肠道黏液层中MUC2、sIgA在婴儿食物过敏中的动态变化及应用价值

doi:10.12372/jcp.2024.23e0852

Abstract

Abstract:

Objective To dynamically monitor and analyze the changes of fecal mucin 2 (MUC2) and secretory immunoglobulin A (sIgA) levels during the clinical treatment process of infants with food allergy, and to investigate the usefulness of food allergy’s interaction with sIgA and MUC2. Methods Fifty-two infants diagnosed with food allergy who received outpatient treatment from July 2022 to June 2023 were selected as the food allergy group. Simultaneously, 52 non-allergic diseases infants were chosen as the control group. The levels of fecal MUC2 and sIgA were compared between the two groups. Results There were 23 boys and 29 girls in the food allergy group and 26 boys and 26 girls in the control group. There were no statistically significant differences in age, delivery mode, feeding method, introduction of complementary foods and family history of allergic diseases between the two groups (P>0.05). The levels of fecal MUC2 and sIgA in the food allergy group were higher than those in the control group [(37.81±14.91) μg/mL vs. (25.33±14.29) μg/mL; 182.4(150.2-202.7) μg/mL vs. 147.7(131.4-157.9) μg/mL], and the differences were statistically significant (P<0.001). At the 2nd and 4th week of follow-up, fecal MUC2 level of children with food allergy group gradually decreased, but there was no statistical significance between groups (P>0.05). The level of fecal sIgA increased gradually, and the difference between groups was statistically significant (P<0.05). Binary logistic regression and ROC curve analysis showed that fecal MUC2 and sIgA both had area under the ROC curves above 0.7 (P<0.001), and the combination of the two could increase the diagnosis specificity. Conclusions There were differences in fecal MUC2 and sIgA levels between the two groups. With the improvement of clinical symptoms of children with food allergy, fecal MUC2 levels showed a downward trend and sIgA levels gradually increased, which may serve as potential biomarkers for the diagnosis of food allergy. The two groups' fecal MUC2 and sIgA levels varied from one another. With the improvement of clinical symptoms of children with food allergy, fecal MUC2 level had a downward trend and sIgA level gradually increased, suggesting that these markers could be useful for food allergy diagnosis.

Key words: food allergy, intestinal mucus layer, mucin 2, secreted immunoglobulin A, biomarker

DAI Nini, GAO Yajuan, SUN Jinbo, ZHANG Juan, LI Zailing. The dynamic changes and application value of MUC2 and sIgA in intestinal mucus layer of infants with food allergy[J].Journal of Clinical Pediatrics, 2024, 42(4): 297-304.

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References 34

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项目	总体（n=104）	过敏组（n=52）	对照组（n=52）	统计值	P
入组年龄[M(P₂₅~P₇₅)/月]	4.10(3.00~5.93)	3.90(2.83~5.33)	4.30(4.00~6.00)	Z=1.56	0.119
性别[n(%)]				χ²=0.35	0.556
男	49（47.12%）	23（44.23%）	26（50.00%）
女	55（52.88%）	29（55.77%）	26（50.00%）
出生方式[n(%)]				χ²=0.04	0.842
剖宫产	43（41.35%）	22（42.31%）	21（40.38%）
经阴分娩	61（58.65%）	30（57.69%）	31（59.62%）
喂养方式[n(%)]				-	0.486¹⁾
纯母乳喂养	48（46.15%）	27（51.92%）	21（40.38%）
人工喂养	3（2.89%）	1（1.92%）	2（3.85%）
混合喂养	53（50.96%）	24（46.16%）	29（55.77%）
入组时辅食添加情况				χ²=3.47	0.063
已添加	24（23.08%）	8（15.38%）	16（30.77%）
未添加	80（76.92%）	44（84.62%）	36（69.23%）
一级亲属过敏性疾病家族史[n(%)]				χ²=3.21	0.073
无	43（41.35%）	17（32.69%）	26（50.00%）
有	61（58.65%）	35（67.31%）	26（50.00%）

临床表现	入组时	治疗2周	治疗4周
皮疹SCORAD评分[M(P₂₅~P₇₅)]	7.30(0.00~21.30)	0.00(0.00~0.00)	0.00(0.00~0.00)
腹泻/%	94.23%	36.67%	7.69%
便血/%	88.46%	26.67%	11.54%
黏液便/%	94.23%	30.00%	7.69%

目标标志物	AUC(95%CI)	P值	灵敏度	特异度	Cut-off值/μg·mL^-1
粪便MUC2	0.728(0.632~0.825)	<0.001	0.635	0.731	34.16
粪便sIgA	0.769(0.676~0.862)	<0.001	0.731	0.788	158.80
联合预测因子	0.794(0.709~0.879)	<0.001	0.577	0.885	0.37

自变量	B	Wald χ²值	P值	OR值(95% CI)
粪便MUC2	0.04	4.70	0.030	1.037(1.003~1.071)
粪便sIgA	0.03	10.05	0.002	1.028(1.011~1.046)

The dynamic changes and application value of MUC2 and sIgA in intestinal mucus layer of infants with food allergy

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