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Вопросы современной педиатрии

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Выбор смеси при диетотерапии детей с аллергией к белкам коровьего молока

https://doi.org/10.15690/vsp.v20i3/2272

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Аннотация

Общепризнанной тактикой ведения детей с аллергией к белкам коровьего молока (АБКМ), находящихся на искусственном вскармливании, считается исключение цельного белка коровьего молока с заменой его на высокогидролизованную или аминокислотную смесь. Одним из актуальных вопросов является выбор конкретной лечебной смеси у ребенка с АБКМ. В статье представлены сведения о клинических проявлениях АБКМ, описаны принципы диетотерапии. Подробно обсуждены этапы создания адаптированной лечебной смеси. Показано, что выбор лечебной смеси для ребенка с АБКМ зависит от клинических проявлений заболевания, степени их тяжести и наличия коморбидных состояний. Современные требования к высокогидролизованным смесям сводятся к ограничениям размеров пептидов, обладающих иммунореактивными свойствами, а также указывают на необходимость получения доказательств клинической эффективности таких смесей в двойных слепых плацебо-контролируемых исследованиях.

Об авторах

Г. А. Новик
Санкт-Петербургский государственный педиатрический медицинский университет
Россия

Новик Геннадий Айзикович, доктор медицинских наук, профессор, заведующий кафедрой педиатрии им. проф. И.М. Воронцова 

194100, Санкт-Петербург, ул. Литовская, д. 2


Раскрытие интересов:

Чтение лекций для компаний «Глаксосмит клайн», «Санофи», «Нестле», «Нутриция», «Новартис», «АстраЗенека», «Эбботт», «Байер», «МСД Фармасьютикалс»

 



М. В. Жданова
Санкт-Петербургский государственный педиатрический медицинский университет
Россия

Санкт-Петербург


Раскрытие интересов:

Авторы статьи подтвердили отсутствие конфликта интересов, о котором необходимо сообщить

 



Ю. О. Зайцева
Санкт-Петербургский государственный педиатрический медицинский университет
Россия

Санкт-Петербург


Раскрытие интересов:

Авторы статьи подтвердили отсутствие конфликта интересов, о котором необходимо сообщить



А. С. Демидова
Санкт-Петербургский государственный педиатрический медицинский университет
Россия

Санкт-Петербург


Раскрытие интересов:

Авторы статьи подтвердили отсутствие конфликта интересов, о котором необходимо сообщить



Список литературы

1. Mahesh PA, Wong GWK, Ogorodova L, et al. Prevalence of food sensitization and probable food allergy among adults in India: the EuroPrevall INCO study. Allergy. 2016;71(7):1010–1019. doi: 10.1111/all.12868

2. Nwaru BI, Hickstein L, Panesar SS, et al: Prevalence of common food allergies in Europe: a systematic review and meta-analysis. Allergy. 2014;69(8):992–1007. doi: 10.1111/all.12423

3. Høst A. Frequency of cow’s milk allergy in childhood. Ann Allergy Asthma Immunol. 2002;89(6 Suppl 1): 33–37. doi: 10.1016/s1081-1206(10)62120-5

4. Venkataraman D, Erlewyn-Lajeunesse M, Kurukulaaratchy RJ, et al. Prevalence and longitudinal trends of food allergy during childhood and adolescence: results of the Isle of Wight Birth Cohort study. Clin Exp Allergy. 2018;48(4):394–402. doi: 10.1111/cea.13088

5. Koletzko S, Niggemann B, Arato A, et al: Diagnostic approach and management of cow’s milk protein allergy in infants and children: ESPGHAN GI Committee practical guidelines. J Pediatr Gastroenterol Nutr. 2012;55(2):221–229. doi: 10.1097/MPG.0b013e31825c9482

6. Shoemaker AA, Sprikkelman AB, Grimshaw KE, et al. EuroPrevall birth cohort. Allergy. 2015;70(8):963–972. doi: 10.1111/all.12630.

