Cow's milk protein allergy is one of the most common pediatric food allergies. It poses a significant socioeconomic burden in industrialized countries and has a profound effect on the quality of life of affected individuals and their families. Diverse immunologic pathways can lead to the clinical symptoms of cow's milk protein allergy; some of the pathomechanisms are known in detail, but others need further elucidation. A comprehensive understanding of the development of food allergies and the features of oral tolerance could have the potential to unlock more precise diagnostic tools and novel therapeutic approaches for patients with cow's milk protein allergy.

Introduction:The most prevalent food allergy in younger children is cow's milk protein allergy (CMPA), a hypersensitivity reaction to cow's milk protein and its most common clinical manifestation is allergic colitis. The goal of our recent study was to assess somatic symptoms of CMPA and to prospectively observe the effects of a dairy elimination diet using objective parameters and questionnaires.Methods:The County Hospital in Szekszárd, Hungary, investigated children aged 1 to 18 who had clinical signs that might indicate CMPA. Stool samples were taken and analyzed using a fecal calprotectin (FC) rapid test (Quantum Blue fCAL, Bühlmann Laboratories, Switzerland) at the time of the diagnosis and following 3 months of an elimination diet. At the baseline visit as well as the first and second follow-up, questionnaires were filled out. Patients were divided into two subgroups according to dietary guidelines based on the results of the questionnaires.Results:A total of 47 patients participated in the study [42.55% female, mean age: 7.36 (SD 4.22) years]. There was no significant difference in FC levels between baseline and after 3-month elimination diet [73.98 (71.12) μg/g and 68.11 (74.4) μg/g, respectively, p = 0.331]. After three months, there was a significant decrease in FC levels among patients who adhered to the strict diet [84.06 (79.48) μg/g and 41.11 (34.24) μg/g, respectively, p = 0.001].Conclusion:The findings of our study suggest that FC can be an objective marker in confirming the diagnosis of CMPA. Significant improvement in clinical symptoms and in FC levels can only be expected after a strictly followed elimination diet.

Introduction: Data on the role of irisin in vascular calcification in patients with end-stage renal diseases on regular dialysis are inconsistent, and the underlying mechanisms are not clearly defined. The present study was designed to explore the association of serum irisin with vascular stiffness and with the impact of well-established risk factors. Methods: The clinical study enrolled 52 hemodialysis (HD) and 15 continuous ambulatory peritoneal dialysis (PD) patients with an age of >18 years receiving dialysis therapy for >3 months. Patients who had major pathologies affecting carbohydrate, lipid, and bone metabolism and those who had acute cardiovascular events were excluded. Thirty-seven healthy subjects matched for age and sex served as controls. Routine biochemical parameters were measured in fasting serum samples by standard methods. Serum irisin was determined using the commercial ELISA kit (BioVendor Laboratory Medicine Inc., Brno, Czech Republic). Arterial stiffness parameters – carotid-femoral pulse wave velocity (cf PWV) and augmentation index (Aix) – were measured using applanation tonometry (SphygmoCor System; AtCor Medical, Sydney, Australia). Body composition was assessed by segmental bioelectric impedance (InBody 2.0; Biospace Co. Ltd., Seoul, Korea). Results: It was demonstrated that serum irisin levels were markedly depressed (p < 0.05), while the cf PWV significantly increased (p < 0.05) in HD/PD patients as compared to controls. Serum irisin proved to be independent of serum insulin, glucose, and HOMA-IR. However, it was inversely related to HbA1c (β = −0.544, p = 0.035), iPTH (β = −0.260, p = 0.035), and alkaline phosphatase (r = −0.325, p = 0.007). Furthermore, significant negative relationships were found of irisin to serum triglyceride and indices of body fat mass. Retrospective analysis at a follow-up period of 40 months revealed a direct relationship of irisin to all-cause mortality (p = 0.039). Conclusions: Our study demonstrated that serum irisin levels are reduced in uremic patients on regular HD/PD but failed to establish significant associations of irisin deficiency with vascular stiffness. However, the significant negative relationship of irisin to HbA1c, iPTH, and alkaline phosphatase suggests that it improves insulin sensitivity, inhibits bone resorption, mitigates bone-vascular interaction, and protects vascular function.

