• Korean Journal of Community Nutrition
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• v.9 no.1
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• pp.90-97
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• 2004

The purpose of this study was to determined the rate of sensitization to food allergen in children with Atopic Dermatitis (AD) in Korea. A total of 3,783 patients (male = 1983, female = 1800) with AD (age under 18 years) who had visited Samsung Medical Center from 1998 to 2003 were enrolled in the study. Food hypersensitivity was measured by specific IgE to egg, cow's milk, soy, peanut, wheat, buckwheat, beef, pork, chicken, shrimp, crab, salmon, mackerel, etc. Specific IgE levels > 0.7 kU/L. by Captured Allergen Product (CAP) assay were considered positive. Chi-square test at p value < 0.05 was used to examine the difference of the prevalence by sex and age. The rate of sensitization to multiple food allergens was 31.2% and decreased with age. Hypersensitivity to egg showed highest prevalence, which was 24.3%, compared to the prevalence of other foods. High prevalence of hypersensitivity to milk. wheat, soy, peanut, crab or shrimp was observed (11.6- 17.7%). Low prevalence of hypersensitivity to beef, pork, tuna or chicken was observed (1.9-3.5%). Children aged under 3 years had significantly higher prevalence of hypersensitivity to egg, milk, soy and beef than children aged at least 3 years. Our results stress the need for examination of food hypersensitivity aimed at identified and limited each food allergen among children with AD caused by food to help patients outgrow their food allergy.

• Nutritional Sciences
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• v.2 no.2
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• pp.119-124
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• 1999

Food allergies play an important role in Atopic Dermatitis (AD). Dietary manipulation is essential in the management of AD. However, there has been a paucity of data reporting the prevalence of food allergies in AD patients in Korea. In this study, the Food Open Challenge Tests (FOCT) were conducted to investigate food allergies in AD patients. The skin-prick test and the detection of specific IgE, as well as allergy history of patient were used to detect food allergies in all AD patients. Elimination diet was conducted for two weeks prior to FOCTs. The prevalence of food allergies by FOCT is as follows: milk (67.3%); chicken (64.2%); pork (62.8%); eggs (61.0%); beef(55.4%) ; wheat (52.0%) and soybean (45.2%). Allergenic food items in Korean AD patients were different from people in other foreign countries. The seven major foods those tested positively by FOCTs were completely eliminated from the replaced diets for two weeks, and were subsequently reintroduced one at a time. Results from FOCTs were not comparable with allergy history or skin-prick tests or specific IgE detection. The sensitivity and specificity of skin-prick tests and specific IgE detection were lower than FOCTs. Allergy history, skin-prick tests, and specific IgE detection are useful for the identification of food allergen but its clinical significance differed according to food items. Therefore, we conclude that even though a 10-day delay was necessary after food challenge, FOCT is a useful and valid method to confirm food allergies and may be essential for the effective control of food allergies for treatment of AD.

• Journal of Dairy Science and Biotechnology
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• v.30 no.1
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• pp.17-22
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• 2012

Since the prevalence of allergies is increasing, food allergy is a major concern for consumers, as well as for the food industry. The foods that account for over 90% of all moderate to severe allergic reactions to food are milk, eggs, peanuts, soybeans, fish, shellfish, wheat, and tree nuts. Of these food allergens, milk is one of the major animal food allergens in infants and young children. Milk is the first food that an infant is exposed to; therefore, the sensitization rate of milk in sensitive individuals is understandably higher. The mechanisms involved in allergic reactions caused by this hypersensitivity are similar to those of other immune-mediated allergic reactions. The reactions occur in the gastrointestinal tract, skin, and respiratory tract, with headaches and psychological disorders occurring in some instances. The major allergenic proteins in milk are casein, ${\beta}$-lactoglobulin, and ${\alpha}$-lactalbumin, while some of the minor allergenic proteins are lactoferrin, bovine serum albumin, and immunoglobulin. Reliable allergen detection and quantification are essential for compliance with food allergen-labeling regulations, which protect the consumer and facilitate international trade.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.24 no.4
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• pp.384-391
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• 2021

