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Innate immune activation occurs in acute food protein–induced enterocolitis syndrome reactions

Food reactions in food protein–induced enterocolitis syndrome are predominantly underpinned by activation of the innate immune system

Citation:
Mehr S, Lee E, Hsu P, Anderson D, de Jong E, Bosco A, et al. Innate immune activation occurs in acute food protein–induced enterocolitis syndrome reactions. Journal of Allergy and Clinical Immunology. 2019;144(2):600-2.e2

Abstract:
Food protein–induced enterocolitis syndrome (FPIES) is a non–IgE-mediated food allergy with a characteristic clinical presentation in early infancy and a tendency for remission in early childhood. The immunopathophysiology of the disorder has been unclear, which contributes to the current lack of available biomarkers for diagnosis or determination of tolerance. Investigators have variably reported increased levels of C-reactive protein. Neutrophilia, thrombocytosis, in vitro T-cell activation to the triggering food protein, and activation of proinflammatory and anti-inflammatory cytokine responses have also been variably documented. Most recently, innate immune activation has been reported by using predominantly CyTOF analysis of immune parameters and whole-blood mRNA sequencing with pathways analysis.