El efecto de las fórmulas nutricionales utilizadas en el tratamiento de niños con alergia a las proteínas de leche de vaca: una revisión sistemática

Autores/as

DOI:

https://doi.org/10.33448/rsd-v11i2.25594

Palabras clave:

Hipersensibilidad a la Leche; Alimentos de Soja; Hipersensibilidad a los alimentos.

Resumen

Introducción: La literatura ha demostrado un aumento en la prevalencia de niños con alergia a la proteína de la leche de vaca (APLV) y su tratamiento consiste en este alimento y sus derivados dietéticos y su sustitución por fórmulas a base de proteína de soja aislada o fórmulas hidrolizadas. Objetivo: Evaluar los efectos del uso de fórmulas nutricionales en niños con APLV. Metodología: La búsqueda y selección de artículos siguió las recomendaciones del Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), utilizando las palabras clave: “hipersensibilidad a la leche”, “hipersensibilidad alimentaria, hidrolizada”, “proteína vegetal”, “vegetal protein”, “proteínas de soja”en combinación o solas, en las bases de datos directas de Pubmed, Scopus y Science. Resultados: Se incluyeron nueve artículos, incluidos seis ensayos clínicos, un estudio de cohorte, un estudio observacional y un estudio multicéntrico. Fueron probados: fórmula de proteína ampliamente hidrolizada, fórmula a base de aminoácidos y fórmula a base de soja. En 3 estudios, las fórmulas de aminoácidos y proteínas ampliamente hidrolizadas se asociaron con probióticos Lactobacillus rhamnosus y hubo 2 estudios asociados con simbióticos. Conclusión: Todos los tipos de fórmulas analizadas contribuyeron a la mejora de los síntomas relacionados con APLV, con los mejores resultados observados para las fórmulas con probióticos. Sin embargo, se necesitan más estudios para evaluar los efectos de los probióticos agregados en las fórmulas nutricionales para el tratamiento del APLV, su potencial debe evaluarse mejor, especialmente en estudios a largo plazo.

Citas

Aguiar, A. L. O. (2013). Avaliação clínica e evolutiva de crianças em programa de ate. Rev Paul Pediatr, 31 (2), 152-8. 10.1590/S0103-05822013000200004.

Barros, K.V. et al. (2017). Evidence for Involvement of IL-9 and IL-22 in Cows' Milk Allergy in Infants. Nutrients, 9 (1040), 1-10. 10.3390/nu9101048.

Berni, R. et al. (2015). Differences in DNA methylation profile of Th1and Th2 cytokine genes are associated with tolerance acquisition in children with IgE-mediated cow's milk allergy. Clin Epigenet. 7 (1), 1-9. 10.1186/s13148-015-0070-8.

Berni, R.et al. (2016). Lactobacillus rhamnosus GG supplemented formula expands butyrate producing bacterial strains in food allergic infants. ISME J.10 (1), 742-750. 10.1038/ismej.2015.151.

Brasil (2008). Associação Brasileira de Alergia e Imunopatologia. Consenso brasileiro sobre alergia alimentar: 2007. Revista Brasileira de Alergia e Imunologia, 31 (2), 64-89.

Brasil (2018). Associação Brasileira de Alergia e Imunopatologia. Consenso brasileiro sobre alergia alimentar: 2007. Arquivos de Asma, Alergia e Imunologia, 2 (1), 39-82.

Boettcher, E. & Crowe, S. E. (2013). Dietary proteins and functional gastrointestinal disorders. Am J Gastroenterol.108 (5), 728-36. 10.1038/ajg.2013.97.

Caetano, M. C., Ortiz, T.T., Silva, S. G. L., Souza F. I. S. & Sarni, R. O. S. (2010). Alimentação complementar: práticas inadequadas em lactentes. J. Pediatr., 86 (3), 196-201. 10.5123/S1679-49742015000300012.

Canani, R.B. et al. (2017). Extensively hydrolyzed casein formula containing Lactobacillus rhamnosus GG reduces the occurrence of other allergic manifestations in children with cow’s milk allergy: 3-year randomized controlled trial. J allergy clin immunol., 139 (6), 1906-1914. 10.1016/j.jaci.2016.10.050.

