Skip to main content

Immune Basis of Food Protein-Induced Enterocolitis Syndrome

  • Chapter
  • First Online:
Food Protein Induced Enterocolitis (FPIES)

Abstract

Food protein-induced enterocolitis syndrome, or FPIES, is a non-IgE-mediated food allergy that presents in infancy and is outgrown in most but not all individuals in the first few years of life. It has commonly been referred to as a cell-mediated food allergy, but the pathophysiology of the disease remains difficult to explain, and there is a lack of conclusive evidence for a role of antigen-specific humoral or cellular immunity in FPIES. However, it is clearly an inflammatory disease triggered by specific foods. In this chapter, the evidence for an immune basis of FPIES will be reviewed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 69.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 89.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 119.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Powell GK. Milk- and soy-induced enterocolitis of infancy. Clinical features and standardization of challenge. J Pediatr. 1978;93(4):553–60.

    Article  CAS  Google Scholar 

  2. Sicherer SH, Eigenmann PA, Sampson HA. Clinical features of food protein-induced enterocolitis syndrome. J Pediatr. 1998;133(2):214–9.

    Article  CAS  Google Scholar 

  3. Wada T, Toma T, Muraoka M, Matsuda Y, Yachie A. Elevation of fecal eosinophil-derived neurotoxin in infants with food protein-induced enterocolitis syndrome. Pediatr Allergy Immunol. 2014;25:617–9.

    PubMed  Google Scholar 

  4. Wada T, Matsuda Y, Toma T, Koizumi E, Okamoto H, Yachie A. Increased CD69 expression on peripheral eosinophils from patients with food protein-induced enterocolitis syndrome. Int Arch Allergy Immunol. 2016;170(3):201–5.

    Article  CAS  Google Scholar 

  5. Goswami R, Blazquez AB, Kosoy R, Rahman A, Nowak-Wegrzyn A, Berin MC. Systemic innate immune activation in food protein-induced enterocolitis syndrome. J Allergy Clin Immunol. 2017;139:1885.

    Article  CAS  Google Scholar 

  6. Caubet JC, Bencharitiwong R, Ross A, Sampson HA, Berin MC, Nowak-Wegrzyn A. Humoral and cellular responses to casein in patients with food protein-induced enterocolitis to cow's milk. J Allergy Clin Immunol. 2016;139:572.

    Article  Google Scholar 

  7. Kimura M, Ito Y, Shimomura M, et al. Cytokine profile after oral food challenge in infants with food protein-induced enterocolitis syndrome. Allergol Int. 2017;66(3):452–7.

    Article  CAS  Google Scholar 

  8. Kimura M, Ito Y, Tokunaga F, et al. Increased C-reactive protein and fever in Japanese infants with food protein-induced enterocolitis syndrome. Pediatr Int. 2016;58(9):826–30.

    Article  CAS  Google Scholar 

  9. Kimura M, Shimomura M, Morishita H, Meguro T, Seto S. Serum C-reactive protein in food protein-induced enterocolitis syndrome versus food protein-induced proctocolitis in Japan. Pediatr Int. 2016;58(9):836–41.

    Article  CAS  Google Scholar 

  10. Pecora V, Prencipe G, Valluzzi R, et al. Inflammatory events during food protein-induced enterocolitis syndrome reactions. Pediatr Allergy Immunol. 2017;28(5):464–70.

    Article  Google Scholar 

  11. Shimomura M, Ito Y, Tanaka H, Meguro T, Kimura M. Increased serum cortisol on oral food challenge in infants with food protein-induced enterocolitis syndrome. Pediatr Int. 2018;60(1):13–8.

    Article  CAS  Google Scholar 

  12. Nomura I, Morita H, Hosokawa S, et al. Four distinct subtypes of non-IgE-mediated gastrointestinal food allergies in neonates and infants, distinguished by their initial symptoms. J Allergy Clin Immunol. 2011;127(3):685–688 e681-688.

