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【medical-news】喝牛奶治疗牛奶过敏？！

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Drinking Milk To Ease Milk Allergy? Oral Immunotherapy Study Shows Promise -- But Do Not Try This At Home
http://www.sciencedaily.com/releases/2008/10/081030192851.htm

ScienceDaily (Oct. 31, 2008) — Giving children with milk allergies increasingly higher doses of milk over time may ease, and even help them completely overcome, their allergic reactions, according to the results of a study led by the Johns Hopkins Children's Center and conducted jointly with Duke University.

Despite the small number of patients in the trial – 19 – the findings are illuminating and encouraging, investigators say, because this is the first-ever double-blinded and placebo-controlled study of milk immunotherapy. In the study, the researchers compared a group of children receiving milk powder to a group of children receiving placebo identical in appearance and taste to real milk powder. Neither the patients nor the investigators knew which child received which powder, a rigorous research setup that minimizes the chance for error and bias.

The findings of the study are reported online ahead of print, Oct. 28, in the Journal of Allergy & Clinical Immunology

"Our findings suggest that oral immunotherapy gradually retrains the immune system to completely disregard or to better tolerate the allergens in milk that previously caused allergic reactions," says Robert Wood, M.D., senior investigator on the study and director of Allergy & Immunology at Hopkins Children's. "Albeit preliminary and requiring further study, these results suggest that oral immunotherapy may be the closest thing yet to a 'true' treatment for food allergy."

Currently, food allergy management involves complete avoidance of the trigger foods, waiting for the child to outgrow the allergy or treating allergic reactions if and when they occur. The latter could be dangerous, investigators say, because these common foods are difficult to avoid and some reactions can be severe and even life-threatening.

In a report released Oct. 22, the Centers for Disease Control and Prevention estimates that food allergies are on the rise with three million children in the United States now having at least one food allergy, an 18 percent jump from 10 years ago. Milk allergy is the most prevalent type of food allergy.

"Given that the quality of life of a child with a food allergy is comparable to the quality of life of a child with diabetes, we urgently need therapies that go beyond strict food avoidance or waiting for the child to outgrow the allergy," Wood says.

Researchers followed allergic reactions over four months among 19 children with severe and persistent milk allergy, 6 to 17 years of age. Of the 19 patients, 12 received progressively higher doses of milk protein, and seven received placebo. At the beginning of the study, the children were able to tolerate on average only 40 mg (.04 ounces or a quarter of a teaspoon) of milk.

At the end of the four-month study, both groups were given milk powder as a "challenge" to see what dose would cause reaction after the treatment. The children who had been receiving increasingly higher doses of milk protein over a few months were able to tolerate a median dose of 5, 140 mg (over 5 ounces) of milk without having any allergic reaction or with mild symptoms, such as mouth itching and minor abdominal discomfort. Those who had been getting the placebo remained unable to tolerate doses higher than the 40 mg of milk powder without having an allergic reaction. In the group receiving milk protein, the lowest tolerance dose was 2, 540 mg (2.5 ounces) and the highest was 8,140 mg (8 ounces). Lab tests showed the children who regularly drank or ate milk had more antibodies to milk in their blood, yet were able to better tolerate milk than those who took the placebo. Researchers say, tolerance in children treated with milk continued to build over time, and recommend that these children continue to consume milk daily to maintain their resistance. The researchers caution that it remains unclear whether the children would maintain their tolerance once they stop consuming milk regularly. "It may very well be that this tolerance is lost once the immune system is no longer exposed to the allergen daily," Wood says.

The Hopkins group is currently studying oral immunotherapy in children with egg allergy to determine whether increasingly higher doses of egg protein can help resolve their allergy, and have recently started another study of milk immunotherapy.

Wood emphasizes the findings require further research and advises parents and caregivers not to try oral immunotherapy without medical supervision.

Other Hopkins investigators in the study: Justin Skripak, M.D., Hannah Rowley, R.D., Nga Brereton, R.D., Susan Oh, R.D., Robert Hamilton, M.D., Elizabeth Matsui, M.D. M.H.S. Duke University co-investigators: Scott Nash, M.D., and A. Wesley Burks, M.D.

The research was funded by the National Institutes of Health and The Eudowood Foundation.