7. Koletzko S, Heine RG. Non-IgE mediated cow’s milk allergy in EuroPrevall. Allergy. 2015;70(12):1679–1680. doi: 10.1111/all.12681

8. Høst A. Cow’s milk protein allergy and intolerance in infancy. Some clinical, epidemiological and immunological aspects. Pediatr Allergy Immunol. 1994;5(5 Suppl):1–36.

9. Heine RG, Elsayed S, Hosking CS, Hill DJ. Cow’s milk allergy in infancy. Curr Opin Allergy Clin Immunol. 2002;2(3):217–225. doi: 10.1097/00130832-200206000-00011

10. Järvinen KM, Chatchatee P. Mammalian milk allergy: clinical suspicion, cross-reactivities and diagnosis. Curr Opin Allergy Clin Immunol. 2009;9(3):251–258. doi: 10.1097/ACI.0b013e32832b3f33

11. Lifschitz C, Szajewska H. Cow’s milk allergy: evidence-based diagnosis and management for the practitioner. Eur J Pediatr. 2015; 174(2):141–150. doi: 10.1007/s00431-014-2422-3

12. Vandenplas Y, Dupont C, Eigenmann P, et al. A workshop report on the development of the Cow’s Milk-related Symptom Score awareness tool for young children. Acta Paediatr. 2015;104(4):334–339. doi: 10.1111/apa.12902

13. Soares-Weiser K, Takwoingi Y, Panesar SS, et al. The diagnosis of food allergy: a systematic review and meta-analysis. Allergy. 2014;69(1):76–86. doi: 10.1111/all.12333

14. Намазова-Баранова Л.С., Макарова С.Г., Вишнёва Е.А. и др. Актуальные вопросы диагностики пищевой аллергии в педиатрической практике // Вестник Российской академии медицинских наук. — 2015. — Т. 70. — № 1. — C. 41–46. doi: 10.15690/vramn.v70i1.1230

15. Vandenplas Y, Al-Hussaini B, Al-Mannaei K, et al. Prevention of Allergic Sensitization and Treatment of Cow’s Milk Protein Allergy in Early Life: The Middle-East Step-Down Consensus. Nutrients. 2019; 11(7):1444. doi: 10.3390/nu11071444

16. Dupont C, Chouraqui JP, de Boissieu D, et al. Committee on Nutrition of the French Society of Pediatrics: dietary treatment of cow’s milk protein allergy in childhood. Br J Nutr. 2012;107(3): 325–338. doi: 10.1017/S0007114511004831

17. Fiocchi A, Brozek J, Schünemann H, et al. World Allergy Organization (WAO) Diagnosis and Rationale for Action against Cow’s Milk Allergy (DRACMA) Guidelines. World Allergy Organ J. 2010;3(4):57–161. doi: 10.1097/WOX.0b013e3181defeb9

18. Dreborg S. Debates in allergy medicine: food intolerance does not exist. World Allergy Organ J. 2015;8:37. doi: 10.1186/s40413-015-0088-6

19. Lin CH. Food allergy: what it is and what it is not? Curr Opin Gastroenterol. 2019;35(2):114–118. doi: 10.1097/MOG.0000000000000506

20. Tsabouri S, Douros K, Priftis KN. Cow’s milk allergenicity. Endocr Metab Immune Disord Drug Targets. 2014;14(1):16–26. doi: 10.2174/1871530314666140121144224

21. Vandenplas Y, Bhatia J, Shamir R, et al. Hydrolyzed formulas for allergy prevention. J Pediatr Gastroenterol Nutr. 2014;58(5): 549–552. doi: 10.1097/MPG.0000000000000318

22. Siemensma AD et al. The importance of peptide lengths in hypoallergenic infant formulae. Trends of Food Science & Technology. 1993;41(1):16–21.