Candy, D. C. A., et al. (2018). A synbiotic-containing amino-acid-based formula improves gut microbiota in non-IgE-mediated allergic infants. Pediatr Res., 83 (3), 677-686.10.1038/pr.2017.270.

Dupont, C., Bradatan, E., Soulaine, P., Nocerino, R. & Berni-Canani, R. (2016). Tolerance and growth in children with cow’s milk allergy fed a thickened extensively hydrolyzed casein-based formula. BMC Pediatrics. 16 (96), 1-8. 10.1186/s12887-016-0637-3.

Dupont C., Hol J. & Nieuwenhuis E. E.S. (2015). An extensively hydrolysed casein-based formula for infants with cows’ milk protein allergy: tolerance/hypo-allergenicity and growth catch-up. British Journal of Nutrition.113 (1), 1102–1112. 10.1017/S000711451500015X.

Delgado, A. F., Cardoso, A. L. & Zamberlan, P. (2010). Nutrologia básica e avançada. 1. ed. São Paulo: Manole.

Dupont, C. et al. (2011). Dietary treatment of cows’ milk protein allergy in childhood: a commentary by the Committee on Nutrition of the French Society of Paediatrics. Br J Nutr, 107 (1), 325-338. 10.1017/S0007114511004831.

Eloe-Fadrosh, E. A. et al. (2015). Functional dynamics of the gut microbiome in elderly people during probiotic consumption. MBio,1 (1), 6. 10.1128/mBio.00231-15.

Ferreira, C. T. & Seidman, E. (2007). Alergia alimentar: atualização prática do ponto de vista gastroenterológico. Jornal de Pediatria, 83 (1), 7-20. 10.1590/S0021-75572007000100004.

Fiocchi, A., et al. (2010). World Allergy Organization (WAO) diagnosis and rationale for action against cow’s milk allergy (DRACMA) Guidelines. World Allergy Organ J. 3 (4), 57–161. 10.1097/WOX.0b013e3181defeb9.

Gourbeyre, P., Denery, S.& Bodinier, M. (2011). Probióticos, prebióticos e simbióticos: Impacto no sistema imunológico do intestino e reações alérgicas. J. Leukoc. Biol., 89 (1), 685–695. 10.1590/S0103-05822010000100014.

Harvey, B. M., Eussen, S. R. B. N., Harthoorn, L. F. & Burks, A. W. (2017). Mineral Intake and Status of Cow’s Milk Allergic Infants Consuming an Amino Acid-based Formula. Short communication: nutrition, 65 (3), 346-340. 10.1097/MPG.0000000000001655.

Hill, C. et al. (2014). Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat. Rev Gastroenterol Hepatol, 11 (8), 506-14. 10.1038/nrgastro.2014.66.

Host, A. & Halken, S. (2014). Cow's milk allergy: where have we come from and where are we going? Endocr Metab Immune Disord Drug Targets., 14 (1), 2-8. 10.2174/1871530314666140121142900.

Koletzko, S. et al. (2012). Diagnostic approach and management of cow’s milk protein allergy in infants and children: ESPGHAN GI Committee pratical guidelines. Journal of Pediatric Gastroenterology and Nutrition, 55 (1), 221-229. 10.1097/MPG.0b013e31825c9482.

Kemp, A. S., et al. (2008). Guidelines for the use of infant formulas to treat cows milk protein allergy: an Australian consensus panel opinion. Med J Aust.188,109-12. 10.5694/j.1326-5377.2008.tb01534.x.

Lebeer S. et al. (2012). Functional analysis of Lactobacillus rhamnosus GG pili in relation to adhesion and immunomodulatory interactions with intestinal epithelial cells. Appl Environ Microbiol.78 (1), 185–193. 10.1128/AEM.06192-11.

London (2002). Milton Keynes Primary Care Trust. Critical Appraisal Skills Programme. London: Oxford.

Manuyakorn, W. & Tanpowpong, P. (2019). Cow milk protein allergy and other common food allergies and intolerances. Paediatr Int Child Health., 39 (1), 32-40. 10.1080/20469047.2018.1490099.

