Clinical Significance of Transforming Growth Factor β1 and Tumor Necrosis Factor Α in the Food-Protein-Induced Enterocolitis Syndrome in Children

Introduction: Nowadays food allergy continues its growth, especially in westernized countries and now it is recognized as a worldwide problem. TGF-β1 is a profibrotic cytokine, which plays an important role in promoting the structural changes in food allergy. For the patients with FPIES TNF-α also has an important role. The objective: To determine the significance of the TGF-β1 and TNF-α in children with FPIES. Materials and methods of the research: We examined 38 patients with FPIES at the age from 4 months to 3 years old. The control group consisted of 11 healthy children of the same age. The definition of TGF-β1 and TNF-α in serum was performed by an ELISA kits from Bender Medsystem (Austria). Results: The level of TGF-β1 in patients with FPIES exceeded the normal values and was equal to 33.5 + 1.6 ng /ml, with normal value 20.2 + 2.1 ng/ml, respectively, p <0.001. The indices of TNF-α also increased and amounted to 8.8 + 1.3 ng/ml in comparison with the normal 4.2 + 0.67 ng/ml, p <0.001. In our patients it was characterized by an increase in the amount of specific IgE to cow's milk in 18 (47.3%) children. In these cases disease was more severe with vivid clinical manifestations (indomitable vomiting, stool with blood, expressed weight deficit). Besides that, among the patients in this group TGF-β1 level was significantly higher than in the control group, reaching 42.01 ± 7.5 ng/ml. TNF - α indicator were also increased: 11 ± 1.2 ng/ml. Conclusion: It is believed that TGF-β1 inhibits allergic inflammation, but in our observations the increase in its values was established, especially in the group of children with high specific IgE levels to cow's milk. It is likely, that the increase of TGF-β1 stimulates the release of TNF-α, which supports chronic inflammation in allergic diseases.