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Correlation between fecal eosinophil cationic protein and cow's milk protein allergy in extremely preterm infants and
Hongjuan Jin1,2,3, Yuandan Chen1,3, Ying Lin1,3
1Fujian Key Laboratory of Neonatal Diseases, Children's Hospital of Fudan University (Xiamen Branch), Xiamen Children's Hospital, No. 92-98, Yibin Road, Huli District, Xiamen, 361006, China.
Insights
Fecal Eosinophil Cationic Protein (ECP) is elevated during Cow's Milk Protein Allergy (CMPA) flare-ups in extremely preterm infants. This finding supports fecal ECP as a non-invasive biomarker for diagnosing CMPA in this vulnerable population.
Area of Science:
- Neonatal Medicine
- Allergy and Immunology
- Biomarker Research
Background:
- Cow's Milk Protein Allergy (CMPA) is a common concern in infants, particularly those born extremely preterm.
- Accurate and non-invasive diagnostic tools are crucial for managing CMPA in vulnerable neonatal populations.
- Eosinophil Cationic Protein (ECP) is a marker of eosinophilic inflammation, but its utility in fecal samples for CMPA diagnosis in preterm infants is under-explored.
Purpose of the Study:
- To investigate the correlation between fecal Eosinophil Cationic Protein (ECP) levels and the presence of Cow's Milk Protein Allergy (CMPA) in extremely preterm infants.
- To assess the diagnostic value of fecal ECP as a non-invasive auxiliary marker for CMPA in this specific infant group.
Main Methods:
- A prospective controlled study involving 60 extremely preterm infants (gestational age < 32 weeks), with 30 diagnosed with CMPA and 30 as matched controls.
- Longitudinal monitoring of fecal ECP levels and routine blood tests.
- Statistical analysis using one-way repeated-measures ANOVA and independent samples t-test to compare ECP levels between groups and over time.
Main Results:
- Fecal ECP levels were significantly elevated in infants with CMPA during active allergic episodes compared to non-allergic periods and controls (P < 0.001).
- No significant differences in fecal ECP were observed between non-allergic timepoints in the CMPA group and the control group (P > 0.05).
- Fecal ECP levels during active CMPA showed a significant positive correlation with CMPA onset in extremely preterm infants.
Conclusions:
- Fecal Eosinophil Cationic Protein (ECP) levels significantly increase during active Cow's Milk Protein Allergy (CMPA) in extremely preterm infants.
- Fecal ECP demonstrates potential as a valuable, non-invasive auxiliary diagnostic biomarker for CMPA in extremely preterm infants.
- Further research can validate fecal ECP for routine clinical use in diagnosing CMPA in preterm neonates.
Abstract:
To explore the correlation between fecal Eosinophil Cationic Protein (ECP) and Cow's Milk Protein Allergy (CMPA) in extremely preterm infants, and to evaluate its value in auxiliary diagnosis. This prospective controlled study enrolled 60 extremely preterm infants (< 32 weeks gestational age), comprising 30 with confirmed CMPA and 30 matched controls. Fecal ECP levels and routine blood tests were monitored longitudinally. Statistical analyses included one-way repeated-measures ANOVA and independent samples t-test. Fecal ECP levels in the experimental group were significantly elevated during allergic manifestation (7.08 ± 1.22 µg/g) compared with all other timepoints (all P < 0.001). No significant differences in ECP levels were observed among non-allergic timepoints (all P > 0.05). The control group maintained stable ECP levels throughout all observed periods (P > 0.05). The mean fecal ECP level during non-allergic periods in the experimental group (3.18 ± 1.01 µg/g) showed no significant difference from the control group (P = 0.262). In contrast, ECP levels during active allergy were significantly higher than those in the control group (P < 0.001). Fecal ECP level is significantly positively correlated with CMPA onset in extremely preterm infants, which provides a clinical basis for non-invasive auxiliary diagnosis of CMPA in extremely preterm infants.
