{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T22:18:40Z","timestamp":1770502720541,"version":"3.49.0"},"reference-count":26,"publisher":"BMJ","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"published-print":{"date-parts":[[1973,6]]},"abstract":"<jats:p>The effect of cow's milk provocation on the immunoglobulins in the intestinal mucosa, intestinal juice, stool extracts, as well as on the levels of antibodies to cow's milk and beta-1C\/A in serum, was studied in 18 infants with the malabsorption syndrome. The infants improved on breast milk and were therefore suspected to be intolerant to cow's milk and challenged with it.<\/jats:p>\n               <jats:p>At the time of clinical relapse a marked and uniform increase in the numbers of IgA- and IgM-containing cells, 2\u00b74 times as many on the average as before challenge, was observed in the jejunal mucosa of eight reacting patients at nine provocations with cow's milk. There was no abnormality in the immunoglobulin-containing cells before challenge or in biopsy specimens taken shortly after the resumption of the elimination diet (breast milk). The clinical reaction was preceded by a pronounced rise in the IgA and IgM contents of stool extracts, and a rise in the titre of haemagglutinating antibodies and serum IgA, changes which subsided rapidly after withdrawal of cow's milk. There was no evidence that the reaction was IgE-mediated or complement-consuming.<\/jats:p>\n               <jats:p>In some of the 10 patients who tolerated cow's milk challenge clinically there was an increase in both IgA- and IgM-containing cells suggestive of a local immunological reaction although no clinical intolerance was provoked and other immunological signs were weak or absent. In other non-reacting patients no immunological reaction was noted. Therefore it is evident that cow's milk is the agent responsible for the strong local intestinal reaction coinciding with the clinical symptoms.<\/jats:p>","DOI":"10.1136\/gut.14.6.491","type":"journal-article","created":{"date-parts":[[2007,9,18]],"date-time":"2007-09-18T17:41:31Z","timestamp":1190137291000},"page":"491-501","source":"Crossref","is-referenced-by-count":78,"title":["Immunochemical study of the malabsorption syndrome with cow's milk intolerance"],"prefix":"10.1136","volume":"14","author":[{"given":"E.","family":"Savilahti","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1973,6,1]]},"reference":[{"key":"ref_1","first-page":"571","article-title":"The metabolism of different immunoglobulin classes in irradiated mice. V. Contribution of the gut to serum IgA levels in normal and irradiated mice","volume":"20","author":"Bazin, H.; Maldague, P.; Schonne, E.; Crabbe, P.A.; Bauldon, H.; Heremans, J.F.","year":"1971","unstructured":"Bazin, H., Maldague, P., Schonne, E., Crabbe, P. A., Bauldon, H., and Heremans, J. F. (1971). The metabolism of different immunoglobulin classes in irradiated mice. V. Contribution of the gut to serum IgA levels in normal and irradiated mice. Immunology, 20, 571-595.","journal-title":"Immunology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1084\/jem.93.2.107","article-title":"The adsorption of proteins on erythrocytes treated with tannic acid and subsequent hemagglutination by antiprotein sera","volume":"93","author":"Boyden, S.V.","year":"1951","unstructured":"Boyden, S. V. (1951). The adsorption of proteins on erythrocytes treated with tannic acid and subsequent hemagglutination by antiprotein sera. J. exp. Med., 93, 107-120.","journal-title":"J. exp. Med"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/S0022-3476(65)80119-6","article-title":"Malabsorption defect induced by ingestion of beta lactoglobulin","volume":"66","author":"Davidson, M.; Burnstine, R.C.; Kugler, M.M.; Bauer, C.H.","year":"1965","unstructured":"Davidson, M., Burnstine, R. C., Kugler, M. M., and