D3.462 - Polysorbate 80 (E433) sensitisation predicts and explains part of the variability of the Chronic Cough and Opposing Defiant Behaviour (ODB) in sensitised children: how the industrialised nutrition impacts the gut-brain axis and favours neuro-inflammation

E433 is a common alimentary additive and emulsifying agent which is considered to be safe. 

E433 patch tests (PT) tested in 52 allergic children(P) along to allergy, asthma, sleep tests. 

Girls (F): (N=14/36) 38.9 %, boys (M): (N=22/36) 61.1%. Age: (M: 7.208 years, SD = 6.25). Clinical signs: Digestive signs: 32N (88,9%), Eczema: 30N (83,3%), Sleep disorders: 29N (80,6%), Chronic Rhinitis:28N (77,8%),  ODB: 19N (52,8%), Oral disorders: 17N (47,2%), Chronic Cough(Chr.Coug.): 16N (44,4%), Asthma/Recurrent urticaria:12N (33,3%), Attention Deficit Hyperreactivity Disorder (ADHD): 9N (25%), Food Protein Induced Enterocolitis (FPIES):7N (19,4%). Chi-square tests reveal a statistically significant association between a)E433sensitisation; and Chronic Cough, Χ²(1,N=51)= 7.696,p =.009.(Somer’s D .388), and b) E433sensitisation; and ODB, Χ²(1, N = 49)=6.533, p = .023. (Somer’s D .364). Number Needed to be exposed to Harm (NNH) E433sensitisation for: Chr.Coug.: 1.1, ODB: 1.2. On average, a) 1.1 Patients would have to be sensitised to E433 (instead of not being sensitised) for one additional patient to HAVE the study outcome (Chr. Coug.). b)  1.2 Patients would have to be sensitised to E433 (instead of not being sensitised) for one additional patient to HAVE the study outcome (ODB). Binary regression GLM indicated that, all else being equal, subjects not being sensitised to E433 had fewer odds of having the outcome “Chr.Coug.” than subjects being sensitised to E433 (OR = 12,632; 95% CI: 1.5 to 106.366; p = 0.020). AIC: 9.95, BIC: 13.814, CAIC: 15.814 (Suppl.Table 25). Binary regression GLM indicated that, all else being equal, subjects not being sensitised to E433 had fewer odds of having the outcome “ODB” than subjects being sensitised to E433 (OR = 6,706; 95% CI: 1.309 to 34.353; p = 0.022). AIC: 10.507, BIC: 14.332, CAIC: 16.332.Receiver operating characteristic(ROC)analysis using E433sensitisation predicted: Chr. Coug. [The Area under the curve (AUC) =0.691, p=.010)] Sensitivity=,941  and Specificity=,559 (cut-off point 0,5, binary variables) & ODB (AUC =0.659, p=.039)(Fig.)Sensitivity=,905 and Specificity=,586 (cut-off point 0,5). The Overall Model Quality (a good model is >0.5) for: Chr. Coug.: 0,55 and for ODB: 0,51.The RE during sleep was very(↑)[RE = 21,7348 (SD=14,986)],but the apnea-hypopnea-index(AHI) was moderately(↑)[AHI=4,34(SD=1,908)].Hormonal variations:8/12N(66,66%), Lactates:5/12N(41.66%):↑,  Noradrenaline:4/13N (30,76%):↑.

The E43 3sensitisation could (↑) the adrenergic stimulation and oxidative stress, thus favoring Chronic Cough and ODB. Increased RE and adrenergic stimulation could be parallel pathways maintaining neuro-inflammation.