Food Allergy In Infants Research Articles

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.

Prevalence of food allergy in infants and pre-schoolers in Brazil

BackgroundFood allergy is an increasing problem in public health, especially in childhood. Its incidence has increased in the last decade. Despite this, estimates of the actual incidence and prevalence are uncertain. The aim of this study was to estimate the prevalence of food allergy in infants and pre-schoolers. MethodsThe parents of 3897 children completed questionnaires on the occurrence of any reaction to food. Children with parentally reported reactions were selected for further examination including a clinical interview, physical examination, allergic tests, and if necessary, oral food challenge to conclude the diagnosis of FA. ResultsThe estimated prevalence of allergy in children aged 4–59 months was 0.61%, being, 1.9% in infants and 0.4% in pre-schoolers. Among the 604 patients physicians evaluated with parent-reported FA, 24 (4%) had a confirmed diagnosis of food allergy, and 580 (96%) were excluded in the remaining. Of these, approximately half (51/52.6%) of 97 infants and (128/48%) of 487 pre-schoolers already performed the diet exclusion suspected food for a period of time. ConclusionThis study shows that high overall prevalence of parental belief of current food allergy however the same was not observed in the in physician-diagnosed food allergy. The prevalence of food allergy was lower than that observed in the literature. This study alerts health professionals to the risk entailed by overestimation of cases of food allergy and unnecessary dietary exclusion, which may result in impairment in growth and development of children, especially in their first years of life.

Enhancement of Oral Tolerance Induction in DO11.10 Mice by Lactobacillus gasseri OLL2809 via Increase of Effector Regulatory T Cells.

Food allergy is a serious problem for infants and young children. Induction of antigen-specific oral tolerance is one therapeutic strategy. Enhancement of oral tolerance induction by diet is a promising strategy to prevent food allergy in infants. Thus, in this study, we evaluate the effect of probiotic Lactobacillus gasseri OLL2809 (LG2809) on oral tolerance induction in a mouse model. The degree of oral tolerance induction was evaluated by measuring the proliferation and level of IL-2 production of splenic CD4+ T cells from DO11.10 mice fed ovalbumin (OVA) alone or OVA with LG2809. Oral administration of LG2809 significantly decreased the rate of proliferation and IL-2 production by CD4+ T cells from OVA-fed mice. LG2809 increased a ratio of CD4+ T-cell population, producing high levels of IL-10 and having strong suppressive activity. Moreover, LG2809 increased a ratio of plasmacytoid dendritic cells (pDCs) among the lamina propria (LP) in small intestine. When used as antigen presenting cells to naïve CD4+ T cells from DO11.10 mice, LP cells from BALB/c mice fed LG2809 induced higher IL-10 production and stronger suppressive activity than those from non-treated mice. These results suggest that oral administration of LG2809 increases the population of pDCs in the LP, resulting in the enhancement of oral tolerance induction by increasing the ratio of effector regulatory T cells. LG2809 could, therefore, act as a potent immunomodulator to prevent food allergies by promoting oral tolerance.

Does Exposing Infants to Peanut Products Influence the Risk of a Peanut Allergy?

Does Exposing Infants to Peanut Products Influence the Risk of a Peanut Allergy?

Nutritional adequacy of a cows' milk exclusion diet in infancy.

