Duration of food protein‐induced allergic proctocolitis (FPIAP) and the role of intestinal microbiota

• DOI: 10.1111/pai.70008
• Publication Date: 2024-12-04T13:18:16Z
• Authors: G. N. Vallianatou; N. Douladiris; L. Mageiros; E. Manousakis; V. Zisaki; M. Galani; P. Xepapadaki; S. Taka; N. G. Papadopoulos
• Keywords: Milk allergy; Oral food challenge

Abstract Background Food protein‐induced allergic proctocolitis (FPIAP) is the leading cause of rectal bleeding in infants. Tolerance presumed to develop until first year age, although natural history studies are scarce, making determination ideal duration for any intervention, challenging. Intestinal microbiota (IM) crucial food allergy development; however, data FPIAP remain limited. This study aimed assess remission after 3 months milk avoidance and its correlation with IM longitudinal changes. Methods A prospective observational infants aged ≤6 a diagnosis FPIAP. After management according clinical algorithm, were subjected challenge using either cow (CM) or goat (GM) formula random order. Stool samples collected longitudinally microbiome analysis. Results Out 61 infants, 57 challenged (29 CM, 28 GM). Of these, 55 (96.5%) achieved tolerance, no difference tolerance rates between CM (28/29) GM (27/28). The average age development was 6.3 months. Enterobacteriaceae clusters (Klebsiella‐ Shigella‐dominated) most often represented from symptomatic In contrast, Bacteroides Bifidobacteria emerged later, apparently healthy Conclusion 3‐month intervention sufficient almost all achieve tolerance. tolerated equally well CM. Symptomatic associated immature enterotypes, while disease coincides changes time.