After treatment,CD3⁺,CD3⁺CD4⁺,CD3⁺CD8⁺ levels increased,the difference was statistically significant（P < 0.05）.CD3^-CD19⁺ levels decreased,the difference was statistically significant（P < 0.05）.Conclusions1.In children with CMPA,there is no significant difference in the distribution of clinical manifestations in different age groups.The physical development of children with CMPA lags behind that of normal children.2.The IgE and CD3^-CD19⁺ levels in CMPA children were higher than those in normal children,while the levels of CD3⁺,CD3⁺CD4⁺ and CD3⁺CD8⁺ were lower than those in normal children,and there were immune system disorders in CMPA children.3.After 3 months of food avoidance treatment,the symptoms of vomiting,diarrhea,eczema and urticaria of the children with milk protein allergy were significantly improved,while the other symptoms were not significantly improved.After 3 months of food avoidance treatment,the children’s immune indexes and physical development improved significantly.