Bauer, C. H. (1965). Malabsorption defect induced by ingestion of beta lactoglobulin. J. Pediat., 66, 545-554.","journal-title":"J. Pediat"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1016\/S0016-5085(19)33750-3","article-title":"Immunochemical studies of the serum, intestinal secretions and intestinal mucosa in patients with adult celiac disease and other forms of the celiac syndrome","volume":"59","author":"Douglas, A.P.; Crabb6, P.A.; Hobbs, J.R.","year":"1970","unstructured":"Douglas, A. P., Crabb6, P. A., and Hobbs, J. R. (1970). Immunochemical studies of the serum, intestinal secretions and intestinal mucosa in patients with adult celiac disease and other forms of the celiac syndrome. Gastroenterology, 59, 414-425.","journal-title":"Gastroenterology"},{"key":"ref_5","first-page":"1004","article-title":"Increased jejunal immunoglobulin synthesis in patients with nontropical sprue as measured by a solid phase immunoadsorption technique","volume":"79","author":"Falchuk, Z.M.; Strober, W.","year":"1972","unstructured":"Falchuk, Z. M., and Strober, W. (1972). Increased jejunal immunoglobulin synthesis in patients with nontropical sprue as measured by a solid phase immunoadsorption technique. J. Lab. clin. Med., 79, 1004-1013.","journal-title":"J. Lab. clin. Med"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1111\/j.1651-2227.1965.tb06352.x","article-title":"Cow's milk induced malabsorption as a precursor of gluten intolerance","volume":"54","author":"Fallstrom, S.P.; Winberg, J.; Andersen, H.J.","year":"1965","unstructured":"Fallstrom, S. P., Winberg, J., and Andersen, H. J. (1965). Cow's milk induced malabsorption as a precursor of gluten intolerance. Acta paediat. scand., 54, 101-115.","journal-title":"Acta paediat. scand"},{"key":"ref_7","first-page":"296","article-title":"The level of antibodies to the proteins of cow's milk in the serum of normal human infants","volume":"3","author":"Gunther, M.; Aschaffenburg, R.; Matthews, R.H.; Parish, W.E.; Coombs, R.R.A.","year":"1960","unstructured":"Gunther, M., Aschaffenburg, R., Matthews, R. H., Parish, W. E., and Coombs, R. R. A. (1960). The level of antibodies to the proteins of cow's milk in the serum of normal human infants. Immunology, 3, 296-306.","journal-title":"Immunology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1016\/S0022-3476(62)80192-9","article-title":"Precipitins to antigens of wheat and cow's milk in celiac disease","volume":"61","author":"Heiner, D.C.; Lahey, M.E.; Wilson, J.F.; Gerrard, J.W.; Shwachman, H.; Khaw, K.-T.","year":"1962","unstructured":"Heiner, D. C., Lahey, M. E., Wilson, J. F., Gerrard, J. W., Shwachman, H., and Khaw, K-T. (1962). Precipitins to antigens of wheat and cow's milk in celiac disease. J. Pediat., 61, 813-830.","journal-title":"J. Pediat"},{"key":"ref_9","first-page":"115","article-title":"Levels of the serum immunoglobulins VA, yG, and vM in the malabsorption syndrome in children","volume":"13","author":"Immonen, P.","year":"1967","unstructured":"Immonen, P. (1967). Levels of the serum immunoglobulins VA, yG, and vM in the malabsorption syndrome in children. Ann. Paediat. Fenn., 13, 115-153.","journal-title":"Ann. Paediat. Fenn"},{"key":"ref_10","first-page":"681","article-title":"ttude immuno-histochimique de la muquese intestinale chez 1'enfant. I. Les syndromes de malabsorption","volume":"29","author":"Jos, J.; Rey, J.; Frezal, J.","year":"1972","unstructured":"Jos, J., Rey, J., and Frezal, J. (1972). ttude immuno-histochimique de la muquese intestinale chez 1'enfant. I. Les syndromes de malabsorption. Arch. franC. Pddiat., 29, 681-698.","journal-title":"Arch. franC. Pddiat"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1159\/000230447","article-title":"Immune responses of normal infants to cow milk. I. Antibody type and kinetics of