Summary
The effect of diet on the development of immunoallergic signs and symptoms in children with phenylketonuria (PKU) was evaluated. Immunological indices of 58 children with PKU treated with diets were compared to the immunological indices of 58 healthy (non-PKU) children. In the PKU group, 39 children had been placed on diet therapy within the first month of life; 19 children had been placed on diet therapy after 6 months of age. Total circulating lymphocytes; CD3+, CD4+, CD8+ circulating lymphocytes; and serum IgA, IgM, IgG and total IgE levels were measured for each child. Skin prick tests were performed for common inhalant and food allergens. Every 3 months over the 2-year period of this study, the signs and symptoms of eczema, allergic rhinitis and asthma were recorded.
The PKU group had lower IgG levels (p=0.004) and higher total IgE levels (p=0.0001) than the control group. Significantly lower IgE levels were found in children started on diet therapy within the first month of life compared with those started on diet therapy after 6 months of age (p=0.0001). Allergic sensitization was significantly more frequent in the PKU group (24/58 vs 13/58,z=2.00,p<0.05), but no significant difference in the incidence of eczema and allergic rhinitis was found. Asthma was less frequent in the PKU group than in the control group (5/58 vs 14/58,z=2.09,p<0.05). Thus, diet appeared to prevent the development of immunoallergic signs and symptoms.
Similar content being viewed by others
References
Abba IT, Allen RJ, Vanselow NA (1966) Immunologic responsiveness in phenylketonuria.J Am Med Assoc 198: 1185–1188.
Berkel WR (1991) The history of nutritional immunology.J Nutr Immunol 1: 1–12.
Blaese RM, Strober W, Brown RS, Waldmann TA (1975) Immunodeficiency in the Wiskott-Aldrich syndrome. In Bergsma D, ed.Birth Defects: Immunodeficiency in Man and Animals. Sunderland, MA: The National Foundation-March of Dimes, Sinauer Associates XI-1, 250–279.
Bounous G, Kongshavn P (1978) The effect of dietary aminoacids on immune reactivity.Immunology 35: 257–261.
Buckley RH, Becker WG (1978) Abnormalities in the regulation of human IgE system.Immunol Rev 41: 288–314.
Chandra RK (1991) Nutrition and immunology. Lessons from the past and visions of the future.Am J Clin Nutr 53: 1087–1101.
Chandra RK (1992) Protein-energy malnutrition and immunological responses.J Nutr 122: 597–600.
Dilella AG, Woo SLC (1987) Molecular basis of phenylketonuria and its clinical applications.Mol Biol Med 4: 183–188.
Dockhorn RJ (1970) Milk allergy in an infant with phenylketonuria.Ann Allergy 28: 33–35.
Galli C, Agostoni C, Mosconi C, Riva E, Salari PC, Giovannini M (1991) Reduced plasma C-20 and C-22 polyunsaturated fatty acids in children with phenylketonuria during dietary intervention.J Pediatr 114: 562–567.
Gershoff SN, Gill TJ, Simoian SG (1968) Some effects of aminoacid deficiency on antibody formation in rats.J Nutr 95: 184–187.
Giovannini M, Agostoni C, Galluzzo C, Beleu' R, Ortisi MT, Riva E (1988) Low serum concentrations of immunoglobulin G, A and M in children on low antigenic charge diets.Acta Paediatr Scand 77: 306.
Guttler F (1984) Phenylketonuria: 50 years since Folling's discovery and still expanding our clinical and biochemical knowledge.Acta Paediatr Scand 73: 705–716.
Kenney MA, Magee JL (1970) Dietary aminoacids and immune response in rats.J Nutr 100: 1063–1068.
Kotylo PK, Sample RB, Redmond NL, Hibner GC (1991) Reference ranges for lymphocyte subsets. A comparison of standard vs rapid whole-blood lysis techniques.Arch Pathol Lab Med 115: 181–184.
Lands WEM (1986) Renewed questions about polyunsaturated fatty acids.Nutr Res 189–195.
Ouchterlony O, Nilsson LA (1978) Immunodiffusion and immunoelectrophoresis. In Weir DM, ed.Handbook of Experimental Immunology. Oxford: Blackwell, 13–30.
Passwell J, Gazit E, Modam M, Lilos P, Cohen BE (1976) Immunologic studies in phenylketonuria.Acta Paediatr Scand 65: 673–690.
Reinhold U, Pawelec C, Wehrmann W, Herold M, Wernet P, Dreysel HW (1988) Immunoglobulin E and immunoglobulin G subclass distribution in vivo and relationship to in vitro generation of interferon gamma and neopterin in patients with severe atopic dermatitis.Int Arch Allergy Appl Immunol 87: 120–126.
Rey F, Munnich A, Lyonnet S, Rey J (1987) Classification et heterogeneité des hyperphenylalaninemies liées à un deficit en phenylalanine-hydroxilase.Arch Fr Pediatr 639–644.
Rosen FS, Wedgwood RJ, Eibl M, et al (1986) Primary immunodeficiency diseases.Clin Immunol Immunopathol 40: 166–175.
Savilahti E, Salmenpera L, Tainio VM, Halme H, Perheentupa J, Siimes MA (1987) Prolonged exclusive breast-feeding results in low serum concentrations of immunoglobulin G, A and M.Acta Paediatr Scand L76: 1–6.
Scriver CR, Kaufman S, Woo SLC (1989) The hyperphenylalaninemias. In Scriver C, Beaudet AL, Sly WS, Valle D, eds.The Metabolic Basis of Inherited Disease, 6th edn. New York: McGraw-Hill, 495–546.
Shibasaki M, Tajima K, Morikawa A, Mitsuhashi M, Sumazaki R, Tokuyama K (1988) Relation between frequency of asthma and IgE antibody levels againstDermatophagoides farinae and total serum IgE levels in schoolchildren.J Allergy Clin Immunol 86–94.
SIAIC, Societa' Italiana di Allergologia ed Immunologia Clinica (1987) Memorandum sulla diagnostica delle allergopatie.Folia Allerg Immunol Clin 34: 389–403.
Tolokh OS, Kolganova NA, Apultsina ID, Lebedin I (1989) A case of atopic bronchial asthma associated with phenylketonuria.Ter Arkh 61: 127–128.
Zwetchenbaum JF (1990) Hypogammaglobulinaemia (clinical conference).Ann Allergy 65: 361–365.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Riva, E., Fiocchi, A., Agostoni, C. et al. PKU-related dysgammaglobulinaemia: The effect of diet therapy on IgE and allergic sensitization. J Inherit Metab Dis 17, 710–717 (1994). https://doi.org/10.1007/BF00712013
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00712013