Common Food Allergies Research Articles

Randomized controlled trial of oral immunotherapy for egg allergy in Japanese patients.

Egg allergy is one of the most common food allergies in young children. While oral immunotherapy (OIT) is not routinely recommended in current guidelines, it has been considered as a potential alternative treatment strategy. Studies on OIT for food allergy have been explored, but no controlled trials have been reported in Japan. The first oral food challenge (OFC) was performed before treatment to ensure diagnosis and evaluate the threshold dose for egg using the double-blind, placebo-controlled food challenge. Participants were randomly assigned by computerized algorithm to receive OIT using egg (OIT group) or no egg (egg elimination [EE] group). A second OFC was performed in both groups approximately 6 months after therapy. Blood samples were collected and egg white-specific immunoglobulin (Ig)E and IgG4 were measured before and after the treatment period. Eight of the 14 patients (57%) in the OIT group had no allergic reaction to 4 g dry egg powder whereas none of the 16 patients in the EE group did. All 14 patients in the OIT group had increased threshold for egg powder in the second OFC compared with baseline. There was no significant change in egg white-specific IgE level during therapy. After therapy, egg white-specific IgG4 increased significantly in the OIT group, but not in the EE group. OIT is effective in increasing the threshold for allergens and inducing desensitization in Japanese egg allergy patients, similarly to North American and European patients.

The establishment of cow's milk protein allergy in infants is related with a deficit of regulatory T cells (Treg) and vitamin D.

Cow's milk protein allergy (CMPA) is the most common food allergy in infants. However, little is known about which specific immune mechanisms are related with the CMPA onset. The objective was to investigate which immune alterations constitute differential factors between allergy and tolerance, and hence could be implicated in the CMPA establishment in infants. An extensive analysis of immune subsets, including Treg and cytokine-secreting cells was performed in blood samples from 28 infants younger than 9 mo obtained 1-4 d after the first adverse reaction to milk. Less than 4 d after first allergic reaction, infants who developed CMPA had decreased Treg counts and increased frequency of IL4-secreting CD4 T cells compared to controls. The deficit of Tregs was correlated with decreased serum levels of vitamin D. Values of Tregs, IL4-secreting cells and vitamin D were good predictors of CMPA diagnosis. Basal vitamin D levels in CMPA infants also predicted those CMPA patients developing spontaneous tolerance in the first year. Establishment of CMPA in infants was related with lower Treg and vitamin D levels. These immune alterations would be crucial factors behind the CMPA establishment and they could constitute a therapeutic target for treatment of CMPA.

Fast Real-Time PCR for the Detection of Crustacean Allergens in Foods.

Crustaceans are one of the most common allergens causing severe food reaction. Hypersensitivity reactions associated with seafood intake are one of the most common food allergies in adults. Crustaceans including shrimps, prawns, crabs, lobster, and crayfish are a common cause of anaphylaxis or hypersensitivity, with shrimps and crabs being the most common causes of allergy. Symptoms occur most often when food or cooking water are ingested.These food allergens are a health problem, and they have become very important; as evidenced by the existence of several regulations that establish that labeling must be present regarding these allergens to warn consumers.The methodology herein exposed allows the detection of crustaceans in any type of product, including those where very aggressive treatments of temperature and pressure are used during the manufacturing process.The main features of this method are its high sensitivity and specificity, and reduced analysis time of real-time PCR (40 min). This assay is a potential tool in issues related to the labeling of products and food security to protect the allergic consumer.

Transcriptional Profiling of Egg Allergy and Relationship to Disease Phenotype.