Mcbride, D. et al., (2012). The EuroPrevall birth cohort study on food allergy: baseline characteristics of 12,000 newborns and their families from nine European countries, Pediatr Allergy Immunol.,23(1), 230-239. 10.1111/j.1399-3038.2011.01254.x.

Paparo, L., et al., (2016). Epigenetic features of FoxP3 in children with cow's milk allergy. Clin Epigenetics.8 (86), 1-8. 10.1186/s13148-016-0252-z.

Petschow, B.W. et al., (2015). Effects of feeding an infant formula containing Lactobacillus GG on the colonization of the intestine: a dose-response study in healthy infants. J Clin Gastroenterol., 39 (1), 86–790, 10.1097/01.mcg.0000177245.53753.86.

Pereira, P. B. & Silva, C. P. (2008). Alergia a proteína do leite de vaca em crianças: repercussões da dieta de exclusão e da dieta substitutiva sobre o estado nutricional. Revista Pediatria, 30 (2), 100-106.

Reche, M. et al., (2010). O efeito de uma fórmula parcialmente hidrolisada à base de proteína de arroz no tratamento de bebês com alergia à proteína do leite de vaca. Pediatr Allergy Immunol. 21(4), 577-85.

Rioux, K.P. et al. (2005). O papel da microflora entérica na doença inflamatória do intestino: Estudos em humanos e animais com probióticos e prebióticos. Gastroenterol. Clin. N. Am., 34 (1), 465–482.

Skripak, J.M. et al. (2007). The natural history of IgE-mediated cow's milk allergy. J Allergy Clin Immunol., 1 (1), 120. 10.1016/j.jaci.2007.08.023.

Savage, J. & Johns, C. B. (2014). Food allergy: epidemiology and natural history. Immunol. Allergy Clin. North Am., 35 (1), 45–59.

1016/j.iac.2014.09.004.

Scalabrin, D., Harris, C., Johnston, W.H. & Berseth, C. L. (2017). Long-term safety assessment in children who received hydrolyzed protein formulas with Lactobacillus rhamnosus GG: a 5-year follow-up. Eur J Pediatr., 176 (2), 217-224. 10.1007/s00431-016-2825-4.

Vandenplas, Y. et al. (2007). Guidelines for the diagnosis and management of cow’s milk protein allergy in infants. Arch Dis Child. 92, 902-908, 10.1136/adc.2006.110999.

Vandenplas, Y., De Greef, E. & Hauser, B. (2014). Safety and tolerance of a new extensively hydrolyzed rice protein-based formula in the management of infants with cow’s milk protein allergy. Eur J Pediatr.173 (1),1209–1216. 10.1007/s00431-014-2308-4.

Vandenplas Y. et al. (2015). Extensive protein hydrolysate formula effectively reduces regurgitation in infants with positive and negative challenge tests for cow's milk allergy. Acta Paediatr.104, 449–457. 10.1111/apa.12615.

Venter, C., & Arshad, S. H.(2011). Epidemiology of food allergy. Pediatr. Clin. N. Am., 58 (1), 327–349. /10.1016/j.pcl.2011.02.011.

Yonamine, G. H. et al., (2011). Uso de fórmulas à base de soja na alergia à proteína do leite de vaca. Revista Brasileira de Alergia e Imunopa, 34 (5),187-192.

Publicado

24/01/2022

Cómo citar

MOURA, R. C. de; COSTA, C. de M.; BRITO, M. M. de; SANTOS, M. A. P. dos; BRANDÃO, A. de C. A. S. .; FREITAS, B. de J. e S. de A.; PAIVA, A. de A. El efecto de las fórmulas nutricionales utilizadas en el tratamiento de niños con alergia a las proteínas de leche de vaca: una revisión sistemática. Research, Society and Development, [S. l.], v. 11, n. 2, p. e26511225594, 2022. DOI: 10.33448/rsd-v11i2.25594. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/25594. Acesso em: 27 jul. 2024.

Número

Sección

Revisiones