{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T05:20:34Z","timestamp":1787462434796,"version":"build-2736575974"},"reference-count":77,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Union","doi-asserted-by":"crossref","award":["101087007\u2014eBio-hub"],"award-info":[{"award-number":["101087007\u2014eBio-hub"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"crossref"}]},{"award":["101087007\u2014eBio-hub"],"award-info":[{"award-number":["101087007\u2014eBio-hub"]}],"id":[{"id":"https:\/\/ror.org\/019w4f821","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int. J. Mol. Sci.","IJMS"],"abstract":"<jats:p>Non-IgE-mediated food allergy is characterized by delayed gastrointestinal manifestations and the absence of reliable non-invasive biomarkers. Increasing evidence suggests that gut microbiota may contribute to this disease pathogenesis. The aim of this study was to characterize the gut microbiome composition in thirty pediatric patients diagnosed with non-IgE-mediated food allergy, in comparison to fifteen healthy controls children, and to investigate its association with fecal calprotectin, eosinophil-derived neurotoxin (EDN) and IgA. Gut microbiota profiling was performed by 16S rRNA gene sequencing targeting the V3\u2013V4 region. Compared with healthy controls, higher mean relative abundances of Bacteroides, Faecalibacterium, Alistipes, Parabacteroides, and Sutterella were observed in patients. Conversely, healthy children showed higher mean relative abundances of Pseudobutyrivibrio, Roseburia, Bifidobacterium, Collinsella, Clostridium, Eubacterium, Streptococcus, and Barnesiella. Several genera (Escherichia\u2013Shigella, Agathobacter, and Enterococcus\/Streptococcus) were detected only in the allergy cohort. Shannon diversity was higher in patients compared to controls and in the subgroups of patients with elevated fecal calprotectin (p = 0.028), previous antibiotic exposure (p = 0.015), and atopic dermatitis (p = 0.021). Stratification according to inflammatory biomarkers identified a distinct inflammatory microbiome endotype characterized by increased fecal calprotectin and EDN together with enrichment of Veillonellaceae and depletion of Bifidobacteriaceae and Lachnospiraceae. Correlation analyses further revealed positive associations between Veillonella abundance and both fecal calprotectin and EDN. These findings suggest that pediatric non-IgE-mediated food allergy is characterized by distinct microbiome\u2013inflammation relationships rather than a single dysbiotic signature.<\/jats:p>","DOI":"10.3390\/ijms27167482","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T09:31:59Z","timestamp":1787304719000},"page":"7482","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Distinct Inflammation-Associated Microbiome Signatures in Pediatric Non-IgE-Mediated Food Allergy"],"prefix":"10.3390","volume":"27","author":[{"given":"Maria-Teodora","family":"Co\u0219oreanu","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Marie Curie Emergency Children\u2019s Hospital, 041451 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6384-1822","authenticated-orcid":false,"given":"Gratiela","family":"Gradisteanu Pircalabioru","sequence":"additional","affiliation":[{"name":"Faculty of Biology, University of Bucharest, 030018 Bucharest, Romania"},{"name":"eBio-Hub Centre of Excellence in Bioengineering, National University for Science and Technology, Politehnica Bucharest, 060042 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina-Oana","family":"Lixandru-Petre","sequence":"additional","affiliation":[{"name":"eBio-Hub Centre of Excellence in Bioengineering, National University for Science and Technology, Politehnica Bucharest, 060042 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9766-1558","authenticated-orcid":false,"given":"Mara-Ioana","family":"Ionescu","sequence":"additional","affiliation":[{"name":"Marie Curie Emergency Children\u2019s Hospital, 041451 Bucharest, Romania"},{"name":"Department of Physiology-Neurosciences, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8628-3352","authenticated-orcid":false,"given":"Andreea","family":"Ioan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Department of Clinical Immunology, National Institute for Mother and Child Health Alessandrescu-Rusescu, 020395 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3239-0704","authenticated-orcid":false,"given":"Eliza-Elena","family":"Cintez\u0103","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Marie Curie Emergency Children\u2019s Hospital, 041451 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicia","family":"Galo\u0219","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Marie Curie Emergency Children\u2019s Hospital, 041451 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"ref_1","first-page":"95","article-title":"Non-IgE Mediated Food Allergy","volume":"16","author":"Cianferoni","year":"2020","journal-title":"Curr. Pediatr. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1097\/MPG.0000000000003897","article-title":"An ESPGHAN Position Paper on the Diagnosis, Management, and Prevention of Cow\u2019s Milk Allergy","volume":"78","author":"Vandenplas","year":"2024","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e70060","DOI":"10.1111\/pai.70060","article-title":"An Update on the Diagnosis and Management of Non-IgE-Mediated Food Allergies in Children","volume":"36","author":"Meyer","year":"2025","journal-title":"Pediatr. Allergy Immunol."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Labrosse, R., Graham, F., and Caubet, J.-C. (2020). Non-IgE-Mediated Gastrointestinal Food Allergies in Children: An Update. Nutrients, 12.","DOI":"10.3390\/nu12072086"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1016\/j.jaci.2015.03.025","article-title":"Non\u2013IgE-Mediated Gastrointestinal Food Allergy","volume":"135","author":"Katz","year":"2015","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1111\/apa.13253","article-title":"Milk Allergy Is a Minor Cause of Milk Avoidance Due to Perceived Hypersensitivity Among Schoolchildren in N Orthern S Weden","volume":"105","author":"Winberg","year":"2016","journal-title":"Acta Paediatr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1549","DOI":"10.1542\/peds.2009-1210","article-title":"Food Allergy Among Children in the United States","volume":"124","author":"Branum","year":"2009","journal-title":"Pediatrics"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"431","DOI":"10.2147\/ITT.S284821","article-title":"Pathophysiology of Non-IgE-Mediated Food Allergy","volume":"10","author":"Zhang","year":"2021","journal-title":"ImmunoTargets Ther."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1097\/ACI.0000000000000644","article-title":"Microbiota in Non-IgE-Mediated Food Allergy","volume":"20","author":"Mennini","year":"2020","journal-title":"Curr. Opin. Allergy Clin. Immunol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"367","DOI":"10.3920\/BM2010.0027","article-title":"Early Life: Gut Microbiota and Immune Development in Infancy","volume":"1","author":"Martin","year":"2010","journal-title":"Benef. Microbes"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"666","DOI":"10.1016\/j.arcmed.2017.11.007","article-title":"Development of Microbiota in Infants and Its Role in Maturation of Gut Mucosa and Immune System","volume":"48","author":"Ximenez","year":"2017","journal-title":"Arch. Med. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1016\/j.immuni.2011.03.021","article-title":"Intestinal Bacterial Colonization Induces Mutualistic Regulatory T Cell Responses","volume":"34","author":"Geuking","year":"2011","journal-title":"Immunity"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Zhang, H., Zhang, Z., Liao, Y., Zhang, W., and Tang, D. (2022). The Complex Link and Disease Between the Gut Microbiome and the Immune System in Infants. Front. Cell. Infect. Microbiol., 12.","DOI":"10.3389\/fcimb.2022.924119"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"343ra82","DOI":"10.1126\/scitranslmed.aad7121","article-title":"Antibiotics, Birth Mode, and Diet Shape Microbiome Maturation During Early Life","volume":"8","author":"Bokulich","year":"2016","journal-title":"Sci. Transl. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"4785","DOI":"10.1038\/s41467-023-40336-4","article-title":"Delayed Gut Microbiota Maturation in the First Year of Life Is a Hallmark of Pediatric Allergic Disease","volume":"14","author":"Hoskinson","year":"2023","journal-title":"Nat. Commun."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/j.anpedi.2015.07.007","article-title":"Calprotectina fecal como apoyo al diagn\u00f3stico en la alergia a las prote\u00ednas de leche de vaca no IgE mediada","volume":"84","author":"Claros","year":"2016","journal-title":"An. Pediatr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"33","DOI":"10.4168\/aair.2014.6.1.33","article-title":"Can Fecal Calprotectin Level Be Used as a Markers of Inflammation in the Diagnosis and Follow-Up of Cow\u2019s Milk Protein Allergy?","volume":"6","author":"Sancak","year":"2014","journal-title":"Allergy Asthma Immunol. Res."