Purpose: The Cow's Milk-related Symptom Score (CoMiSS^TM) was developed as an awareness tool for evaluating cow's milk-related symptoms in otherwise healthy children. Using a convenience sample of participants, this cross-sectional study aimed to determine CoMiSS^TM values of symptomatic infants based on retrospectively or prospectively obtained information. Methods: CoMiSS^TM values were determined in infants aged <12 months with symptoms suggestive of cow's milk protein allergy or functional gastrointestinal disorders. The exclusion criteria were previous diagnosis with acute or chronic disease, treatment with a therapeutic formula, and in case of breastfeeding, an elimination diet followed by the mother. Two CoMiSS^TM values were assessed. A retrospective collection was defined as the collection of data after initial contact with the medical center but before the first medical consultation. A prospective collection was defined as the collection of data within 24 hours from the time of medical consultation but before starting any therapeutic intervention. The CoMiSS^TM total and individual component scores obtained retrospectively or prospectively were compared between groups using the Wilcoxon signed-rank test. Results: This study was performed between August and November 2019. Data of 110 children (62 males and 48 females), with a mean±standard deviation age of 18.2±11.7 weeks, were obtained. The total CoMiSS^TM value (p<0.001) and some individual component scores (crying, regurgitation, and stool) were significantly lower when collected prospectively than when collected retrospectively. Conclusion: CoMiSS^TM values were retrospectively and prospectively determined. Lower CoMiSS^TM values were obtained during prospective evaluation. Possible differences should be considered when using CoMiSS^TM in clinical practice.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.4 no.1
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• pp.47-53
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• 2001

Purpose: Following up the cases of cow's milk-sensitive enteropathy (CMSE), We observed the development of clinical tolerance with cow's milk and other foods. We investigated the clinical outcome of CMSE. Methods: We reviewed the clinical records of patients who had been admitted and diagnosed as CMSE by responses to cow's milk challenge and elimination test and the findings of small intestinal biopsy at Department of Pediatrics, Taegu Catholic University Hospital from March 1992 to March 1997. All of them were being fed with protein hydrolysate before 6 months old, and tried cow's milk and other foods challenge test at following each two month. Twenty-one cases of them returned to be followed. The age at admission was $30.7{\pm}8.8$ (18~47) days old and at survey was $43.4{\pm}23.7$ (16~84) months old. Results: 1) Although the body weight at birth of the patients was 25~75 percentile, all on admission was below 3 percentile. The body weight on interview was 25~75 percentile. 2) The development of clinical tolerance in cow's milk was observed at 16~24 months of age and the tolerance rate was 61% at 12 months of age, 90% at 16 months of age. The development of clinical tolerance in other foods was observed at 10~24 months of age and the tolerance rate was 33% at 12 months of age, 80% at 18 months of age. 3) Adverse reactions after challenge test with cow's milk were observed at 19 cases, manifestated as vomiting (31%), diarrhea (31%), irritability or lethargy (21%), skin rash (10%), and abdominal distention (5%). 4) Comparing serum IgE and milk RAST positive group on admission (5 cases) and negative group on admission (16 cases), there was no significant difference at the age of tolerance in cow's milk (p>0.05), the age of tolerance in other foods (p>0.05), allergy history in family, and the incidence of other allergic diseases. 5) The history of family allergy was observed in 3 cases (14%) in 21 patients and 3 cases (14%) showed rhinitis, urticaria or asthma through a follow-up interview. Conclusion: The development of clinical tolerance in cow's and other foods was sharply increased at 12 months of age and most of all tolerated within 24 months of age. CMSE is a temporary disorder of infancy.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.3 no.1
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• pp.30-40
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• 2000

