Results:

Eosinophils and mast cells within the lamina propria were increased in number in children with atopic functional dyspepsia and degranulated rapidly after cow's milk challenge in the atopic group. For degranulating eosinophils, median= 13.0%(interquartile range= 3.7–31.0) premilk versus 32.0%(12.0–42.0) after milk biopsies (P< 0.05); for degranulating mast cells, 5.35%(2.7–10.9) premilk biopsies versus 18.75%(12.9–22.1) after milk biopsies (P< 0.05). No such differences were seen in nonatopic patients. Mast cells were closely associated with mucosal nerve fibres and released tryptase, which colocalised with proteinase-activated receptors on mucosal nerve fibres. The gastric antral slow wave became abnormal within 2 minutes of antigen challenge in atopics with an increase in dominant frequency instability coefficient (P< 0.005), decrease in 3 cycles per minute myoelectrical activity (P< 0.01), and increase in bradygastria (P< 0.01).

Conclusions:

Early-onset neuroimmune interactions induced by cow's milk in the gastric mucosa of atopic children are associated with rapid disturbance of gastric myoelectrical activity and dyspeptic symptoms.