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Calvani, M., Anania, C., Cuomo, B., D\u2019Auria, E., Decimo, F., Indirli, G.C., Marseglia, G., Mastrorilli, V., Sartorio, M.U.A., and Santoro, A. (2021). Non\u2013IgE- or Mixed IgE\/Non\u2013IgE-Mediated Gastrointestinal Food Allergies in the First Years of Life: Old and New Tools for Diagnosis. Nutrients, 13.","DOI":"10.3390\/nu13010226"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1016\/j.anai.2021.02.024","article-title":"Gastrointestinal Immunopathology of Food Protein-Induced Enterocolitis Syndrome and Other Non-Immunoglobulin E-Mediated Food Allergic Diseases","volume":"126","author":"Su","year":"2021","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Aparicio, M., Alba, C., Proctocolitis Study Group of CAM Public Health Area 6, Rodr\u00edguez, J.M., and Fern\u00e1ndez, L. (2020). Microbiological and Immunological Markers in Milk and Infant Feces for Common Gastrointestinal Disorders: A Pilot Study. Nutrients, 12.","DOI":"10.3390\/nu12030634"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1002\/jpn3.12155","article-title":"Gut Microbiota and Inflammatory Mediators Differentiate IgE Mediated and Non-IgE Mediated Cases of Cow\u2019s Milk Protein at Diagnosis","volume":"78","author":"Castro","year":"2024","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"113943","DOI":"10.1016\/j.isci.2025.113943","article-title":"Skin and Gut Microbiota Composition and Immune Regulatory Response Differentiate IgE and Non-IgE Cow\u2019s Milk Allergy Patients with Atopic Dermatitis","volume":"28","author":"Thon","year":"2025","journal-title":"iScience"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1111\/1471-0528.13601","article-title":"Impact of Maternal Intrapartum Antibiotics, Method of Birth and Breastfeeding on Gut Microbiota During the First Year of Life: A Prospective Cohort Study","volume":"123","author":"Azad","year":"2016","journal-title":"BJOG Int. J. Obstet. Gynaecol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"\u0141o\u015b-Rycharska, E., Go\u0142\u0119biewski, M., Sikora, M., Grzybowski, T., Gorzkiewicz, M., Popielarz, M., Gawryjo\u0142ek, J., and Krogulska, A. (2021). A Combined Analysis of Gut and Skin Microbiota in Infants with Food Allergy and Atopic Dermatitis: A Pilot Study. Nutrients, 13.","DOI":"10.3390\/nu13051682"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1016\/j.jaci.2016.03.041","article-title":"Early-Life Gut Microbiome Composition and Milk Allergy Resolution","volume":"138","author":"Bunyavanich","year":"2016","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Aldriwesh, M.G., Al-Mutairi, A.M., Alharbi, A.S., Aljohani, H.Y., Alzahrani, N.A., Ajina, R., and Alanazi, A.M. (2023). Paediatric Asthma and the Microbiome: A Systematic Review. Microorganisms, 11.","DOI":"10.3390\/microorganisms11040939"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.2147\/JAA.S521800","article-title":"Distinct Airway Microbiome and Metabolite Profiles in Eosinophilic and Neutrophilic Asthma","volume":"18","author":"Liu","year":"2025","journal-title":"J. Asthma Allergy"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1673","DOI":"10.1111\/jgh.15921","article-title":"The Microbiota in Eosinophilic Esophagitis: A Systematic Review","volume":"37","author":"Burns","year":"2022","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1053\/j.gastro.2019.11.294","article-title":"Differences in Gut Microbiota in Patients With vs. Without Inflammatory Bowel Diseases: A Systematic Review","volume":"158","author":"Pittayanon","year":"2020","journal-title":"Gastroenterology"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Haytoglu, Z., Ozcan, D., and Altintas, D.U. (2025). Gut Microbiota Differences in Infants with Cow-Milk-Induced Allergic Proctocolitis: A Comparative Cross-Sectional Study. Children, 12.","DOI":"10.3390\/children12060734"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"jjaf231.1532","DOI":"10.1093\/ecco-jcc\/jjaf231.1532","article-title":"P1351 Gut Microbiome Alterations in Pediatric Inflammatory Bowel Disease: Insights from a Pilot Study in Romania","volume":"20","author":"Ionescu","year":"2026","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"D\u00edaz, M., Guadamuro, L., Espinosa-Martos, I., Mancabelli, L., Jim\u00e9nez, S., Molinos-Norniella, C., P\u00e9rez-Solis, D., Milani, C., Rodr\u00edguez, J.M., and Ventura, M. (2018). Microbiota and Derived Parameters in Fecal Samples of Infants with Non-IgE Cow\u2019s Milk Protein Allergy Under a Restricted Diet. Nutrients, 10.","DOI":"10.3390\/nu10101481"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1136\/gutjnl-2012-303249","article-title":"Decreased Gut Microbiota Diversity, Delayed Bacteroidetes Colonisation and Reduced Th1 Responses in Infants Delivered by Caesarean Section","volume":"63","author":"Jakobsson","year":"2014","journal-title":"Gut"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1016\/j.jpeds.2014.09.041","article-title":"Intestinal Microbiota Development in Preterm Neonates and Effect of Perinatal Antibiotics","volume":"166","author":"Arboleya","year":"2015","journal-title":"J. Pediatr."