Purpose: During the first year of life, cow's milk protein is the major offender causing food allergy. Cow's milk allergy (CMA) affects 2~7% of infants, of which approximately one-half show predominantly gastrointestinal symptoms. We studied the clinical types of cow's milk allergy with predominantly gastrointestinal symptoms (CMA-GI) of childhood. Methods: The retrospective study was performed on 30 (male 22, female 8) patients who had diagnosed as CMA-GI during 2 years and 3 months from March 1995 to June 1997. Results: 1) Children with CMA-GI presented in the three types of clinical manifestation on the basis of time to reaction to milk ingestion: Quick (Q) onset (5 cases), Slow (S) onset (20 cases), Quick & Slow (Q&S) (5 cases). 2) Age on admission of the three groups was significantly different (p<0.05): (Q onset: $81.4{\pm}67.1$ days, S onset: $31.9{\pm}12.7$ days, Q&S: $366.0{\pm}65.0$ days). Although the body weight at birth was 10~95 percentile in all patients, body weight on admission was different: (Q onset: 10~50 percentile, S onset: below 10 percentile, Q&S: 10~25 percentile). S onset group was significantly different compared with other groups (p<0.05) and 90% of this one was failure to thrive below 3 percentile. 3) Peripheral leukocyte counts were as followings: (Q onset: $5,700{\sim}12,300/mm^3$, S onset: $10,000{\sim}33,400/mm^3$, Q&S: $5,200{\sim}14,900/mm^3$). Slow onset group was significantly different compared with other groups (p<0.05). Serum albumin levels on admission were as followings: (Q onset: $4.2{\pm}0.4\;g/dl$, S onset: $3.0{\pm}0.3\;g/dl$, Q&S: $4.0{\pm}0.3\;g/dl$). S onset group was significantly different compared with other groups (p<0.05) and 85% of this one was below 3.5 g/dl. 4) Although morphometrical analysis on small intestinal mucosa did not show enteropathy in Q onset and Q&S groups, all cases of S onset revealed enteropathy: 45% of this one showed subtotal villous atrophy, 55 % showed partial villous atrophy. 5) Allergic reaction test to other foods was not performed in S onset group because of ethical problem and high risk in general condition. In Q onset group, allergic reaction to one or two other foods: soy formula, weaning formula and eggs. Q&S goup revealed allergic reactions to several foods or to most of all foods except protein hydrolysate formula: eggs, potatos, some kinds of sea food, apples, carrots, beef and chicken. 6) Serum IgE level, peripheral eosinophil counts, milk RAST, soy RAST, skin test were not significantly different among groups. Conclusion: CMA-GI may present in three clinical ways on the basis of time to reaction to milk ingestion, typical clinical findings and morphologic changes in the small bowel mucosal biopsy specimens. This clinical subdivision might be helpful in diagnostic and therapeutic approaches in CMA-GI. Early suspicion is mandatory especially in S onset type because of high risks with malnutrition and enteropathy.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.11 no.sup1
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• pp.1-6
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• 2008

Previous infant feeding guidelines recommended a delayed introduction of solids to beyond 6 months of age to prevent atopic diseases. However, scientific evidence supporting a delayed introduction of solids for prevention of atopic diseases is scarce and inconsistent. Current evidence does not support a major role for maternal dietary restrictions during pregnancy or lactation in the prevention of atopic disease. In studies of infants at high risk of developing atopic disease, there is evidence that exclusive breastfeeding for at least 4 months compared with feeding intact cow milk protein decreases the incidence of atopic dermatitis, cow milk allergy, and wheezing in early childhood. For infants at high risk of developing atopic disease who are not breastfed exclusively for 4 to 6 months, there is modest evidence that atopic dermatitis may be delayed or prevented by the use of extensively or partially hydrolyzed formulas, compared with cow milk formula, in early childhood. There is no convincing evidence that a delayed introduction of solid foods beyond 4 to 6 months of age prevents the development of atopic disease. For infants after 4 to 6 months of age, there are insufficient data to support a protective effect of any dietary intervention for the development of atopic disease.

• Clinical and Experimental Pediatrics
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• v.50 no.9
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• pp.912-918
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• 2007