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2008-10-31 12:23 浏览 : 1468 回复 : 3

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胭脂编辑于 2008-11-03 23:53

• 山东一乡镇卫生院院长荣获全国脱贫攻坚先进个人荣誉称号

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本人已经认领此文，48小时后未能上交译文，请其他战友认领

2008-11-02 22:55

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• （原创）低血糖、低血钠、多尿，高尿糖、酮体阳性？

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因事务繁忙，未能如期上交译文，实感抱歉，本人再次认领此文，并在48小时内上次，如未能上交，请其他战友认领

2008-11-05 09:05

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• 19岁小姑娘意识不清，抽搐，2小时后死亡

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Drinking Milk To Ease Milk Allergy? Oral Immunotherapy Study Shows Promise -- But Do Not Try This At Home
http://www.sciencedaily.com/releases/2008/10/081030192851.htm
喝牛奶缓解牛奶过敏？口服的免疫治疗的研究表明可能性，但是不要在家里尝试。
ScienceDaily (Oct. 31, 2008) — Giving children with milk allergies increasingly higher doses of milk over time may ease, and even help them completely overcome, their allergic reactions, according to the results of a study led by the Johns Hopkins Children's Center and conducted jointly with Duke University.
科学日报（2008年10月31日）——根据约翰斯霍普金斯儿童中心和Duck大学联合的一项研究结果显示，给予牛奶过敏儿童逐渐加量的牛奶反复多次可以使其得到缓解，并且能完全帮助他们消除过敏反应。
Despite the small number of patients in the trial – 19 – the findings are illuminating and encouraging, investigators say, because this is the first-ever double-blinded and placebo-controlled study of milk immunotherapy. In the study, the researchers compared a group of children receiving milk powder to a group of children receiving placebo identical in appearance and taste to real milk powder. Neither the patients nor the investigators knew which child received which powder, a rigorous research setup that minimizes the chance for error and bias.
尽管在试验中仅有少量的患者，但是结果却是让人振奋和受鼓舞的，研究者说，因为这是第一次进行双盲和牛奶免疫治疗安慰剂控制的研究，在研究中，研究者对比了接受奶粉的儿童组和接受外表和味道和牛奶一样的安慰剂的儿童组。患者和观察者都不知道儿童接受的是哪一种奶粉，这是一种减少的误差和偏倚的严密的研究方案。
The findings of the study are reported online ahead of print, Oct. 28, in the Journal of Allergy & Clinical Immunology
研究结果在十月二十八日的变态反应和临床免疫杂志中发表前就已经在网上报道了。
"Our findings suggest that oral immunotherapy gradually retrains the immune system to completely disregard or to better tolerate the allergens in milk that previously caused allergic reactions," says Robert Wood, M.D., senior investigator on the study and director of Allergy & Immunology at Hopkins Children's. "Albeit preliminary and requiring further study, these results suggest that oral immunotherapy may be the closest thing yet to a 'true' treatment for food allergy."
“我们的发现表明，口服的免疫治疗逐渐更新免疫系统以至于完全忽略，或者不是之前对牛奶的过敏反应而是对牛奶耐受。” Robert Wood博士说，他是这个研究中的高级研究员并且是Hopkins儿童过敏和免疫学院的主任，他说：“虽然是初步研究并且需要进一步的研究，这些结果显示口服的免疫治疗方法是一种最贴近的‘真’的食物过敏治疗方法。
Currently, food allergy management involves complete avoidance of the trigger foods, waiting for the child to outgrow the allergy or treating allergic reactions if and when they occur. The latter could be dangerous, investigators say, because these common foods are difficult to avoid and some reactions can be severe and even life-threatening.
当今，食物过敏的治疗需要完全避免接触食物，等待儿童免疫过度反应，或者是当他们发生的时候治疗变态反应。研究者说，后者是危险的，因为这些普通的食物是很难避免的，并且有些反应是很严重甚至威胁生命。
In a report released Oct. 22, the Centers for Disease Control and Prevention estimates that food allergies are on the rise with three million children in the United States now having at least one food allergy, an 18 percent jump from 10 years ago. Milk allergy is the most prevalent type of food allergy.
在十月二十二日发表的文章中，疾病预防控制中心表示，食物过敏在美国每三百万的儿童中有至少增加一个，也相当于十年前的百分之十八。牛奶是最常见的一种食物过敏。