BackgroundEgg allergy is one of the most common food allergies of childhood. There is a lack of information on the immunologic basis of egg allergy beyond the role of IgE.ObjectiveTo use transcriptional profiling as a novel approach to uncover immunologic processes associated with different phenotypes of egg allergy.MethodsPeripheral blood mononuclear cells (PBMCs) were obtained from egg-allergic children who were defined as reactive (BER) or tolerant (BET) to baked egg, and from food allergic controls (AC) who were egg non-allergic. PBMCs were stimulated with egg white protein. Gene transcription was measured by microarray after 24 h, and cytokine secretion by multiplex assay after 5 days.ResultsThe transcriptional response of PBMCs to egg protein differed between BER and BET versus AC subjects. Compared to the AC group, the BER group displayed increased expression of genes associated with allergic inflammation as well as corresponding increased secretion of IL-5, IL-9 and TNF-α. A similar pattern was observed for the BET group. Further similarities in gene expression patterns between BER and BET groups, as well as some important differences, were revealed using a novel Immune Annotation resource developed for this project. This approach identified several novel processes not previously associated with egg allergy, including positive associations with TLR4-stimulated myeloid cells and activated NK cells, and negative associations with an induced Treg signature. Further pathway analysis of differentially expressed genes comparing BER to BET subjects showed significant enrichment of IFN-α and IFN-γ response genes, as well as genes associated with virally-infected DCs.ConclusionsTranscriptional profiling identified several novel pathways and processes that differed when comparing the response to egg allergen in BET, BER, and AC groups. We conclude that this approach is a useful hypothesis-generating mechanism to identify novel immune processes associated with allergy and tolerance to forms of egg.

Prospective evaluation of testing with baked milk to predict safe ingestion of baked milk in unheated milk-allergic children.

BackgroundCow’s milk allergy is one of the most common food allergies affecting young children. A subset of milk-allergic individuals can eat baked milk without allergic symptoms which is beneficial in terms of prognostication and liberalization of the diet. A retrospective study suggested that skin prick testing (SPT) with a baked milk (muffin) slurry may provide a sensitive means of predicting the outcome of a medically supervised baked milk oral food challenge. We evaluated the predictive value of SPT with baked milk to identify unheated milk-allergic children who are able to safely eat baked milk.MethodsChildren aged 2–16 years with a prior history of reaction to milk and a milk extract SPT of 8–14 mm were recruited. Investigator-blinded SPT to muffin slurry and powdered milk in triplicate and specific IgE (sIgE) to casein and milk were performed. Graded oral challenge to egg-free baked milk muffins (total 2.6 gm milk protein) was performed in the hospital. Reliability of tests was analyzed for intraclass correlation. Statistical significance for clinical characteristics of population and muffin testing versus baked milk reactivity was calculated with Fisher exact test for dichotomous and t-test for continuous variables. Wilcoxon rank sum test was used to compare immunological characteristics between individuals who tolerated or reacted to baked milk. Fitted predicted probability curves and ROC curves were generated.ResultsThirty-eight children were consented and 30 met study criteria. The muffin SPT and casein sIgE were significantly different in those who passed versus failed baked milk challenge. Negative (<3 mm) baked milk tests were found in 8/30 children (27 %) and were associated with non-reactivity to baked milk (p = 0.01) with a sensitivity of 1 (0.70–1.00). All children with negative SPT for baked milk passed the oral challenge. Specificity was 0.41 (0.19–0.67). The optimal decision point for the muffin SPT was 4 mm and the casein sIgE was 6 kU/L. The powdered milk test was not helpful.ConclusionsSkin prick testing with a baked milk (muffin) slurry may have a role in clinical practice to identify baked milk tolerance in milk-allergic patients.

The ingestion of cow's milk formula in the first 3 months of life prevents the development of cow's milk allergy.

BackgroundIgE-mediated cow's milk allergy (CMA) is one of the most common food allergies in infants. It is still controversial whether the early introduction of cow's milk formula (CMF) prevents the development of CMA.ObjectiveWe aimed to evaluate the duration and frequency of CMF ingestion as compere with exclusive breast-fed for preventing CMA in high-risk infants.MethodsWe enrolled the patients diagnosed with hen's egg allergy by an oral food challenge. A questionnaire was completed by the caregivers of the patients regarding the timing of introduction and discontinuation of CMF, and the frequency of CMF ingestion. Based on the information, we analyzed the relationship between the duration and frequency of CMF ingestion and the development of CMA at 3–24 months of age.ResultsThree hundred seventy-four patients were analyzed; 171 were diagnosed with CMA (45.7%). The analyzed patients (n = 374) were categorized into the following subgroups: exclusively breast-fed (breast-fed group, n = 75); discontinued ingestion of CMF before 3 months of age (temporary group, n = 177); continuous ingestion of CMF, but not daily, up to 3 months of age (nondaily group, n = 47); continuous ingestion of CMF at least once daily (daily group, n = 75). The incidence of developing CMA between the breast-fed group and temporary group did not show any statistical difference. Nondaily group and daily group had significantly lower incidence of developing CMA in comparison to the breast-fed group (nondaily group odds ratio 0.43; p = 0.02, daily group odds ratio 0.11; p < 0.001).ConclusionIngestion of CMF during the first 3 months of life might prevent the development of CMA in high-risk infants.

The role of specific IgE antibodies in infants with cow milk protein allergy

Objectives This article aims to evaluate the role of lactoglobulin-specific IgE and lactalbumin-specific IgE in cow milk allergy. Background Allergy to cow milk is the most common food allergy in infants and young children. Symptoms of milk allergy reaction can range from mild symptoms such as hives, to severe symptoms, such as anaphylaxis. The allergy is most likely to persist in children who have high levels of cow milk antibodies in their blood. The aim of this study is to assess the value of lactalbumin-specific IgE and lactoglobulin-specific IgE in the diagnosis of cow milk protein allergy. Participants and methods This study was carried out on 70 participants classified into the following groups: group 1: it included 50 infants with suspected cow milk protein allergy, who were diagnosed with chronic diarrhea with a history of recent introduction of cow milk and a positive elimination test. Group 2: it included 20 age-matched and sex-matched apparently healthy participants. Their ages ranged between 8 and 18 months. All individuals included in this study were subjected to full history taking, clinical examination, complete blood count, and determination of serum total IgE, lactoglobulin-specific and lactalbumin-specific IgE which was carried out using the enzyme-linked immunosorbent assay technique. Results The diagnostic accuracy of lactoglobulin IgE in the diagnosis of cow milk protein allergy was 84%, with sensitivity of 78%, specificity of 100%, positive predictive value of 100%, and a negative predictive value of 65% at the cutoff point of 0.345 IU/ml. The diagnostic accuracy of lactoalbumin IgE in the diagnosis of cow milk protein allergy was 83%, with sensitivity of 84%, specificity of 80%, positive predictive value of 91%, and negative predictive value of 67% at the cutoff point of 0.335 IU/ml. Conclusion Lactalbumin-specific and lactoglobulin-specific IgE assays are important in the diagnosis of cow milk protein allergy and their combination may give better diagnostic accuracy than the total IgE assay.

Strongyloidiasis: An Uncommon Cause of Villous Blunting

Introduction: We describe an interesting case of villous blunting caused by Strongyloidies stercolaris infection. Case description: 57-year-old female presented with one-week history of myalgias, chills and tactile fever. She also reported chornic diarrhea, intermittent abdominal pain and recent onset dry cough. She denied weight loss, dyspnea, melena, hematochezia, dysuria, pruritus and skin rash. She was originally from Michoacan, Mexico and had lived in United States for several years. She frequently visited a lake near her house in Micohoacan where she enjoyed walking barefoot. Previous travel to Mexico was three years prior to this encounter. Physical exam was notable for mild epigastric tenderness. Lab workup revealed anemia and leukocytosis. Previous workup was significant for peripheral eosinophilia, which had remained unexplained. ESR and CRP values were 36 and 4 respectively. CT scan of abdomen revealed submucosal fatty infiltration in distal duodenum and proximal jejunum. EGD findings were consistent with villous blunting and fissures in mid jejunum. Biopsy of this region revealed larvae of Strongyloides stercolaris. This was confirmed with a positive Strongyloides IgG serology. A diagnosis of Strongyloidiasis was made and treatment with ivermectin was initiated. Discussion: Villi are finger like projections of epithelial lining of intestinal wall, which are involved in absorption of nutrients. Villous blunting is defined by flattening of villi. It can be caused by a various conditions, which include celiac disease, autoimmune enteropathy, common variable immunodeficiency (CVID), peptic duodenitis, food allergies, giardiasis and viral enteritis. Strongyloidiasis can lead to broad range of endoscopic findings in small intestine, which include edema, brown discoloration, subepithilial hemorrhages and megaduodenum1. Strongyloides infection can cause duodenitis which leads to villous blunting and atrophy depending on degree of inflammation. Effects in jejunum have not been well described. Endoscopists must be aware that strongyloidiasis is a cause of villous blunting and keep a high index of suspicion in symptomatic patients who travel frequently to endemic areas, those who are immunosuppressed and recent immigrants.Figure 2Figure 1

Egg sensitization, allergy and component patterns in African children with atopic dermatitis

Egg allergy is the most common food allergy in children with atopic dermatitis (AD). This study aimed to determine the prevalence of egg allergy, component patterns and predictive values of screening tests in egg allergy in South African children with AD. This was a prospective, observational study in a paediatric university hospital in Cape Town. Children with AD, aged 6 months to 10 years, were recruited randomly. They were assessed for sensitization and allergy to egg by questionnaire, skin prick tests (SPT), Immuno Solid Phase Allergen Chip (ISAC 103® ) test, ImmunoCAP component tests to egg and ovomucoid (Gal d 1) and incremental food challenges. Hundred participants (59 Black Africans and 41 of mixed ethnicity) were enrolled, median age 42 months. There was a high rate of egg sensitization of 54% and prevalence of confirmed egg allergy of 25%. History and screening laboratory tests overestimated egg allergy significantly. SPT to fresh egg white was significantly more sensitive in diagnosing egg allergy than SPT to the commercial egg white extract and produced the highest area under the receiver operator characteristics curve of all the screening tests in predicting true egg allergy. In those participants sensitized to egg, the component ovomucoid was best at differentiating true egg allergy from tolerance. Commonly used 95% positive predictive values (PPVs) for SPT to egg and ImmunoCAP egg white produced low PPV of 57% and 74%, respectively, in this population overall, with generally poorer predictive values amongst the Black Africans than the mixed ethnicity participants. A SPT to fresh egg of 17 mm and ImmunoCAP egg white of 13 kU/l produced the best PPV for egg allergy in this population. The prevalence of egg allergy is high in African children with AD, but history of egg allergy and sensitization to egg significantly overestimate the true egg allergy rate. SPT to fresh egg white was more sensitive than that to commercial egg white extract; hence, fresh egg white should be recommended in an egg allergy screening panel. The component ovomucoid was useful for differentiating allergy from tolerance in egg-sensitized participants. Population-specific 95% PPV for egg allergy tests may need to be established in developing world populations.

Egg and Milk Proteins as Hidden Allergens in Food: 5-Year (2010 to 2014) Results of Food Allergen Monitoring in Piedmont, Italy

Cow's milk and egg allergies are two of the most common food allergies. Manufacturers of food products containing milk or eggs or their derivatives as an ingredient are required by European Union regulations to list their presence on the ingredient label. Under European Union legislation, member states are mandated to carry out food safety monitoring programs to verify compliance with food labeling requirements. Through the Regional Integrated Plan for Food Safety, the Piedmont (Italy) regional authority carries out an annual program to determine the presence of undeclared allergens in foods. In the 5-year period from 2010 to 2014, a total of 1,566 food samples were analyzed for the presence of hidden egg and milk proteins. The average positive percentage was 2.8% (3.6% egg and 2% milk proteins). Comparison between the allergen concentration and the published eliciting dose (ED) for egg proteins (0.03 mg) and for total milk proteins (0.1 mg) indicated a high risk of allergen exposure for sensitized consumers. The calculated exposure was up to 135× (for milk) the ED01 reported in the literature. Food manufacturers will need to improve their allergen control programs to reduce allergen exposure and risk.

Egg allergy in children under the age of 5 years

Egg allergy is the second most common food allergy in infants and young children after cows' milk allergy ( Caubet and Wang, 2011 ). It usually presents within the first year of life after initial exposure to egg protein. The presence of atopic dermatitis is a significant risk factor for egg allergy, as is the presence of atopy ( Clark et al, 2010 ). Fortunately, egg allergy typically resolves during childhood ( Sicherer et al, 2014 ), although rates of tolerance acquisition vary depending on different study cohorts. This article will look at how egg allergy can be managed through dietary avoidance. Parents of egg-allergic children should be educated on the appropriate level of restriction required for their child, as many infants and children will tolerate baked or well-cooked egg at diagnosis while still reacting to loosely cooked, plain and raw egg, while others will need to avoid egg altogether. It is useful for families and older patients to be informed about the importance of reading food labels, hidden sources of egg and appropriate alternatives.

Cow's Milk Allergy Prescribing Is Influenced by Regional and National Guidance.

Cow's milk allergy (CMA) is the most common food allergy in children with many clinical manifestations, leading to misdiagnoses such as gastro-oesophageal reflux, infantile colic, and lactose intolerance with inappropriate prescribing. We aimed to determine the impact of infant feeding guidelines on CMA prescribing in UK primary care using a simple and inexpensive training package. Prospectively collected data of infant feeding prescriptions in Northern Ireland from June 2012 to March 2014 were analysed with the intervention period between November 2012 and March 2013. A comparison was made between hypoallergenic formulae, appropriate for CMA, versus alternative prescriptions including antiregurgitation and colic products, lactose-free and partially hydrolysed milks, or infant Gaviscon. Comparing pre- and postintervention period, the total quantity of hypoallergenic formulae increased by 63.2% and alternative prescriptions decreased by 44.6% (P < 0.001). The total amount of all prescribed products decreased by 41.0% (P < 0.001). During the study period, the proportion of recommended CMA treatment increased from 3.4% before training to 9.8% in the short- and long-term follow-up (P < 0.001). The overall increase was £33,508 per year or £95.5 per general practitioner's surgery. We present the first study evaluating the impact of infant feeding guidelines on CMA prescribing in UK primary care. Practical advice and teaching of health professionals allowed for effective implementation of regional and national guidelines, with a significant impact on prescription patterns. This study shows promising results for prospective research on a national scale, including socioeconomical impact and cost-effectiveness.

Usefulness of molecular diagnosis in egg allergic children.

IntroductionEgg allergy is one of the most common food allergies in children. Egg white, including ovomucoid (OVM or Gal d 1) and ovalbumin (OVA or Gal d 2), is the major source of allergens. The aim of this study was to assess the role of Gal d 1 and Gal d 2 in predicting the risk of anaphylaxis caused by eggs in children, and to compare this new diagnostic tool with established methods of allergen-specific IgE detection.Material and methodsOne hundred and forty-eight children were divided into 2 groups according to a positive (group A, 33 children) or negative (group B, 115 children) history of anaphylaxis after ingestion/contact with eggs. All patients underwent an allergological evaluation by measurements of specific IgE against egg white: Gal d 1 and Gal d 2.ResultsHigher levels of Gal d 1, Gal d 2 and IgE against egg white were detected in group A compared to group B (p < 0.001). Although the area under the curve was similar for Gal d 1 and Gal d 2, egg white specific IgE showed a better sensitivity (85%) for a cut-off value ≥ 0.975 kUA/l, while Gal d 1 and Gal d 2 demonstrated a better specificity (90% and 80%, respectively) for cut-off values ≥ 1.460 kUA/l and ≥ 2.310 kUA/l, respectively.ConclusionsEgg white specific IgE showed a similar ability as Gal d 1 and Gal d 2 in differentiating children at risk for egg anaphylaxis, although Gal d 1 and Gal d 2 showed a better specificity.

Hydrolysed egg displays strong decrease in allergenicity and is well tolerated by egg-allergic patients.

Food allergies are believed to be on the rise, and currently, management relies on the avoidance of the food. Hen's egg allergy is after cow's milk allergy the most common food allergy; eggs are used in many food products and thus difficult to avoid. A technological process using a combination of enzymatic hydrolysis and heat treatment was designed to produce modified hen's egg with reduced allergenic potential. Biochemical (SDS-PAGE, Size exclusion chromatography and LC-MS/MS) and immunological (ELISA, immunoblot, RBL-assays, animal model) analysis showed a clear decrease in intact proteins as well as a strong decrease of allergenicity. In a clinical study, 22 of the 24 patients with a confirmed egg allergy who underwent a double-blind food challenge with the hydrolysed egg remained completely free of symptoms. Hydrolysed egg products may be beneficial as low-allergenic foods for egg-allergic patients to extent their diet.

Peanut Allergy-A Review

Aim :To study about the prevalence, symptoms, causes and treatment of peanut allergy. Objective :Compounds in peanut acts as allergen for many people. A systematic review is conducted to know the prevalence and incidence of peanut allergy. Background :Peanut allergy develops when the body’s immune system has an abnormal hypersensitivity response to one or more of the peanut proteins. Peanut allergy is one of the most common food allergies in both children and adults. This prevalence of peanut allergy has increased significantly over the past decade , most notable in westernised countries. The immune system reacts to the allergy resulting in mild rashes to anaphylaxis. Reason :Peanut is a common food ingredient making strict avoidance difficult. Therefore, there is a relatively high rate of accidental peanut ingestions for those trying to avoid peanuts. For all of the above reasons. Peanut allergy has become an important public health issue. This review will create awareness about the various symptoms and features of peanut allergy and its prevention.

Debates in allergy medicine: baked milk and egg ingestion accelerates resolution of milk and egg allergy

Cow’s milk and hen’s egg are ubiquitous in diets around the world and can be important sources of protein in young children. Unfortunately, milk and egg allergies are also some of the most common food allergies in childhood. Less allergenic forms of milk and egg due to heating and interactions with a food matrix, as in baked goods, are tolerated by a majority of milk- and egg-allergic patients. Adding baked milk and egg into the diets of milk- and egg-allergic children can broaden diets, increase nutrition, and improve quality of life. Most important, regular ingestion of baked milk and egg can help children outgrow their allergies to milk and egg. This article will review our current understanding of baked milk and egg tolerance and outline how these baked forms accelerates tolerance to regular milk and egg.

Incidence and natural history of hen's egg allergy in the first 2 years of life-the EuroPrevall birth cohort study.

Parents and health staff perceive hen's egg allergy (HEA) as a common food allergy in early childhood, but the true incidence is unclear because population-based studies with gold-standard diagnostic criteria are lacking. To establish the incidence and course of challenge-confirmed HEA in children, from birth until the age of 24 months, in different European regions. In the EuroPrevall birth cohort study, children with a suspected HEA and their age-matched controls were evaluated in 9 countries, using a standardized protocol including measurement of HE-specific immunoglobulin E-antibodies in serum, skin prick tests, and double-blind, placebo-controlled food challenges (DBPCFC). Across Europe, 12 049 newborns were enrolled, and 9336 (77.5%) were followed up to 2 years of age. In 298 children, HEA was suspected and DBPCFC was offered. HEA by age two was confirmed in 86 of 172 challenged children (mean raw incidence 0.84%, 95% confidence interval (95% CI) 0.67-1.03). Adjusted mean incidence of HEA was 1.23% (95% CI 0.98-1.51) considering possible cases among eligible children who were not challenged. Centre-specific incidence ranged from United Kingdom (2.18%, 95% CI 1.27-3.47) to Greece (0.07%). Half of the HE-allergic children became tolerant to HE within 1 year after the initial diagnosis. The largest multinational European birth cohort study on food allergy with gold-standard diagnostic methods showed that the mean adjusted incidence of HEA was considerably lower than previously documented, although differences in incidence rates among countries were noted. Half of the children with documented HEA gained tolerance within 1 year postdiagnosis.

Development of a biodegradable sensor platform from gold coated zein nanophotonic films to detect peanut allergen, Ara h1, using surface enhanced raman spectroscopy

Peanuts are among the most common food allergies, which may result in life-threatening reactions in certain people. For this reason, it is very important to monitor the presence of peanuts in the food system. Biosensors are an emerging way of detecting allergen proteins. In this research, we present a surface enhanced Raman spectroscopy (SERS) technique to detect the main allergen protein, Ara h1. The sensors were biodegradable and made out of a corn protein, zein. Nanophotonic structures on zein films consisted of gold coated pyramid structures. It was found that both detection and quantification was possible by using a statistical clustering technique principal component analysis (PCA). An optimization in data processing yielded the result that baseline correction and shorter data collection times were needed in order to successfully cluster data. The limit of detection was found to be 0.14mg/ml. Furthermore, specificity of the sensor was provided by functionalizing the surface with monoclonal antibodies of Ara h1. Antibody functionalization, and Ara h1 capturing was tested and identified by also utilizing PCA analysis. As a proof-of-concept, this study showed that a biodegradable platform can be used in detection of a peanut allergen protein, Ara h1, using surface enhanced Raman spectroscopy.

Anaphylaxis to TDaP Vaccine in an Infant with IgE Mediated Cow’s Milk Allergy

Food allergy is an increasing health problem world-wide. CMA is one of the most common food allergies during childhood. Certain vaccines such as TDaP may contain milk protein residues that have been associated to severe allergic reactions among patients with proven IgE mediated CMA and receiving booster vaccination. We present an infant with IgE mediated CMA who presented anaphylaxis when receiving a booster dose of TDaP. The possibility of an allergic reaction to certain vaccines in a small group of children suffering from IgE mediated CMA should be discussed with caregivers and health professionals to better care of these patients.

Probiotic Dahi containing Lactobacillus acidophilus and Bifidobacterium bifidum modulates immunoglobulin levels and cytokines expression in whey proteins sensitised mice.

Cow milk allergy is the most common food allergy in children. So far, no effective treatment is available to prevent or cure food allergy. This study investigated whether orally administrated probiotics could suppress sensitisation in whey proteins (WP)-induced allergy mouse model. Two types of probiotic Dahi were prepared by co-culturing Dahi bacteria (Lactococcus lactis ssp. cremoris NCDC-86 and Lactococcus lactis ssp. lactis biovar diacetylactis NCDC-60) along with selected strain of Lactobacillus acidophilus LaVK2 and Bifidobacterium bifidum BbVK3. Mice were fed with probiotic Dahi (La-Dahi and LaBb-Dahi) from 7 days before sensitisation with WP, respectively, in addition to milk protein-free basal diet, and control group received no supplements. Feeding of probiotic Dahi suppressed the elevation of whey proteins-specific IgE and IgG response of WP-sensitised mice. In addition, sIgA levels were significantly (P < 0.001) increased in intestinal fluid collected from mice fed with La-Dahi. Production of T helper (Th)-1 cell-specific cytokines, i.e. interferon-γ (IFN-γ), interleukin (IL)-12, and IL-10 increased, while Th2-specific cytokines, i.e. IL-4 decreased in the supernatant of cultured splenocytes collected from mice fed with probiotic Dahi as compared to the other groups. Moreover, the splenic mRNA levels of IFN-γ, interleukin-10 were found to be significantly increased, while that of IL-4 decreased significantly in La-Dahi groups, as compared to control groups. Results of the present study indicate that probiotic Dahi skewed Th2-specific immune response towards Th1-specific response and suppressed IgE in serum. Collectively, this study shows the potential use of probiotics intervention in reducing the allergic response to whey proteins in mice. © 2015 Society of Chemical Industry.