The most common food allergy in children is cow's milk protein allergy (CMPA). The aim of this research is to observe gastrointestinal changes induced by this nutritional allergy and to monitor the effect of dairy elimination diet on these symptoms. Children with symptoms suggesting CMPA were included in this study (n=47). The investigation was performed at the Balassa János County Hosptital in Szekszárd, Hungary. Stool samples were collected from the children at the time of the diagnosis, and after 3 months of elimination diet. During visits, a self-edited questionnaire was filled by the parents. Stool samples were evaluated using Bristol stool scale and Quantum Blue fecal calprotectin (FC) rapid test. In the entire study population (n=47, mean age:7.36 years, 42.6 % female), no significant difference in FC values was observed before (mean: 73.98 μg/g, SD: 71.12) and after (mean: 68.11 μg/g, SD: 74.04) elimination diet (p=0.21). However, after dividing the participants into two subgroups according to the questionnaires, the following was observed: a significant decrease in FC values (p<0.001) was detected in children who strictly followed the diet (n=35) comparing the first (mean: 84.057 μg/g, SD: 79.48) and the second (mean: 41.114 μg/g, SD: 34.24) stool sample. Evaluating the results of Bristol stool scales before eliminaion diet, 36.2% of the study population presented with normal stool, 63.8% had stool abnormalities. After 3 months of elimination diet, the former results changed as the following: 93.6% showed normal stool, 6.4% still had constipation or diarrhea. According to our data, FC can be an objective parameter in monitoring of allergic colitis in children with CMPA. Significant improvement in symptoms can only be expected after a strict diet. Beneficial effects of elimination diet on the gastrointestinal symptoms can also be confirmed using the Bristol stool scale among children with CMPA.

Introduction Food allergy in children is a frequent topic of clinical studies, considering the increasing number of the affected individuals and the diversity of the symptoms these children demonstrate. Cow’s milk protein allergy is the most common food allergy in the paediatric population, with an estimated prevalence of 2–6% in infants. Cow’s milk protein allergy can induce a variety of clinical symptoms, therefore establishing the correct diagnosis is often difficult. Beside the various clinical presentation, demographic and additional medical data of the research population and their families were also reviewed in this study. Methods The study was conducted at the Paediatric Gastroenterology Department of the Balassa János County Hospital in Szekszárd, Hungary. The research population (n=47) included children (0–18 years) with symptoms suggesting cow’s milk protein allergy. This component of our research represents the data from questionnaires filled in by the parents. The evaluation of the results was performed with SPSS statistical software. Results 47 children were included in our study (57.4% male, mean age: 7.36 years, SD: 4.22). By reviewing the parents’ medical history, 23.4% of mothers and 25.5% of fathers were diagnosed with either an atopic disease or an inflammatory bowel disease; however, examining the siblings of the affected children, 45,7% are reported to have one of these conditions (12 children do not have any siblings). In the study population, 8.5% were born prematurely and 85.1% were born at term (6,4% did not provide an answer). 46,8% were exclusively breastfed in the first 6 months of life. Analysing the data about the forms of clinical presentation, 85.1% showed gastrointestinal symptoms, 63.8% demonstrated skin-related problems, 57.4% presented with respiratory manifestation and 44.7% showed behavioural problems. Conclusion According to our results, a positive family history for atopic diseases and/or inflammatory bowel disease can increase the risk of developing cow’s milk protein allergy; siblings showed a higher prevalence of food allergy when the parents were affected by the aforementioned entities. The clinical manifestations represent a wide variety of symptoms which frequently overlap, making the diagnostic process often challenging. We did not observe a significant effect of feeding (breastfeeding or formula feeding), or being premature on the risk of developing cow’s milk protein allergy in children. However, it is important to emphasize the relatively small number of the study population, which is why we plan to continue the research with a larger study group.