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e3","DOI":"10.1016\/j.anai.2017.09.070","article-title":"P504 Comparison of the Gut Microbiome between Food Protein-Induced Enterocolitis Sydrome (FPIES) Infants and Allergy-Free Infants","volume":"119","author":"Boyer","year":"2017","journal-title":"Ann. Allergy. Asthma. Immunol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.jacig.2022.07.005","article-title":"Intestinal Microbiota Is Modified in Pediatric Food Protein-Induced Enterocolitis Syndrome","volume":"1","author":"Cenit","year":"2022","journal-title":"J. Allergy Clin. Immunol. Glob."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"102634","DOI":"10.1016\/j.clinre.2025.102634","article-title":"Trends in Food Protein-Induced Allergic Proctocolitis (FPIAP): Mechanisms and Treatment Targeting Gut Microbiome","volume":"49","author":"Liu","year":"2025","journal-title":"Clin. Res. Hepatol. Gastroenterol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1016\/j.jpeds.2009.09.012","article-title":"Lactobacillus GG Improves Recovery in Infants with Blood in the Stools and Presumptive Allergic Colitis Compared with Extensively Hydrolyzed Formula Alone","volume":"156","author":"Baldassarre","year":"2010","journal-title":"J. Pediatr."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1016\/j.jaci.2011.10.004","article-title":"Effect of Lactobacillus GG on Tolerance Acquisition in Infants with Cow\u2019s Milk Allergy: A Randomized Trial","volume":"129","author":"Nocerino","year":"2012","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1038\/pr.2017.270","article-title":"A Synbiotic-Containing Amino-Acid-Based Formula Improves Gut Microbiota in Non-IgE-Mediated Allergic Infants","volume":"83","author":"Candy","year":"2018","journal-title":"Pediatr. Res."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Anania, C., Mond\u00ec, F., Brindisi, G., Spagnoli, A., De Canditiis, D., Gesmini, A., Marchetti, L., Fichera, A., Piccioni, M.G., and Zicari, A.M. (2025). Fecal Calprotectin Determination in a Cohort of Children with Cow\u2019s Milk Allergy. Nutrients, 17.","DOI":"10.3390\/nu17010194"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Czaja-Bulsa, G., Bulsa, K., \u0141okie\u0107, M., and Drozd, A. (2024). Can Faecal Zonulin and Calprotectin Levels Be Used in the Diagnosis and Follow-Up in Infants with Milk Protein-Induced Allergic Proctocolitis?. Nutrients, 16.","DOI":"10.3390\/nu16172949"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1159\/000525961","article-title":"Fecal Calprotectin in Children with Cow\u2019s Milk Protein Allergy: A Systematic Review and Meta-Analysis","volume":"183","author":"Zhang","year":"2022","journal-title":"Int. Arch. Allergy Immunol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/2045-7022-4-8","article-title":"Markers of Gut Mucosal Inflammation and Cow\u2019s Milk Specific Immunoglobulins in non-IgE Cow\u2019s Milk Allergy","volume":"4","author":"Kolho","year":"2014","journal-title":"Clin. Transl. Allergy"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Czaja-Bulsa, G., \u0141okie\u0107, M., and Drozd, A. (2025). Can Faecal Eosinophil Cationic Protein and \u03b2-Defensin-2 Levels Be Useful in the Diagnosis and Follow-Up of Infants with Milk-Protein-Induced Allergic Proctocolitis?. Nutrients, 17.","DOI":"10.3390\/nu17172796"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1007\/s12519-020-00364-2","article-title":"Current Status of Fecal Calprotectin as a Diagnostic or Monitoring Biomarker for Cow\u2019s Milk Protein Allergy in Children: A Scoping Review","volume":"17","author":"Xiong","year":"2021","journal-title":"World J. Pediatr."