Purpose : Breast milk contains several components that provide specific immunity and affect the maturation of the infant's immune system. Allergic disease (AD), including atopic eczema, asthma, allergic rhinitis, and food allergy is characterized by an imbalance between cytokines produced by distinct T-helper cell subtypes. The aim of the study was to investigate the concentrations of cytokines and chemokines that were involved in allergic reactions in breast milk from allergic and nonallergic mothers and then analyse the effect of breastfeeding duration on the prevalence of allergic disease in the age of two. Methods : The breast milk samples were collected from mothers with AD (n=88) and without AD (n=47). Breast milk was collected at the second day (colostrum) and four weeks later (mature milk).The level of Interlukine (IL)-4, IL-5, IL-6, IL-8, IL-10, IL-13, $TGF-{\beta}1$, $TGF-{\beta}2$, RANTES in breast milk were determined by commercially available enzyme-linked immunosorbent assay (ELISA) kits according to the manufacturer's instructions. Results : Mothers with AD had a higher concentration of IL-8 in colostrum compared with those without AD (P=0.021). But, $TGF-{\beta}1$ and $TGF-{\beta}2$ were higher concentrated in colostrum of mother without AD (P=0.013, P=0.001). Whereas concentrations of other cytokines were not significantly different between the two groups. There was no association between levels of cytokines and chemokines in the breast milk and allergic development during the first 2 years of life in the infants. Conclusion : The higher concentration of $TGF-{\beta}1$ and $TGF-{\beta}2$ in colostrum from non-allergic mothers may explain the protective effect. But, the higher concentrations of IL-8 in colostrum from allergic mothers may in part explain the controversial results on the protective effect of breastfeeding against allergic diseases. We conclude that there is no convincing evidence form a relation between cytokines in breast milk and allergic diseases in infants. Longer follow-up are necessary to evaluate the effects of breast milk components on AD.

• Nutrition Research and Practice
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• v.16 no.3
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• pp.344-353
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• 2022

BACKGROUND/OBJECTIVES: Hydrolyzed formula is often fed to infants with gastrointestinal or immune issues, such as malabsorption or cow's milk allergy, because enzymatic treatment has rendered it more digestible and less allergenic than standard cow's milk formula (SF). Partially hydrolyzed formula (PHF) should be considered for those infants who are intolerant to extensively hydrolyzed formula. However, there are concerns about the nutritional insufficiencies of PHF. We aimed to evaluate the effects of PHF on the growth and health indicators in infants who were at high-risk of allergic disease and potential candidates for consuming PHF. SUBJECTS/METHODS: A total of 83 infants aged 0-2 mon with a family history of allergies were assigned to consume either PHF or SF until 24 weeks of age. Anthropometric measures were obtained at baseline, 12 weeks, and 24 weeks; blood samples were drawn and evaluated at the end of the study. RESULTS: No significant differences were observed in weight, height, and weight-for-height at any time point in each sex between the PHF and SF groups. At 24 weeks of age, the weight-for-age and height-for-age z-scores of the SF group were higher than those of the PHF group, but there was no significant difference in the weight-for-height z-score. There were no significant differences in levels of white blood cells, hemoglobin, ferritin, protein, albumin, aspartate aminotransferase, alanine aminotransferase, eosinophil cationic protein, and immunoglobulin E. CONCLUSIONS: In this study, there were no differences in growth and blood panels between the infants consuming PHF or SF. Therefore, infants who are unable to tolerate SF can be fed PHF without nutritional concerns about growth.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.1
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• pp.93-102
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• 1998

Infant formula in nursing bottle, with inappropriate feeding habits, is major factor associated with the development of nursing caries. Although each infant formula has different carbohydrate and protein composition, studies comparing cariogenic potential of many Korean-branded infant formulas are deficient. In addition, it is on the point of being difficult to evaluate the cariogenecity of milk due to development of many infant formulas. In this study, to evaluate the cariogenic potential of many infant formulas, after oral rinse with six Korean-branded infant formulas(three milk based formulas, one soy based formula and two specific formulas for infants with allergy to milk protein and with lactose intolerance) for ten adult volunteers(eight males and two females), plaque pH change was measured with In vivo/In vitro combination technique and results were as follows. 1. All six different kinds of Korean-branded commercial infant formulas dropped the plaque pH significantly(p<0.05) and at an hour after rinse, plaque pH was not recovered in most of subjects. 2. Soy based infant formula and casein-hydrolyzated infant formula containing no casein dropped the plaque pH significantly more than milk based infant formula containing casein (p<0.05). 3. In the milk protein of infant formulas, casein had more effect on buffering the pH change of the infant formula than whey protein and casein-hydrolyzated infant formula had a reduced effect of casein. 4. In infant formulas with similar protein composition, infant formula containing sucrose dropped plaque pH more than infant formula containing lactose, but there was no significant difference (p>0.05).