23. Wang J, Su Y, Jia F, Jin H. Characterization of casein hydrolysates derived from enzymatic hydrolysis. Chem Cent J. 2013;7(1):62. doi: 10.1186/1752-153X-7-62

24. Chicon R, Belloque J, Alonso E, et al. Hydrolysis under high hydrostatic pressure as a means to reduce the binding of beta-lactoglobulin to immunoglobulin E from human sera. J Food Prot. 2008; 71(7):1453–1459. doi: 10.4315/0362-028x-71.7.1453

25. Aalaei K, Sjöholm I, Rayner M, et al. Early and advanced stages of Maillard reaction in infant formulas: Analysis of available lysine and carboxymethyl-lysine. PLoS One. 2019;14(7):e0220138. doi: 10.1371/journal.pone.0220138

26. Toda M, Hellwig M, Henle T, Vieths S. Influence of the Maillard Reaction on the Allergenicity of Food Proteins and the Development of Allergic Inflammation. Curr Allergy Asthma Rep. 2019;19(1):4. doi:10.1007/s11882-019-0834-x

27. Rosendal A, Barkholt V. Detection of potentially allergenic material in 12 hydrolyzed milk formulas. J Dairy Sci. 2000;83(10): 2200–2210. doi: 10.3168/jds.S0022-0302(00)75103-4

28. Meulenbroek LAPM, den Hartog Jager CF, Lebens AFM, et al. Characterization of T cell epitopes in bovine α-lactalbumin. Int Arch Allergy Immunol. 2014;163(4):292–296. doi: 10.1159/000360733

29. Huby RDJ, Dearman RJ, Kimber I. Why are some proteins allergens? Toxicol Sci. 2000;55(2):235–246. doi: 10.1093/toxsci/55.2.235

30. Levin ME, Blackhurst DM, Kirstein F. Residual allergenicity of amino acid-based and extensively hydrolysed cow’s milk formulas. S Afr Med J. 2017;107(9):763–767. doi: 10.7196/SAMJ.2017.v107i9.12137

31. Hochwallner H, Schulmeister U, SwobodaI, et al. Infant milk formulas differ regarding their allergenic activity and induction of T-cell and cytokine responses. Allergy. 2017;72(3):416–424. doi: 10.1111/all.12992

32. Lambers TT, Gloerich J, van Hoffen E, et al. Clustering analyses in peptidomics revealed that peptide profiles of infant formulae are descriptive. Food Sci Nutr. 2015;3(1):81–90. doi: 10.1002/fsn3.196

33. Nutten S, Maynard F, Järvi A, et al. Peptide size profile and residual immunogenic milk protein or peptide content in extensively hydrolyzed infant formulas. Allergy. 2020;75(6):1446–1449. doi: 10.1111/all.14098

34. Host A, Koletzko B, Dreborg S, et al. Dietary products used in infants for treatment and prevention of food allergy. Joint Statement of the European Society for Paediatric Allergology and Clinical Immunology (ESPACI) Committee on Hypoallergenic Formulas and the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee on Nutrition. Arch Dis Child. 1999;81(1):80–84. doi: 10.1136/adc.81.1.80

35. Greer FR, Sicherer SH, Burks AW. Effects of early nutritional interventions on the development of atopic disease in infants and children: the role of maternal dietary restriction, breastfeeding, timing of introduction of complementary foods and hydrolyzed formulas. Pediatrics. 2008;121(1):183–192. doi: 10.1542/peds.2007-3022

36. Scientific Opinion on the essential composition of infant and follow‐on formulae. EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA). EFSA J. 2014;12(7):3760. doi: 10.2903/j.efsa.2014.3760

37. Halken S, Muraro A, de Silva D, et al. European Academy of Allergy and Clinical Immunology Food Allergy and Anaphylaxis Guidelines Group. EAACI guideline: preventing the development of food allergy in infants and young children (2020 update). Pediatr Allergy Immunol. 2021;32(5):843–858. doi: 10.1111/pai.13496

38. Australasian Society of Clinical Immunology and Allergy. Infant feeding and allergy prevention: ASCIA guidelines. Sydney: ASCIA; 2020. Available online: https://www.allergy.org.au/images/pcc/ASCIA_Guidelines_Infant_Feeding_and_Allergy_Prevention_2020.pdf. Accessed on July 3, 2021.

