Fecal Calprotectin in Self-Reported Milk Intolerance: Not Only Lactose Intolerance.

Content Provider	Europe PMC
Author	Seidita, Aurelio Mansueto, Pasquale Giuliano, Alessandra Chiavetta, Marta Soresi, Maurizio Carroccio, Antonio
Editor	Allen, Stephen J.
Copyright Year	2023
Abstract	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 (p < 0.0001, for both) and absolute values (p = 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.
Journal	Nutrients
Volume Number	15
PubMed Central reference number	PMC9962554
Issue Number	4
PubMed reference number	36839406
e-ISSN	20726643
DOI	10.3390/nu15041048
Language	English
Publisher	MDPI
Publisher Date	2023-02-20
Access Restriction	Open
Rights License	Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). © 2023 by the authors.
Subject Keyword	milk intolerance lactose intolerance fecal calprotectin cow’s milk proteins allergy LHBT lactose hydrogen breath test SRMI
Content Type	Text
Resource Type	Article
Subject	Food Science Nutrition and Dietetics