"Given that the quality of life of a child with a food allergy is comparable to the quality of life of a child with diabetes, we urgently need therapies that go beyond strict food avoidance or waiting for the child to outgrow the allergy," Wood says.
“鉴于有食物过敏的儿童和生活质量跟有糖尿病的儿童的生活质量相似，我们急切地需要一种不是严格地避免接触食物和等待儿童过敏反应过度产生。”Wood说。
Researchers followed allergic reactions over four months among 19 children with severe and persistent milk allergy, 6 to 17 years of age. Of the 19 patients, 12 received progressively higher doses of milk protein, and seven received placebo. At the beginning of the study, the children were able to tolerate on average only 40 mg (.04 ounces or a quarter of a teaspoon) of milk.
研究者对六到十七岁的十九位有严重和持久的牛奶过敏的儿童进行四个多月的跟踪。在十九个患者中，十二位接受了逐渐增加剂量的牛奶蛋白，还有七位接受安慰剂。在研究开始，儿童只能耐受四十毫克的剂量（0.04盎司或四分之一汤匙的量）的牛奶。
At the end of the four-month study, both groups were given milk powder as a "challenge" to see what dose would cause reaction after the treatment. The children who had been receiving increasingly higher doses of milk protein over a few months were able to tolerate a median dose of 5, 140 mg (over 5 ounces) of milk without having any allergic reaction or with mild symptoms, such as mouth itching and minor abdominal discomfort. Those who had been getting the placebo remained unable to tolerate doses higher than the 40 mg of milk powder without having an allergic reaction. In the group receiving milk protein, the lowest tolerance dose was 2, 540 mg (2.5 ounces) and the highest was 8,140 mg (8 ounces). Lab tests showed the children who regularly drank or ate milk had more antibodies to milk in their blood, yet were able to better tolerate milk than those who took the placebo. Researchers say, tolerance in children treated with milk continued to build over time, and recommend that these children continue to consume milk daily to maintain their resistance. The researchers caution that it remains unclear whether the children would maintain their tolerance once they stop consuming milk regularly. "It may very well be that this tolerance is lost once the immune system is no longer exposed to the allergen daily," Wood says.
在四个月的研究末，两组儿童给予奶粉作为一种“挑战”看在治疗之后他们的反应是怎么样的。接受几个月逐渐增加牛奶蛋白量的儿童能够耐受中位数为5140毫克（大于5盎司）的牛奶量，而不产生过敏反应或者轻微的症状，像口周瘙痒和轻微的腹部不适。那些接受安慰剂的儿童仍然不能耐受比40毫克更高剂量的奶粉而不产生过敏反应。在接受牛奶蛋白的那个组中，最低的耐受是2540毫克，最高的是8140毫克。实验检验显示规律地喝牛奶的儿童在血中有更多的抗体，相比那组服用安慰剂的儿童对牛奶有更好的耐受性。研究者说，接受牛奶治疗的儿童的耐受性还需进一步研究，并建议这些儿童继续每天服用牛奶以维持抵抗能力。研究者告诫说，一旦儿童停止规律地服用牛奶是否还能维持他们的耐受能力还不清楚。“一旦免疫系统不每天接触过敏原，这种耐受性可以会消失。”Wood说。
The Hopkins group is currently studying oral immunotherapy in children with egg allergy to determine whether increasingly higher doses of egg protein can help resolve their allergy, and have recently started another study of milk immunotherapy.
Hopkins组织现在正在研究鸡蛋过敏的儿童经口服的免疫治疗，看是否经过逐渐增加鸡蛋蛋白能帮助解决过敏问题，并且最近也开始另一项有关牛奶的免疫治疗的研究。
Wood emphasizes the findings require further research and advises parents and caregivers not to try oral immunotherapy without medical supervision.
Wood强调，如果需要进一步的研究，并建议病人和医务工作者不是在没有医疗监护的情况下试用口服免疫治疗方法。
Other Hopkins investigators in the study: Justin Skripak, M.D., Hannah Rowley, R.D., Nga Brereton, R.D., Susan Oh, R.D., Robert Hamilton, M.D., Elizabeth Matsui, M.D. M.H.S. Duke University co-investigators: Scott Nash, M.D., and A. Wesley Burks, M.D.
其他Hopkins的研究者有：Justin Skripak博士, Hannah Rowley, R.D., Nga Brereton, R.D., Susan Oh, R.D., Robert Hamilton, M.D., Elizabeth Matsui, M.D. M.H.S. Duke University co-investigators: Scott Nash, M.D., and A. Wesley Burks, M.D.

2008-11-05 09:49

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