Fecal Calprotectin in Self-Reported Milk Intolerance: Not Only Lactose Intolerance
The hypothesis is that inflammatory/allergic conditions should be considered in self-reported milk intolerance (SRMI) patients who test negative and/or are asymptomatic at Lactose Hydrogen Breath Test (LHBT). We analyzed fecal calprotectin (FCP) values in SRMI patients to investigate the frequency o...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-02-01
|
| Series: | Nutrients |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6643/15/4/1048 |
| _version_ | 1797618870600597504 |
|---|---|
| author | Aurelio Seidita Pasquale Mansueto Alessandra Giuliano Marta Chiavetta Maurizio Soresi Antonio Carroccio the Internal Medicine Study Group |
| author_facet | Aurelio Seidita Pasquale Mansueto Alessandra Giuliano Marta Chiavetta Maurizio Soresi Antonio Carroccio the Internal Medicine Study Group |
| author_sort | Aurelio Seidita |
| collection | DOAJ |
| description | The hypothesis is that inflammatory/allergic conditions should be considered in self-reported milk intolerance (SRMI) patients who test negative and/or are asymptomatic at Lactose Hydrogen Breath Test (LHBT). We analyzed fecal calprotectin (FCP) values in SRMI patients to investigate the frequency of a “positive” intestinal inflammation marker and its correlation with lactose tolerance/intolerance. Data from 329 SRMI patients were retrospectively analyzed; according to the positive/negative results (maldigester/digester) and the presence/absence of symptoms reported during LHBT (intolerant/tolerant), patients were divided into: ‘lactose tolerants’ (n. 104), ‘maldigesters/intolerants’ (n. 187), ‘digesters/intolerants’ (n. 38). FCP values were analyzed in all three subgroups. A percentage of SRMI patients complained of constipation (>15%), extraintestinal symptoms (>30% including anemia), multiple food hypersensitivity (7.6%) and had intraepithelial lymphocytic infiltration at duodenal biopsy (>50%). Over 50.0% showed FCP values above the normal limit. Lactose tolerants and maldigesters/intolerants had higher positivity frequencies (<i>p</i> < 0.0001, for both) and absolute values (<i>p</i> = 0.04, for maldigesters/intolerants) of FCP compared to digesters/intolerants. FCP was not useful to differentiate tolerant from intolerant subjects (AUC 0.58). Our data suggest the existence of an allergic/inflammatory pathogenetic mechanism in a subset of SRMI subjects. FCP results are in keeping with this hypothesis, even if they cannot differentiate lactose tolerant from intolerant patients. |
| first_indexed | 2024-03-11T08:18:41Z |
| format | Article |
| id | doaj.art-2e8cf7eedf1d435997cae60b993a509b |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-11T08:18:41Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-2e8cf7eedf1d435997cae60b993a509b2023-11-16T22:32:31ZengMDPI AGNutrients2072-66432023-02-01154104810.3390/nu15041048Fecal Calprotectin in Self-Reported Milk Intolerance: Not Only Lactose IntoleranceAurelio Seidita0Pasquale Mansueto1Alessandra Giuliano2Marta Chiavetta3Maurizio Soresi4Antonio Carroccio5the Internal Medicine Study GroupUnit of Internal Medicine, “V. Cervello” Hospital, Ospedali Riuniti “Villa Sofia-Cervello”, 90120 Palermo, ItalyUnit of Internal Medicine, Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, ItalyUnit of Internal Medicine, “V. Cervello” Hospital, Ospedali Riuniti “Villa Sofia-Cervello”, 90120 Palermo, ItalyUnit of Internal Medicine, “V. Cervello” Hospital, Ospedali Riuniti “Villa Sofia-Cervello”, 90120 Palermo, ItalyUnit of Internal Medicine, Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, ItalyUnit of Internal