Background Infants with suspected cows’ milk allergy are required to follow a strict milk exclusion diet which may lead to nutritional deficiencies, especially if not supervised by a healthcare professional. The aim of this study was to assess the nutritional adequacy of a cows’ milk exclusion diet in a group of UK infants over a period of 6 months.Methods Participants in this study are a subgroup of the Prevalence of Infant Food Allergy study, a prospective food allergy birth cohort study from the South of England. Each infant consuming a milk free diet, following advice from a specialist allergy dietitian, was matched to two control infants who were consuming an unrestricted diet, forming a nested matched case–control study. Detailed food diaries completed prospectively for 1 week per month over a 5 month period, were coded and analysed according to a standard protocol.ResultsThe diets of 39 infants (13 milk-free and 26 controls) were assessed. Mean age at diet commencement was 14 weeks. Two of the eleven infants started on an extensively hydrolysed formula did not tolerate it and required an amino acid formula for symptom resolution. All infants had mean intakes in excess of the estimated average requirement for energy and the recommended nutrient intake (RNI) for protein, calcium, iron, selenium, zinc, vitamins A, C and E. Vitamin D intake was in excess of the RNI at all time-points, except at 44 weeks of age. Across the study period, selenium intake was higher for infants consuming a milk free diet whilst vitamin C intake was higher for infants consuming an unrestricted diet. Differences were found between the two groups for protein, calcium, iron and vitamin E intakes at differing time points.ConclusionThis study demonstrated that although infants consuming a milk-free diet have a nutritional intake that is significantly different to matched controls who are eating an unrestricted diet, this difference is not constant and it is not seen for all nutrients. Further research in infants without dietetic input is needed to explore the nutritional implications of unsupervised cows’ milk exclusion diets.

Doctor, can we prevent food allergy and eczema in our baby?

The purpose is to review evidence from recent clinical trials that focus on early life interventions to prevent the onset of eczema and food allergy. There is evidence that skin barrier defects may be a risk factor for the development of eczema and may increase the risk of early onset food sensitization and allergy. The measurement of transepidermal water loss as a marker of skin barrier defect may be a simple, noninvasive measurement that may predict who is at risk of eczema, however, the protective effects of daily moisturizer application in high-risk infants remains unclear.Although there is increased attention on the role of intestinal microbiota and its influence on sensitization, there is limited evidence to support the preventive effects of probiotics on allergic diseases.Recent clinical trials have provided much needed evidence supporting the early introduction of peanut in the primary and secondary prevention of peanut allergy in high-risk children. There still remain unanswered questions and challenges regarding protocols and implementation of current recommendations. Although progress has been considerable, the fact is that there are no simple strategies to prevent the development of eczema and food allergy in infants. Physicians must remain informed of the dynamic evidence in allergy prevention to make responsible, informed recommendations to families.

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.

RETRACTED: Skin barrier impairment at birth predicts food allergy at 2 years of age

Transcutaneous exposure to food allergens can lead to food sensitization (FS)/food allergy (FA). We measured skin barrier function in early infancy and related it to the later development of FS/FA at age 2 years. We sought to examine the relationship between early life skin barrier function and FA in infancy. Infants in the Babies After Scope: Evaluating the Longitudinal Impact Using Neurological and Nutritional Endpoints (BASELINE) birth cohort had transepidermal water loss (TEWL) measured in the early newborn period and at 2 and 6 months of age. At age 2 years, infants had FS/FA screening with skin prick tests and oral food challenges. One thousand nine hundred three infants were enrolled. One thousand three hundred fifty-five were retained to age 2 years, and 1260 underwent FS screening. FS was present in 6.27% (79/1260; 95% CI, 4.93% to 7.61%), and FA prevalence was 4.45% (56/1258; 95% CI, 3.38% to 5.74%). Egg was the most prevalent allergen (2.94%), followed by peanut (1.75%) and cow's milk (0.74%). Day 2 upper-quartile TEWL (>9 g water/m(2)/h) was a significant predictor of FA at age 2 years (odds ratio [OR], 4.1; 95% CI, 1.5-4.8). Seventy-five percent of children with FA at 2 years of age had day 2 TEWL in the upper quartile. Even in those without atopic dermatitis (AD), infants with upper-quartile day 2 TEWL were 3.5 times more likely to have FA at 2 years than infants in the lowest quartile (95% CI, 1.3-11.1; P = .04). Neonatal skin barrier dysfunction predicts FA at 2 years of age, supporting the concept of transcutaneous allergen sensitization, even in infants who do not have AD. TEWL could be used for stratifying infants in the first few days of life before development of AD or FA for targeted intervention studies to potentially alter the atopic march.