Introduction Food allergies are very common in the pediatric population; the most common among them is cow’s milk protein allergy (CMPA). The clinical manifestations of this entity are diverse, thus establishing the diagnosis can be challenging. The aim of our human research is to evaluate and compare commonly performed diagnostic tests regarding CMPA. Methods Children with symptoms suggesting cow’s milk protein allergy were included in this study (n=47). The investigation was performed at the Balassa János County Hosptital in Szekszárd, Hungary. Stool samples were collected from the participating children at the time of the diagnosis, and after 3 months of elimination diet. On the first hospital visit, blood samples were drawn for lymphocyte transformation test (LTT), and a skin allergy test was also performed. On the first and third visit, parents were asked to fill in a questionnaire about the child’s symptoms, which was constructed by the research team. Stool samples were analysed with a fecal calprotectin (FC) rapid test. The lymphocyte transformation tests were conducted in an accredited university laboratory. Skin allergy testing was performed in the hospital setting. Evaluation of the data and the questionnaires was performed with SPSS statistical software. Results In the study population (n=47, mean age:7.36 years, 42.6% female), skin test was performed on 45 subjects; only 2 children (4.44%) showed positive test result for cow’s milk. Positive LTT was observed in 8 children (17%), 4 subjects demonstrated questionable results. Examining the entire research population, no significant difference in fecal calprotectin values was observed before (mean: 73.98 µg/g, SD: 71.12) and after (mean: 68.11 µg/g, SD: 74.04) the elimination diet (p=0.21). However, after dividing the participants into two subgroups according to the questionnaires, the following was observed: a significant decrease in FC values (p<0.001) was detected in children who strictly followed the diet (n=35) comparing the first (mean: 84.057 µg/g, SD: 79.48) and the second (mean: 41.114 µg/g, SD: 34.24) stool sample. Conclusion According to our research data, skin allergy testing and LTT are not reliable diagnostic tools for establishing the diagnosis of CMPA. However, fecal calprotectin can be an objective parameter in confirming the diagnosis of allergic colitis in children with CMPA. Significant improvement in clinical symptoms can only be expected after a strictly followed elimination diet.

Introduction and aim: The aim of our research is to evaluate and compare commonly performed diagnostic tests, and to examine the psychological disorders induced by this food allergy. Children with symptoms suggesting cow's milk protein allergy were included in this study (n = 47). Blood and saliva samples were collected from the participants. Parents were asked to fill in a questionnaire constructed by the research team (containing the DSM-5 symptoms checklist about attention deficit hyperactivity disorder). Method: One of the most widely used diagnostic tool is the skin allergy test, which was performed in 47 subjects (n = 47, mean age: 7.36 years); only 2 children showed positive test result for cow's milk. Lymphocyte transformation test was observed to be positive in 8 children (17%), 4 subjects demonstrated questionable results. In our sub-study about psychological symptoms (n = 43, mean age: 7.88 years), the score was according to the attention deficit hyperactivity disorder symptom checklist before the diet (6.88, SD: 4.43) and showed significant decrease after 3 months of the elimination diet (4.48, SD: 3.69, p = 0.001). Scores of children with sleep disorder (10.62, SD: 4.23) also represented a significant reduction after 3 months of the diet (6.69, SD: 4.59, p = 0.009). Salivary cortisol levels did not show significant changes before and after elimination diet. Results: According to our data, skin allergy testing and lymphocyte transformation test are not reliable diagnostic tools for establishing the diagnosis. Conclusion: We conclude that a significant improvement in clinical symptoms can only be achieved with a strict elimination diet.

Introduction The most common food allergy in children is cow’s milk protein allergy, and the clinical manifestations of the entity are very diverse. Beside the organic symptoms of milk protein allergy, behavioural problems often occur in these children: the parents describe problems with attention, increased impulsivity and sleeping disorder; the biological background of these symptoms in not fully understood at the moment. The aim of our human research is to examine the psychological aspects induced by these proteins. Methods Participants of the study were children above 3 years of age, with suggested symptoms of cow’s milk protein allergy (n=43). The location of the study was the Paediatric Gastroenterology Department of the Balassa János County Teaching Hospital. The parents of the involved children were asked to fill in a self-edited questionnaire, which contained questions about sociodemographical and health status, as well as features about behaviour (according to DSM-5 symptoms-cheklist about attention deficit-hyperactivity disorder). The evaluation of the questionnaires were performed with SPSS statistical program. Results Examining the entire research population (n=43, mean age:7.88 years, 41.9% female) the score received according to the ADHD symptoms-cheklist before the diet (6.88, SD: 4.43) showed significant decrease after 3 months of the elimination diet (4.48, SD: 3.69, p=0.001). The above mentioned score of the children with sleeping disorder (n=13, 10.62, SD: 4.23) also represented a significant reduction after 3 months of the diet (6.69, SD: 4.59, p=0.009). Discussion According to our results it is found that psychological symptoms (attention deficit, hyperactivity, sleeping disorder) can be induced by cow’s milk protein allergy, but a significant improvement in these symptoms – beside the somatic symptoms - can only be achieved with a strict elimination diet.