39. Linhart B, Freidl R, Elisyutina O, et al. Molecular Approaches for Diagnosis, Therapy and Prevention of Cow’s Milk Allergy. Nutrients. 2019;11(7):1492. doi: 10.3390/nu11071492

40. Munblit D, Perkin MR, Palmer DJ, et al. Assessment of Evidence About Common Infant Symptoms and Cow’s Milk Allergy. JAMA Pediat. 2020;174(6):599–608. doi: 10.1001/jamapediatrics.2020.0153

41. Allen KJ, Remington BC, Baumert JL, et al. Allergen reference doses for precautionary labeling (VITAL 2.0): clinical implications. J Allergy Clin Immunol. 2014;133(1):156–164. doi: 10.1016/j.jaci.2013.06.042

42. Kobayashi T, Iijima K, Dent AL, Kita H. Follicular Helper T Cells Mediate IgE Antibody Response to Airborne Allergens. J Allergy Clin Immunol. 2017;139(1):300–313.e7. doi: 10.1016/j.jaci.2016.04.021

43. Gowthaman U, Chen JS, Zhang B, et al. Identification of a T follicular helper cell subset that drives anaphylactic IgE. Science. 2019; 365(6456):eaaw6433. doi: 10.1126/science.aaw6433

44. Баранов А.А., Намазова-Баранова Л.С., Хаитов Р.М. и др. Пищевая аллергия у детей: методическое руководство / Союз педиатров России. — М.: ПедиатрЪ; 2021. — 76 с.

45. Badger TM, Gilchrist JM, Pivik RT, et al. The health implications of soy infant formula. Am J Clin Nutr. 2009;89(5):1668S–1672S. doi: 10.3945/ajcn.2009.26736U

46. ESPGHAN Committee on Nutrition. Soy protein infant formulae and follow-on formulae: A commentary by the ESPGHAN Committee on Nutrition. J Pediatr Gastroenterol Nutr. 2006;42(4):352–361. doi: 10.1097/01.mpg.0000189358.38427.cd

47. Luyt D, Ball H, Makwana N, et al. Standards of Care Committee (SOCC) of the British Society for Allergy and Clinical Immunology (BSACI). BSACI guideline for the diagnosis and management of cow’s milk allergy. Clin Exp Allergy. 2014;44(5):642–672. doi: 10.1111/cea.12302

48. Commission Directive 96/4/EC of 16 Februrary 1996. Amending Directive 91/321/EEC on infant formula and follow-on formulae. Official Journal European Communities. 28.02.1996;L 49.

49. Turck D. Soy protein for infant feeding: what do we know? Curr Opin Clin Nutr Metab Care. 2007;10(3):360–365. doi: 10.1097/MCO.0b013e3280fa821b

50. Zeiger RS, Sampson HA, Bock SA, et al. Soy allergy in infants and children with IgE associated cow’s milk allergy. J Pediatr. 1999; 134(5):614–622. doi: 10.1016/s0022-3476(99)70249-0

51. Zung A, Reifen R, Kerem Z, Zadik Z. Phytoestrogens: the pediatric perspective. J Pediatr Gastroenterol Nutr. 2001;33(2):112–118. doi: 10.1097/00005176-200108000-00003

52. Vandenplas Y, Castrellon PG, Rivas R, et al. Safety of soya-based infant formulas in children. Br J Nutr. 2014;111(8):1340–1360. doi: 10.1017/S0007114513003942

53. Sinai T, Ben-Avraham S, Guelmann-Mizrahi I, et al. Consumption of soy-based infant formula is not associated with early onset of puberty. Eur J Nutr. 2019;58(2):681–687. doi: 10.1007/s00394-018-1668-3

54. Miraglia Del Giudice M, D’Auria E, Peroni D, et al. Flavor, relative palatability and components of cow’s milk hydrolysed formulas and amino acid-based formula. Ital J Pediatr. 2015;41:42. doi: 10.1186/s13052-015-0141-7

55. Latcham F, Merino F, Lang A, et al. A consistent pattern of minor immunodeficiency and subtle enteropathy in children with multiple food allergy. J Pediatr. 2003;143(1):39–47. doi: 10.1016/S0022-3476(03)00193-8