    Article  CAS  Google Scholar 

  13. Nomura I, Morita H, Ohya Y, Saito H, Matsumoto K. Non-IgE-mediated gastrointestinal food allergies: distinct differences in clinical phenotype between Western countries and Japan. Curr Allergy Asthma Rep. 2012;12(4):297–303.

    Article  CAS  Google Scholar 

  14. Caubet JC, Ford LS, Sickles L, et al. Clinical features and resolution of food protein-induced enterocolitis syndrome: 10-year experience. J Allergy Clin Immunol. 2014;134(2):382–9.

    Article  Google Scholar 

  15. Duffey H, Egan M. Development of Food Protein-Induced Enterocolitis Syndrome (FPIES) to egg following Immunoglobulin E (IgE)-mediated egg allergy. Ann Allergy Asthma Immunol. 2018;121:379.

    Article  CAS  Google Scholar 

  16. Barni S, Mori F, Bianchi A, Pucci N, Novembre E. Shift from IgE-mediated cow's milk allergy to food protein-induced enterocolitis syndrome in 2 infants. Pediatr Allergy Immunol. 2018;29(4):446–7.

    Article  Google Scholar 

  17. McDonald PJ, Goldblum RM, Van Sickle GJ, Powell GK. Food protein-induced enterocolitis: altered antibody response to ingested antigen. Pediatr Res. 1984;18(8):751–5.

    Article  CAS  Google Scholar 

  18. Konstantinou GN, Ramon B, Grishin A, et al. The role of casein-specific IgA and TGF-beta in children with Food Protein-Induced Enterocolitis Syndrome to milk. Pediatr Allergy Immunol. 2014;25:651.

    Article  Google Scholar 

  19. Shek LPC, Bardina L, Castro R, Sampson HA, Beyer K. Humoral and cellular responses to cow milk proteins in patients with milk-induced IgE-mediated and non-IgE-mediated disorders. Allergy. 2005;60(7):912–9.

    Article  CAS  Google Scholar 

  20. Van Sickle GJ, Powell GK, McDonald PJ, Goldblum RM. Milk- and soy protein-induced enterocolitis: evidence for lymphocyte sensitization to specific food proteins. Gastroenterology. 1985;88(6):1915–21.

    Article  Google Scholar 

  21. Hoffman KM, Ho DG, Sampson HA. Evaluation of the usefulness of lymphocyte proliferation assays in the diagnosis of allergy to cow's milk. J Allergy Clin Immunol. 1997;99(3):360–6.

    Article  CAS  Google Scholar 

  22. Morita H, Nomura I, Orihara K, et al. Antigen-specific T-cell responses in patients with non-IgE-mediated gastrointestinal food allergy are predominantly skewed to T(H)2. J Allergy Clin Immunol. 2013;131(2):590–592 e591-596.

    Article  CAS  Google Scholar 

  23. Berin MC, Grishin A, Masilamani M, et al. Egg-specific IgE and basophil activation but not egg-specific T cells correlate with phenotypes of clinical egg allergy. J Allergy Clin Immunol. 2018;142:149.

    Article  CAS  Google Scholar 

  24. Chiang D, Chen X, Jones SM, et al. Single-cell profiling of peanut-responsive T cells in patients with peanut allergy reveals heterogeneous effector TH2 subsets. J Allergy Clin Immunol. 2018;141(6):2107–20.

    Article  CAS  Google Scholar 

Download references

Acknowledgments

Thanks to Ms. Lisette Peres for research assistance in the preparation of this manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. Cecilia Berin .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Berin, M.C. (2019). Immune Basis of Food Protein-Induced Enterocolitis Syndrome. In: Brown-Whitehorn, T., Cianferoni, A. (eds) Food Protein Induced Enterocolitis (FPIES). Springer, Cham. https://doi.org/10.1007/978-3-030-21229-2_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-21229-2_3

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-21228-5

  • Online ISBN: 978-3-030-21229-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics