Abstract

The introduction of baked milk products in cow’s milk (CM) allergic children has previously been shown to accelerate induction tolerance in a selected group of children. However, there is no standardized baked milk product on the market. Recently, a new standardized, heated and glycated cow’s milk protein (HP) product was developed. The aim of this study was to measure safety and tolerability of a new, well characterized heated CM protein (HP) product in cow’s milk allergic (CMA) children between the age of 3 and 36 months. The children were recruited from seven clinics throughout The Netherlands. The HP product was introduced in six incremental doses under clinical supervision. Symptoms were registered after introduction of the HP product. Several questionnaires were filled out by parents of the children. Skin prick tests were performed with CM and HP product, sIgE to CM and α-lactalbumin (Bos d4), β-lactoglobulin (Bos d5), serum albumin (Bos d 6), lactoferrin (Bos d7) and casein (Bos d8). Whereas 72% percent (18 out of 25) of the children tolerated the HP product, seven children experienced adverse events. Risk factors for intolerance to the HP product were higher skin prick test (SPT) histamine equivalent index (HEP) results with CM and the HP product, higher specific IgE levels against Bos d4 and Bos d8 levels and Bos d5 levels. In conclusion, the HP product was tolerated by 72% of the CM allergic children. Outcomes of SPT with CM and the HP product, as well as values of sIgE against caseins, α-lactalbumin, and β-lactoglobulin may predict the tolerability of the HP product. Larger studies are needed to confirm these conclusions.

Highlights

  • Introduction of HeatedCow’s Milk Protein in Challenge-ProvenCow’s Milk Allergic Children: The iAGE StudyNicolette W. de Jong 1,2, *,†, Marloes E. van Splunter 1,†, Joyce A

  • 25 cow’s milk allergy (CMA) children participated in this study: 9 girls and 16 boys, with a mean age of 14.5 months

  • Product (HPt group), and seven children developed an allergic reaction to the heated CM protein (HP) product (HPr group)

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Summary

Introduction

Introduction of HeatedCow’s Milk Protein in Challenge-ProvenCow’s Milk Allergic Children: The iAGE StudyNicolette W. de Jong 1,2, *,† , Marloes E. van Splunter 1,† , Joyce A. Cow’s Milk Allergic Children: The iAGE Study. Nicolette W. de Jong 1,2, *,† , Marloes E. van Splunter 1,† , Joyce A. J. Schreurs , Frank E. van Boven 1 and Nicolette J. In Europe, the prevalence of challenge-proven/confirmed cow’s milk allergy (CMA) in young children (< age 3 year) varies between 0.35 and 2.0% [1,2]. About 70% of CMA children reach clinical tolerance to milk proteins before the age of two years, and 60% before the age of three years, indicating transient CMA [3]. Several studies have reported high percentages (59–81%) of tolerance to baked milk in CMA children [4,5,6,7].

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