Nut allergy prevalence and differences between Asian-born children and Australian-born children of Asian descent: a state-wide survey of children at primary school entry in Victoria, Australia.

Asian infants born in Australia are three times more likely to develop nut allergy than non-Asian infants, and rates of challenge-proven food allergy in infants have been found to be unexpectedly high in metropolitan Melbourne. To further investigate the risk factors for nut allergy, we assessed the whole-of-state prevalence distribution of parent-reported nut allergy in 5-year-old children entering school. Using the 2010 School Entrant Health Questionnaire administered to all 5-year-old children in Victoria, Australia, we assessed the prevalence of parent-reported nut allergy (tree nut and peanut) and whether this was altered by region of residence, socio-economic status, country of birth or history of migration. Prevalence was calculated as observed proportion with 95% confidence intervals (CI). Risk factors were evaluated using multivariable logistic regression and adjusted for appropriate confounders. Parent-reported nut allergy prevalence was 3.1% (95% CI 2.9-3.2) amongst a cohort of nearly 60000 children. It was more common amongst children of mothers with higher education and socio-economic index and less prevalent amongst children in regional Victoria than in Melbourne. While children born in Australia to Asian-born mothers (aOR 2.67, 95% CI 2.28-3.27) were more likely to have nut allergy than non-Asian children, children born in Asia who subsequently migrated to Australia were at decreased risk of nut allergy (aOR 0.1, 95% CI 0.03-0.31). Migration from Asia after the early infant period appears protective for the development of nut allergy. Additionally, rural regions have lower rates of nut allergy than urban areas.

Nut Allergy Prevalence and Differences Between Asian-Born Children and Australian-Born Children of Asian Descent: A State-Wide Survey of Children at Primary School Entry in Victoria, Australia

RationaleAsian infants born in Australia are 3 times more likely to develop peanut allergy than non-Asian infants and rates of challenge-proven food allergy in infants have been found to be unexpectedly high in metropolitan Melbourne. To further investigate risk factors for nut allergy we assessed the whole of State prevalence distribution of parent-reported nut allergy in 5 year old children entering school.MethodsUsing the 2010 School Entrant Health Questionnaire administered to all 5 year old children in Victoria, Australia, we assessed the prevalence of parent-reported nut allergy (tree nut and peanut) and whether this was altered by region of residence, socioeconomic status, country of birth or history of migration. Prevalence was calculated as observed proportion with 95% confidence intervals (CI). Risk factors were evaluated using multivariable logistic regression and adjusted for appropriate confounders.ResultsNut allergy prevalence was 3.1% (95%CI 2.9-3.2) amongst a cohort of nearly 60,000 children. It was more common amongst children of mothers with higher education and socioeconomic index and less prevalent amongst children in regional Victoria than in Melbourne. While children born in Australia to Asian-born mothers (aOR 2.67 95%CI 2.28, 3.27) were more likely to have nut allergy than non-Asian children, children born in Asia who subsequently migrated to Australia were at decreased risk of nut allergy (aOR 0.1 95%CI 0.03, 0.31).ConclusionsMigration from Asia after the early infant period appears protective for the development of nut allergy. Additionally, rural regions have lower rates of nut allergy than urban areas. RationaleAsian infants born in Australia are 3 times more likely to develop peanut allergy than non-Asian infants and rates of challenge-proven food allergy in infants have been found to be unexpectedly high in metropolitan Melbourne. To further investigate risk factors for nut allergy we assessed the whole of State prevalence distribution of parent-reported nut allergy in 5 year old children entering school. Asian infants born in Australia are 3 times more likely to develop peanut allergy than non-Asian infants and rates of challenge-proven food allergy in infants have been found to be unexpectedly high in metropolitan Melbourne. To further investigate risk factors for nut allergy we assessed the whole of State prevalence distribution of parent-reported nut allergy in 5 year old children entering school. MethodsUsing the 2010 School Entrant Health Questionnaire administered to all 5 year old children in Victoria, Australia, we assessed the prevalence of parent-reported nut allergy (tree nut and peanut) and whether this was altered by region of residence, socioeconomic status, country of birth or history of migration. Prevalence was calculated as observed proportion with 95% confidence intervals (CI). Risk factors were evaluated using multivariable logistic regression and adjusted for appropriate confounders. Using the 2010 School Entrant Health Questionnaire administered to all 5 year old children in Victoria, Australia, we assessed the prevalence of parent-reported nut allergy (tree nut and peanut) and whether this was altered by region of residence, socioeconomic status, country of birth or history of migration. Prevalence was calculated as observed proportion with 95% confidence intervals (CI). Risk factors were evaluated using multivariable logistic regression and adjusted for appropriate confounders. ResultsNut allergy prevalence was 3.1% (95%CI 2.9-3.2) amongst a cohort of nearly 60,000 children. It was more common amongst children of mothers with higher education and socioeconomic index and less prevalent amongst children in regional Victoria than in Melbourne. While children born in Australia to Asian-born mothers (aOR 2.67 95%CI 2.28, 3.27) were more likely to have nut allergy than non-Asian children, children born in Asia who subsequently migrated to Australia were at decreased risk of nut allergy (aOR 0.1 95%CI 0.03, 0.31). Nut allergy prevalence was 3.1% (95%CI 2.9-3.2) amongst a cohort of nearly 60,000 children. It was more common amongst children of mothers with higher education and socioeconomic index and less prevalent amongst children in regional Victoria than in Melbourne. While children born in Australia to Asian-born mothers (aOR 2.67 95%CI 2.28, 3.27) were more likely to have nut allergy than non-Asian children, children born in Asia who subsequently migrated to Australia were at decreased risk of nut allergy (aOR 0.1 95%CI 0.03, 0.31). ConclusionsMigration from Asia after the early infant period appears protective for the development of nut allergy. Additionally, rural regions have lower rates of nut allergy than urban areas. Migration from Asia after the early infant period appears protective for the development of nut allergy. Additionally, rural regions have lower rates of nut allergy than urban areas.