production","volume":"40","author":"Kletter, B.; Gery, I.; Freier, S.; Davies, A.M.","year":"1971","unstructured":"Kletter, B., Gery, I., Freier, S., and Davies, A. M. (1971). Immune responses of normal infants to cow milk. I. Antibody type and kinetics of production. Int. Arch. Allergy, 40, 656-666.","journal-title":"Int. Arch. Allergy"},{"key":"ref_12","first-page":"101","article-title":"Duodeno-jejunal histology in malabsorption syndrome in infants","volume":"12","author":"Kuitunen, P.","year":"1966","unstructured":"Kuitunen, P. (1966). Duodeno-jejunal histology in malabsorption syndrome in infants. Ann. Paediat. Fenn., 12, 101-132.","journal-title":"Ann. Paediat. Fenn"},{"key":"ref_13","first-page":"237","article-title":"Light and electronmicroscopic changes in the small intestinal mucosa in patients with cow's milk induced malabsorption syndrome","volume":"61","author":"Kuitunen, P.; Rapola, J.; Savilahti, E.; Visakorpi, J.K.","year":"1972","unstructured":"Kuitunen, P., Rapola, J., Savilahti, E., and Visakorpi, J. K. (1972). Light and electronmicroscopic changes in the small intestinal mucosa in patients with cow's milk induced malabsorption syndrome. Acta paediat. scand., 61, 237-238.","journal-title":"Acta paediat. scand"},{"key":"ref_14","first-page":"27","article-title":"Bovine milk protein induced intestinal malabsorption of lactose and fat in infants","volume":"54","author":"Liu-H-Y., Tsao; U., M.; Moore, B.; Giday, Z.","year":"1967","unstructured":"Liu-H-Y., Tsao, M. U., Moore, B., and Giday, Z. (1967). Bovine milk protein induced intestinal malabsorption of lactose and fat in infants. Gastroenterology, 54, 27-34.","journal-title":"Gastroenterology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1172\/JCI106525","article-title":"Incorporation of L-leucine-l\"C into immunoglobulins by jejunal biopsies of patients with celiac sprue and other gastrointestinal diseases","volume":"50","author":"Loeb, P.M.; Strober, W.; Falchuk, Z.M.; Laster, L.","year":"1971","unstructured":"Loeb, P. M., Strober, W., Falchuk, Z. M., and Laster, L. (1971). Incorporation of L-leucine-l\"C into immunoglobulins by jejunal biopsies of patients with celiac sprue and other gastrointestinal diseases. J. clin. Invest., 50, 559-569.","journal-title":"J. clin. Invest"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1016\/0019-2791(69)90191-8","article-title":"Studies of electroimmunodiffusion: immunochemical quantitation of proteins in dilute solutions","volume":"6","author":"Lopez, M.; Tsu, T.; Hyslop, Jr, N.E.","year":"1969","unstructured":"Lopez, M., Tsu, T., and Hyslop, N. E., Jr. (1969). Studies of electroimmunodiffusion: immunochemical quantitation of proteins in dilute solutions. Immunochemistry, 6, 513-526.","journal-title":"Immunochemistry"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1016\/0019-2791(65)90004-2","article-title":"Immunochemical quantitation of antigens by single radial immunodiffusion","volume":"2","author":"Mancini, G.; Carbonara, A.O.; Heremans, J.F.","year":"1965","unstructured":"Mancini, G., Carbonara, A. O., and Heremans, J. F. (1965). Immunochemical quantitation of antigens by single radial immunodiffusion. Immunochemistry, 2, 235-254.","journal-title":"Immunochemistry"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1016\/S0140-6736(70)92068-4","article-title":"Complement activation after milk feeding in children with cow's milk allergy","volume":"11","author":"Matthews, T.S.; Soothill, J.F.","year":"1970","unstructured":"Matthews, T. S., and Soothill, J. F. (1970). Complement activation after milk feeding in children with cow's milk allergy. Lancet, 11, 893-895.","journal-title":"Lancet"},{"key":"ref_19","first-page":"613","article-title":"Radioactive single radial diffusion: a method for increasing the sensitivity of immunochemical quantification of proteins in agar gel","volume":"40","author":"Rowe, D.S.","year":"1969","unstructured":"Rowe, D. S. (1969). Radioactive