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Roca, M., Donat, E., Rodriguez Varela, A., Carvajal, E., Cano, F., Armisen, A., Ekoff, H., Ca\u00f1ada-Mart\u00ednez, A.J., Rydell, N., and Ribes-Koninckx, C. (2021). Fecal Calprotectin and Eosinophil-Derived Neurotoxin in Children with Non-IgE-Mediated Cow\u2019s Milk Protein Allergy. J. Clin. Med., 10.","DOI":"10.3390\/jcm10081595"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Lendvai-Emmert, D., Emmert, V., Makai, A., Fusz, K., Pr\u00e9musz, V., Eklics, K., Sarl\u00f3s, P., T\u00f3th, P., Amrein, K., and T\u00f3th, G. (2022). Fecal Calprotectin Levels in Pediatric Cow\u2019s Milk Protein Allergy. Front. Pediatr., 10.","DOI":"10.3389\/fped.2022.945212"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Park, J.S., Cho, J.Y., Chung, C., Oh, S.H., Do, H., Seo, J.-H., Lim, J.Y., Park, C.-H., Woo, H.-O., and Youn, H.-S. (2020). Dynamic Changes of Fecal Calprotectin and Related Clinical Factors in Neonates. Front. Pediatr., 8.","DOI":"10.3389\/fped.2020.00326"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1515\/cclm-2012-0083","article-title":"Intestinal Permeability and Fecal Eosinophil-Derived Neurotoxin Are the Best Diagnosis Tools for Digestive Non-IgE-Mediated Cow\u2019s Milk Allergy in Toddlers","volume":"51","author":"Kalach","year":"2013","journal-title":"Clin. Chem. Lab. Med."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Rycyk, A., Cudowska, B., and Lebensztejn, D.M. (2020). Eosinophil-Derived Neurotoxin, Tumor Necrosis Factor Alpha, and Calprotectin as Non-Invasive Biomarkers of Food Protein-Induced Allergic Proctocolitis in Infants. J. Clin. Med., 9.","DOI":"10.3390\/jcm9103147"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1111\/pai.12254","article-title":"Elevation of Fecal Eosinophil-Derived Neurotoxin in Infants with Food Protein-Induced Enterocolitis Syndrome","volume":"25","author":"Wada","year":"2014","journal-title":"Pediatr. Allergy Immunol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1692","DOI":"10.1016\/j.jaip.2019.12.029","article-title":"Prospective Assessment of Pediatrician-Diagnosed Food Protein\u2013Induced Allergic Proctocolitis by Gross or Occult Blood","volume":"8","author":"Martin","year":"2020","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_54","first-page":"1","article-title":"Food Protein-Induced Enterocolitis Syndrome","volume":"27","author":"Castro","year":"2017","journal-title":"J. Investig. Allergol. Clin. Immunol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"e44","DOI":"10.2500\/aap.2018.39.4159","article-title":"Early Risk Factors for Cow\u2019s Milk Allergy in Children in the First Year of Life","volume":"39","author":"Sardecka","year":"2018","journal-title":"Allergy Asthma Proc."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1007\/s00431-025-06070-3","article-title":"A Web-Based Questionnaire to Evaluate Risk Factors to Develop Cow Milk Allergy","volume":"184","author":"Dinleyici","year":"2025","journal-title":"Eur. J. Pediatr."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1159\/000527870","article-title":"Prevalence and Influencing Factors of Food Allergy in Global Context: A Meta-Analysis","volume":"184","author":"Feng","year":"2023","journal-title":"Int. Arch. Allergy Immunol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1111\/apa.16195","article-title":"Complementary Bottles During the First Month and Risk of Cow\u2019s Milk Allergy in Breastfed Infants","volume":"111","author":"Garcette","year":"2022","journal-title":"Acta Paediatr."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Gao, X., Yan, Y., Zeng, G., Sha, T., Liu, S., He, Q., Chen, C., Li, L., Xiang, S., and Li, H. (2019). Influence of Prenatal and Early-Life Exposures on Food Allergy and Eczema in Infancy: A Birth Cohort Study. BMC Pediatr., 19.","DOI":"10.1186\/s12887-019-1623-3"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"e003203","DOI":"10.1136\/bmjpo-2024-003203","article-title":"Factors Influencing the Natural History of Non-IgE-Mediated Gastrointestinal Food Allergies in Paediatric Age: A Prospective Multicentre Cohort Study","volume":"9","author":"Carucci","year":"2025","journal-title":"BMJ Paediatr. Open"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.anai.2013.01.017","article-title":"Role of Parental Atopy in Cow\u2019s Milk Allergy: A Population-Based Study","volume":"110","author":"Goldberg","year":"2013","journal-title":"Ann. Allergy. Asthma. Immunol."