Nutritional allergies in children are a frequent topic of studies, considering the increasing number of affected individuals and the diversity of symptoms. Cow’s milk protein allergy (CMPA) is the most common food allergy in children, with a prevalence of 2-6%. The aim of our study was to examine the perinatal circumstances in children with cow’s milk protein allergy. The study was conducted at the Pediatric Gastroenterology Department in Szekszárd, Hungary. The research population (n=47) included children (0-18 years) with cow’s milk protein allergy. This research subtopic analyses questionnaire data. Beside the various clinical presentation, demographic, socio-economic and medical data of the research population and their families were also reviewed. 47 children were included (57.4% male, mean age: 7.36 years, SD: 4.22). 23.4% of mothers and 25.5% of fathers were diagnosed with either atopy or an inflammatory bowel disease; examining the siblings of the affected children, 45.7% have one of these conditions (12 children do not have any siblings). In the study population, 8.5% were born prematurely and 85.1% were born at term (6.4% did not answer). 46.8% were exclusively breastfed in the first 6 months. The introduction of dairy products before 12 months was observed in 46.8% of the study population, 48.9% received dairy between 12-24 months, and 4.3% first consumed milk after 24 months. Based on our results, a positive family history for atopy and/or inflammatory bowel disease can increase the risk of developing cow’s milk protein allergy; siblings with affected parents showed a higher prevalence of food allergy. A significant effect of feeding or gestational age on the risk of developing CMPA was not observed. The time of introduction of dairy to the child’s diet did not represent a significant difference in our research population.

The most common food allergy in children is cow milk protein allergy, and the clinical manifestations of the entity are very diverse. Beside the organic symptoms of milk protein allergy, behavioural problems often occur in these children: the parents describe problems with attention, increased impulsivity and sleep disturbance; the biological background of these symptoms is not known yet. The aim of our human research is to understand the psychological aspects induced by this food allergy. Participants of the study were children with suggested symptoms of cow milk protein allergy (n=43). The location of the study was the Paediatric Gastroenterology Department of the Balassa János County Teaching Hospital. The parents of the involved children were asked to fill in a self-edited questionnaire, which contained questions about sociodemographical and health status, as well as features about behaviour (according to DSM-5 symptoms-cheklist about attention deficit-hyperactivity disorder). The evaluation of the questionnaires were performed with SPSS statistical program. Examining the entire research population (n=43, mean age:7.88 years, 41.9 % female) the score received according to the ADHD symptom checklist before the diet (6.88, SD: 4.43) showed significant decrease after 3 months of the elimination diet (4.48, SD: 3.69, p=0.001). The above mentioned score of the children with sleep disturbance (n=13, 10.62, SD: 4.23) also represented a significant reduction after 3 months of the diet (6.69, SD: 4.59, p=0.009). According to our results it is found that psychological symptoms (attention deficit, hyperactivity, sleep disturbance) can be induced by cow milk protein allergy, but a significant improvement in these symptoms – beside the somatic symptoms - can be achieved with a strict elimination diet.

The most common food allergy in the pediatric population is cow’s milk protein allergy (CMPA). The clinical manifestations of this entity are very diverse, thus establishing the diagnosis can be challenging. The aim of our human research is the more precise understanding of the complex physiological and psychological mechanisms induced by CMPA. Children with symptoms suggesting cow’s milk protein allergy were included in this study (n=46). The examinations were performed at the Balassa János County Hosptital in Szekszárd, Hungary. Stool samples were collected from the participating children at the time of the diagnosis, then after 3 months of strict elimination diet. On these occasions, parents were asked to fill out a questionnaire, constructed by the research team. Stool samples were analysed with QuantumBlue fecal calprotectin (FC) rapid test. Evaluation of the data and the questionnaires was performed with SPSS statistical software. Examining the entire research population (n=46, mean age:7.28 years, 43.5% female), no significant difference in FC values was observed before (mean: 61,17 µg/g, SD: 63,72) and after (mean: 68.35 µg/g, SD: 74.74) the elimination diet (p=0.21). However, after dividing the participants into two subgroups according to the questionnaires, the following was observed: a significant decrease in FC values (p<0.001) was detected in children following a really strict diet (n=36) comparing the first (mean: 77 µg/g, SD: 69.76) and the second (mean: 41.69 µg/g, SD: 34.68) stool sample. According to research data, fecal calprotectin can be an objective parameter in establishing the diagnosis of allergic colitis in children with CMPA. Significant improvement in clinical symptoms can be expected after a strictly followed elimination diet.