Allergic colitis pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Qasim Salau, M.B.B.S., FMCPaed [2]
Overview
Pathophysiology
The exact pathophysiologic mechanism for by which allergic colitis develops is not fully understood.
Pathogenesis
Hypotheses regarding pathogenesis of Allergic colitis
- It is a non IgE immunological reaction against food protein antigens, which is thought to be T cell mediated.[1][2][3][4][5]
- Activation of T cells (CD8 and TH-2) results in release of inflammatory cytokines, such as TNF-alpha, which attract Eosinophils mainly and other polymorphonuclear cells (PMN) to the intestinal tract, subsequently causing intestinal inflammation and damage.
- Genetic influence may have a role to play, may be seen in families.
- Autoimmunity may play a role in the pathogenesis. Atypical p antineutrophil cytoplasmic antibodies (a-pANCA) have been found in some of the infants, with intestinal infiltration by neutrophils.[6]
- Specific IgE antibodies against food proteins has been demonstrated in 4 to 24% the children suggesting a role in the pathogenesis of allergic colitis. These antibodies developed over time.[7][8]
References
- ↑ Pumberger W, Pomberger G, Geissler W (2001). "Proctocolitis in breast fed infants: a contribution to differential diagnosis of haematochezia in early childhood". Postgrad Med J. 77 (906): 252–4. PMC 1741985. PMID 11264489.
- ↑ Lucarelli S, Di Nardo G, Lastrucci G, D'Alfonso Y, Marcheggiano A, Federici T; et al. (2011). "Allergic proctocolitis refractory to maternal hypoallergenic diet in exclusively breast-fed infants: a clinical observation". BMC Gastroenterol. 11: 82. doi:10.1186/1471-230X-11-82. PMC 3224143. PMID 21762530.
- ↑ Chesworth BM, Hamilton CB, Walton DM, Benoit M, Blake TA, Bredy H; et al. (2014). "Reliability and validity of two versions of the upper extremity functional index". Physiother Can. 66 (3): 243–53. doi:10.3138/ptc.2013-45. PMC 4130402. PMID 25125777.
- ↑ Academy of Breastfeeding Medicine (2011). "ABM Clinical Protocol #24: Allergic Proctocolitis in the Exclusively Breastfed Infant". Breastfeed Med. 6 (6): 435–40. doi:10.1089/bfm.2011.9977. PMID 22050274.
- ↑ Fagundes-Neto U, Ganc AJ (2013). "Allergic proctocolitis: the clinical evolution of a transitory disease with a familial trend. Case reports". Einstein (Sao Paulo). 11 (2): 229–33. PMC 4872900. PMID 23843067.
- ↑ Sekerkova A, Fuchs M, Cecrdlova E, Svachova V, Kralova Lesna I, Striz I; et al. (2015). "High Prevalence of Neutrophil Cytoplasmic Autoantibodies in Infants with Food Protein-Induced Proctitis/Proctocolitis: Autoimmunity Involvement?". J Immunol Res. 2015: 902863. doi:10.1155/2015/902863. PMC 4592904. PMID 26484355.
- ↑ Nowak-Węgrzyn A (2015). "Food protein-induced enterocolitis syndrome and allergic proctocolitis". Allergy Asthma Proc. 36 (3): 172–84. doi:10.2500/aap.2015.36.3811. PMC 4405595. PMID 25976434.
- ↑ Caubet JC, Ford LS, Sickles L, Järvinen KM, Sicherer SH, Sampson HA; et al. (2014). "Clinical features and resolution of food protein-induced enterocolitis syndrome: 10-year experience". J Allergy Clin Immunol. 134 (2): 382–9. doi:10.1016/j.jaci.2014.04.008. PMID 24880634.