Pediatr. pro Praxi, 2004; 3: 137-141

Účinky přípravků na bázi aminokyselin u kojenců s alergií / intolerancí kravského mléka - výsledky studie

Bodo Niggemann1, Christiane Binder1, Christophe Dupont2, Said Hadji2, Taina Arvola3, Erika Isolauri4
1 University Children's Hospital (Univerzitní dětská nemocnice) Charité, Humboldt University, Berlín, Německo
2 Department of Paediatric Gastroenterology (Oddělení pediatrické gastroenterologie), Hopital St Vincent de Paul, Paříž, Francie
3 Department of Paediatrics (Oddělení pediatrie), Tampere University Hospital
4 Department of Paediatrics (Oddělení pediatrie), University of Turku, Turku, Finsko

Keywords: allergy, amino-acid formula, atopy, atopic dermatitis, pediatric, food allergy, DBPCFC, extensively hydrolyzed formula, intolerance, SCORAD.

Published: December 31, 2004  Show citation

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Niggemann B, Binder C, Dupont C, Hadji S, Arvola T, Isolauri E. Účinky přípravků na bázi aminokyselin u kojenců s alergií / intolerancí kravského mléka - výsledky studie. Pediatr. praxi. 2004;7(3):137-141.

Alergie / intolerance kravského mléka (A/IKM) je léčena eliminací bílkovin kravského mléka. Protože pro kojence je kravské mléko důležitou potravinou, může jeho eliminace vést ke zvýšenému riziku poruchy růstu. Existují důkazy o příznivém účinku extenzivně hydrolyzovaných formulí (eHF) u A/IKM. Je však známo méně informací o efektu preparátů na bázi aminokyselin (AA). Proto jsme provedli prospektivní, kontrolovanou, multicentrickou studii s cílem porovnat efekt přípravků eHF a AA na růst a výskyt klinických symptomů. Bylo hodnoceno 73 kojenců (medián 5,7 měsíců) s A/IKM a s atopickou dermatitidou (AD). A/IKM byla u všech probandů prokázána dvojitě slepým expozičním testem s placebem. U obou skupin jsme pozorovali významné zlepšení indexu SCORAD - pokles z 24,6 při zahájení na 10,7 (p < 0,0001) po šesti měsících. Ve skupině s přípravkem AA byl pozorován signifikatní nárůst skóre směrodatné odchylky délky (p < 0,04), ve skupině s eHF nebyl pozorován. Hodnoty váha / výška byly v obou skupinách stabilní. V obou skupinách byl během studie srovnatelný příjem energie. Přípravky eHF i AA vedly k významnému klinickému zlepšení u kojenců s časným výskytem A/IKM. Podávání AA vedlo v porovnání s eHF k lepšímu růstu, přestože byl srovnatelný dietní příjem. U kojenců s těžkou A/IKM je proto potřeba považovat podání AA za lepší alternativu.

THE EFFECT OF AN AMINO-ACID-BASED FORMULA IN INFANTS WITH COW´S MILK ALLERGY/INTOLERANCE AND ATOPIC DERMATITIS

Cow´s milk allergy / intolerance is treated by complete avoidance of cow´s milk proteins. Because cow´s milk is an important food for infants, its avoidance may lead to an increase risk of growth impairment. Whilst there is evidence for the beneficial effects of extensively hydrolyzed cow´s milk formulae (eHF) in infants with cow´s milk allergy / intolerance, little is known about the effects of an amino-acid-based formulae (AA) in such infants. We therefore performed a prospective, controlled, multi-center trial to study the efficacy of AA in comparison with eHF, on the growth and clinical symptoms of 73 infants (median age 5,7 months) with cow´s milk allergy / intolerance and atopic dermatitis. Cow´s milk allergy / intolerance was proven in all infants by double-blind, placebo-controlled food-challenge. We observed a significant improvement in the SCORAD index in the both groups, from a mean of 24,6, at entry, to a mean of 10,7 (p < 0.0001) after 6 months. In the AA group there was a significant increase in the length standard deviation score (p < 0,04), whilst there was no difference in the eHF group. The Weight-for-length values were stable in both groups. Both an AA and eHF resulted in a significant clinical improvement in infants with an early onset of symptoms of cow´s milk allergy / intolerance. Feeding an AA resulted in improved growth compared with feeding eHF, despite similar dietary intakes, and may therefore be considered as a beneficial alternative in infants with severe cow´s milk allergy intolerance.

<sup>1</sup>University Children-s Hospital (Univerzitní dětská nemocnice)

Charité, Humboldt University, Berlín, Německo <sup>2</sup>Department of Paediatric Gastroenterology (Oddělení pediatrické gastroenterologie),

Hopital St Vincent de Paul, Paříž, Francie <sup>3</sup>Department of Paediatrics (Oddělení pediatrie), Tampere University Hospital,

Tampere, Finsko <sup>4</sup>Department of Paediatrics (Oddělení pediatrie), University of Turku, Turku, Finsko

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