Medicine, “V. Cervello” Hospital, Ospedali Riuniti “Villa Sofia-Cervello”, 90120 Palermo, ItalyThe hypothesis is that inflammatory/allergic conditions should be considered in self-reported milk intolerance (SRMI) patients who test negative and/or are asymptomatic at Lactose Hydrogen Breath Test (LHBT). We analyzed fecal calprotectin (FCP) values in SRMI patients to investigate the frequency of a “positive” intestinal inflammation marker and its correlation with lactose tolerance/intolerance. Data from 329 SRMI patients were retrospectively analyzed; according to the positive/negative results (maldigester/digester) and the presence/absence of symptoms reported during LHBT (intolerant/tolerant), patients were divided into: ‘lactose tolerants’ (n. 104), ‘maldigesters/intolerants’ (n. 187), ‘digesters/intolerants’ (n. 38). FCP values were analyzed in all three subgroups. A percentage of SRMI patients complained of constipation (>15%), extraintestinal symptoms (>30% including anemia), multiple food hypersensitivity (7.6%) and had intraepithelial lymphocytic infiltration at duodenal biopsy (>50%). Over 50.0% showed FCP values above the normal limit. Lactose tolerants and maldigesters/intolerants had higher positivity frequencies (<i>p</i> < 0.0001, for both) and absolute values (<i>p</i> = 0.04, for maldigesters/intolerants) of FCP compared to digesters/intolerants. FCP was not useful to differentiate tolerant from intolerant subjects (AUC 0.58). Our data suggest the existence of an allergic/inflammatory pathogenetic mechanism in a subset of SRMI subjects. FCP results are in keeping with this hypothesis, even if they cannot differentiate lactose tolerant from intolerant patients.https://www.mdpi.com/2072-6643/15/4/1048milk intolerancelactose intolerancefecal calprotectincow’s milk proteins allergyLHBTlactose hydrogen breath test |
| spellingShingle | Aurelio Seidita Pasquale Mansueto Alessandra Giuliano Marta Chiavetta Maurizio Soresi Antonio Carroccio the Internal Medicine Study Group Fecal Calprotectin in Self-Reported Milk Intolerance: Not Only Lactose Intolerance Nutrients milk intolerance lactose intolerance fecal calprotectin cow’s milk proteins allergy LHBT lactose hydrogen breath test |
| title | Fecal Calprotectin in Self-Reported Milk Intolerance: Not Only Lactose Intolerance |
| title_full | Fecal Calprotectin in Self-Reported Milk Intolerance: Not Only Lactose Intolerance |
| title_fullStr | Fecal Calprotectin in Self-Reported Milk Intolerance: Not Only Lactose Intolerance |
| title_full_unstemmed | Fecal Calprotectin in Self-Reported Milk Intolerance: Not Only Lactose Intolerance |
| title_short | Fecal Calprotectin in Self-Reported Milk Intolerance: Not Only Lactose Intolerance |
| title_sort | fecal calprotectin in self reported milk intolerance not only lactose intolerance |
| topic | milk intolerance lactose intolerance fecal calprotectin cow’s milk proteins allergy LHBT lactose hydrogen breath test |
| url | https://www.mdpi.com/2072-6643/15/4/1048 |
| work_keys_str_mv | AT aurelioseidita fecalcalprotectininselfreportedmilkintolerancenotonlylactoseintolerance AT pasqualemansueto fecalcalprotectininselfreportedmilkintolerancenotonlylactoseintolerance AT alessandragiuliano fecalcalprotectininselfreportedmilkintolerancenotonlylactoseintolerance AT martachiavetta fecalcalprotectininselfreportedmilkintolerancenotonlylactoseintolerance AT mauriziosoresi fecalcalprotectininselfreportedmilkintolerancenotonlylactoseintolerance AT antoniocarroccio fecalcalprotectininselfreportedmilkintolerancenotonlylactoseintolerance AT theinternalmedicinestudygroup fecalcalprotectininselfreportedmilkintolerancenotonlylactoseintolerance |