56. de Boissieu D, Matarazzo P, Dupont C. Allergy to extensively hydrolyzed cow milk proteins in infants: identification and treatment with an amino acid-based formula. J Pediatr. 1997;131(5): 744–747. doi: 10.1016/s0022-3476(97)70104-5

57. Antunes J, Borrego LM, Queiroz A, et al. Allergy to extensively hydrolysed formulas. Allergol Immunopathol (Madr). 2009;37(5):272–274. doi: 10.1016/j.aller.2009.05.003

58. Fox A, Brown T, Walsh J, et al. An update to the Milk Allergy in Primary Care guideline. Clin Transl Allergy. 2019;9:40. doi: 10.1186/s13601-019-0281-8

59. Brandtzaeg P. Food allergy: separating the science from the mythology. Nat Rev Gastroenterol Hepatol. 2010;7(7):380–400. doi: 10.1038/nrgastro.2010.80

60. Savilahti EM, Savilahti E. Development of natural tolerance and induced desensitization in cow’s milk allergy. Pediatr Allergy Immunol. 2013;24(2):114–121. doi: 10.1111/pai.12004

61. Berni Canani R, Nocerino R, Terrin G, et al. Formula selection for management of children with cow’s milk allergy influences the rate of acquisition of tolerance: a prospective multicenter study. J Pediatr. 2013;163(3):771–777.e1. doi: 10.1016/j.jpeds.2013.03.008

62. Traul KA, Driedger A, Ingle DL, Nakhasi D. Review of the toxicologic properties of medium-chain triglycerides. Food and chemical toxicology: an international journal published for the British Industrial Biological Research Association. Food Chem Toxicol. 2000; 38(1):79–98. doi: 10.1016/s0278-6915(99)00106-4

63. Heine RG, AlRefaee F, Bachina P, et al. Lactose intolerance and gastrointestinal cow’s milk allergy in infants and children — common misconceptions revisited. World Allergy Organ J. 2017;10(1):41. doi: 10.1186/s40413-017-0173-0

64. Łoś-Rycharska E, Kieraszewicz Z, Czerwionka-Szaflarska M. Medium chain triglycerides (MCT) formulas in paediatric and allergological practice. Prz Gastroenterol. 2016;11(4):226–231. doi:10.5114/pg.2016.61374

65. Zeisel SH, da Costa KA. Choline: an essential nutrient for public health. Nutr Rev. 2009;67(11):615–623. doi: 10.1111/j.1753-4887.2009.00246.x

66. Национальная программа по оптимизации обеспеченности витаминами и минеральными веществами детей России (и использованию витаминных и витаминно-минеральных комплексов и обогащенных продуктов в педиатрической практике). — М.: ПедиатрЪ; 2017. — 152 с.

67. Aggett P, Leach JL, Rueda R, MacLean WC Jr. Innovation in infant formula development: a reassessment of ribonucleotides in 2002. Nutrition. 2003;19(4):375–384. doi: 10.1016/s0899-9007(02)00999-1

68. Lack G. Epidemiologic risks for food allergy. J Allergy Clin Immunol. 2008;121(6):1331–1336. doi: 10.1016/j.jaci.2008.04.032

69. Vandenplas Y, De Greef E, Veereman G. Prebiotics in infant formula. Gut Microbes. 2014;5(6):681–687. doi: 10.4161/19490976.2014.972237

70. Foolad N, Armstrong AW. Prebiotics and probiotics: the prevention and reduction in severity of atopic dermatitis in children. Benef Microbes. 2014;5:151–160. doi: 10.3920/BM2013.0034


Для цитирования:


Новик Г.А., Жданова М.В., Зайцева Ю.О., Демидова А.С. Выбор смеси при диетотерапии детей с аллергией к белкам коровьего молока. Вопросы современной педиатрии. 2021;20(3):223-231. https://doi.org/10.15690/vsp.v20i3/2272

For citation:


Novik G.A., Zhdanova M.V., Zaitseva Yu.O., Demidova A.S. Formula Alternatives for Nutrition Therapy of Children with Cow’s Milk Protein Allergy. Current Pediatrics. 2021;20(3):223-231. (In Russ.) https://doi.org/10.15690/vsp.v20i3/2272

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