single radial diffusion: a method for increasing the sensitivity of immunochemical quantification of proteins in agar gel. Bull. Wld Hith Org., 40, 613-616.","journal-title":"Bull. Wld Hith Org"},{"key":"ref_20","first-page":"609","article-title":"A research standard for human serum immunoglobulin E","volume":"43","author":"Rowe, D.S.; Tackett, L.; Bennich, H.; Ishizaka, K.; Johansson, S.G.O.; Anderson, S.G.","year":"1970","unstructured":"Rowe, D. S., Tackett, L., Bennich, H., Ishizaka, K., Johansson, S. G. O., and Anderson, S. G. (1970). A research standard for human serum immunoglobulin E. Bull. Wld Hlth Org., 43, 609-611.","journal-title":"Bull. Wld Hlth Org"},{"key":"ref_21","article-title":"Immunoglobulin-containing cells in the intestinal mucosa and immunoglobulins in the intestinal juice in children","author":"Savilahti, E.","year":"1972","unstructured":"Savilahti, E. (1972a). Immunoglobulin-containing cells in the intestinal mucosa and immunoglobulins in the intestinal juice in children."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"958","DOI":"10.1136\/gut.13.12.958","article-title":"Intestinal immunoglobulins in children with coeliac disease","volume":"13","author":"Savilahti, E.","year":"1972","unstructured":"Savilahti, E. (1972b). Intestinal immunoglobulins in children with coeliac disease. Gut, 13, 958-964.","journal-title":"Gut"},{"key":"ref_23","first-page":"395","article-title":"IgA deficiency in children. Immunoglobulincontaining cells in the intestinal mucosa, immunoglobulins in secretions and serum IgA levels","volume":"13","author":"Savilahti, E.","year":"1973","unstructured":"Savilahti, E. (1973). IgA deficiency in children. Immunoglobulincontaining cells in the intestinal mucosa, immunoglobulins in secretions and serum IgA levels. Clin. exp. Immunol., 13, 395-406.","journal-title":"Clin. exp. Immunol"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1136\/adc.43.227.17","article-title":"Milk intolerance in infancy","volume":"43","author":"Silver, H.; Douglas, D.M.","year":"1968","unstructured":"Silver, H., and Douglas, D. M. (1968). Milk intolerance in infancy. Arch. Dis. Childh., 43, 17-22.","journal-title":"Arch. Dis. Childh"},{"key":"ref_25","first-page":"27","article-title":"Origin and molecular size of immunoglobulin-A in the mesenteric lymph of the dog","volume":"18","author":"Vaerman, J.P.; Heremans, J.F.","year":"1970","unstructured":"Vaerman, J. P., and Heremans, J. F. (1970). Origin and molecular size of immunoglobulin-A in the mesenteric lymph of the dog. Immunology, 18, 27-38.","journal-title":"Immunology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1111\/j.1651-2227.1967.tb15343.x","article-title":"Intolerance to cow's milk and wheat gluten in the primary malabsorption syndrome in infancy","volume":"56","author":"Visakorpi, J.K.; Immonen, P.","year":"1967","unstructured":"Visakorpi, J. K., and Immonen, P. (1967). Intolerance to cow's milk and wheat gluten in the primary malabsorption syndrome in infancy. Acta paediat. scand., 56, 49-56.","journal-title":"Acta paediat. scand"}],"container-title":["Gut"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/gut.14.6.491","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T05:38:56Z","timestamp":1757309936000},"score":1,"resource":{"primary":{"URL":"https:\/\/gut.bmj.com\/lookup\/doi\/10.1136\/gut.14.6.491"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1973,6]]},"references-count":26,"journal-issue":{"issue":"6","published-online":{"date-parts":[[1973,6,1]]},"published-print":{"date-parts":[[1973,6]]}},"alternative-id":["10.1136\/gut.14.6.491"],"URL":"https:\/\/doi.org\/10.1136\/gut.14.6.491","relation":{},"ISSN":["0017-5749","1468-3288"],"issn-type":[{"value":"0017-5749","type":"print"},{"value":"1468-3288","type":"electronic"}],"subject":[],"published":{"date-parts":[[1973,6]]}}}