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1608","DOI":"10.1016\/j.jaip.2022.02.013","article-title":"Clinical Features and Clinical Course of Food Protein\u2014Induced Allergic Proctocolitis: 10-Year Experience of a Tertiary Medical Center","volume":"10","author":"Senocak","year":"2022","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_63","first-page":"1","article-title":"Analysis of IL-13 Gene Polymorphisms in Pediatric Patients with Food Allergy","volume":"54","author":"Berghea","year":"2026","journal-title":"Allergol. Immunopathol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13601-016-0089-8","article-title":"Incidence and Risk Factors for Food Hypersensitivity in UK Infants: Results from a Birth Cohort Study","volume":"6","author":"Grimshaw","year":"2015","journal-title":"Clin. Transl. Allergy"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1016\/j.jaci.2010.12.1105","article-title":"The Prevalence and Natural Course of Food Protein-Induced Enterocolitis Syndrome to Cow\u2019s Milk: A Large-Scale, Prospective Population-Based Study","volume":"127","author":"Katz","year":"2011","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s40413-016-0135-y","article-title":"Establishing the Prevalence of Low Vitamin D in Non-Immunoglobulin-E Mediated Gastrointestinal Food Allergic Children in a Tertiary Centre","volume":"10","author":"Foong","year":"2017","journal-title":"World Allergy Organ. J."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1466","DOI":"10.1111\/all.14148","article-title":"Eosinophilic Esophagitis and Allergic Comorbidities in a US-population-based Study","volume":"75","author":"Cianferoni","year":"2020","journal-title":"Allergy"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1111\/pai.13039","article-title":"Association between Antibiotic Treatment During Pregnancy and Infancy and the Development of Allergic Diseases","volume":"30","author":"Metzler","year":"2019","journal-title":"Pediatr. Allergy Immunol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1097\/EDE.0b013e31827f520f","article-title":"Mother\u2019s and Offspring\u2019s Use of Antibiotics and Infant Allergy to Cow\u2019s Milk","volume":"24","author":"Lundqvist","year":"2013","journal-title":"Epidemiology"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"106377","DOI":"10.1016\/j.jinf.2024.106377","article-title":"The Association between Prenatal Antibiotic Exposure and Adverse Long-Term Health Outcomes in Children: A Systematic Review and Meta-Analysis","volume":"90","author":"Duong","year":"2025","journal-title":"J. Infect."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1111\/pai.13411","article-title":"Maternal Antibiotic Exposure During Pregnancy and the Risk of Allergic Diseases in Childhood: A Meta-Analysis","volume":"32","author":"Zhong","year":"2021","journal-title":"Pediatr. Allergy Immunol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"134506","DOI":"10.1016\/j.jhazmat.2024.134506","article-title":"Children\u2019s Food Allergy: Effects of Environmental Influences and Antibiotic Use across Critical Developmental Windows","volume":"472","author":"Lu","year":"2024","journal-title":"J. Hazard. Mater."},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Vassilopoulou, E., Rallis, D., Milani, G.P., Agostoni, C., Feketea, G., Lithoxopoulou, M., Stefanaki, E., Ladomenou, F., Douladiris, N., and Cronin, C. (2023). Nurturing Infants to Prevent Atopic Dermatitis and Food Allergies: A Longitudinal Study. Nutrients, 16.","DOI":"10.3390\/nu16010021"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1097\/01.all.0000168790.82206.17","article-title":"Genetic and Environmental Risk Factors for the Development of Food Allergy","volume":"5","year":"2005","journal-title":"Curr. Opin. Allergy Clin. Immunol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1111\/pai.13448","article-title":"An Exploration of Factors Associated with Food Protein-Induced Enterocolitis Syndrome: Birth, Infant Feeding and Food Triggers","volume":"32","author":"Lee","year":"2021","journal-title":"Pediatr. Allergy Immunol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1016\/j.anai.2022.04.025","article-title":"Predictors and Biomarkers of Food Allergy and Sensitization in Early Childhood","volume":"129","author":"Davis","year":"2022","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"99","DOI":"10.2500\/jfa.2020.2.200026","article-title":"Food Allergy and Breast-Feeding","volume":"2","author":"Pier","year":"2020","journal-title":"J. Food Allergy"}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/16\/7482\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T04:21:59Z","timestamp":1787458919000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/16\/7482"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,21]]},"references-count":77,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["ijms27167482"],"URL":"https:\/\/doi.org\/10.3390\/ijms27167482","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,21]]}}}