Food Allergy in Infancy Is Associated with Dysbiosis of the Intestinal Microbiota

Food Allergy in Infancy Is Associated with Dysbiosis of the Intestinal Microbiota

Elevated IL-5 and IL-13 responses to egg proteins predate the introduction of egg in solid foods in infants with eczema.

Egg allergy is a leading cause of food allergy in young infants; however, little is known about early allergen-specific T-cell responses which predate the presentation of egg allergy, and if these are altered by early egg exposure. To investigate the early T-cell responses to multiple egg proteins in relation to patterns of egg exposure and subsequent IgE-mediated egg allergy. Egg-specific T-cell cytokine responses (IL-5, IL-13, IL-10, IFNγ and TNFα) to ovomucoid (OM), ovalbumin (OVA), conalbumin (CON) and lysozyme (LYS) were measured in infants with eczema at 4months of age (n=40), before randomization to receive 'early egg' or a placebo as part of a randomized controlled trial (Australian New Zealand Clinical Trials Registry number 12609000415202) and at 12months of age (n=58), when IgE-mediated egg allergy was assessed by skin prick test and food challenge. In 4-month-old infants, who had not directly ingested egg, those who subsequently developed egg allergy already had significantly higher Th2 cytokine responses to multiple egg allergens, particularly elevated IL-13 responses to OVA (P=0.004), OM (P=0.012) and LYS (P=0.003) and elevated IL-5 to the same antigens (P=0.031, 0.04 and 0.003, respectively). IL-13 responses (to OVA and LYS) and IL-5 responses (to LYS) at 4months significantly predicted egg allergy at 12months. All responses significantly declined with age in the egg-allergic infants, and this did not appear to be modified by 'early' introduction of egg. Elevated egg-specific Th2 cytokine responses were established prior to egg ingestion at 4months and were not significantly altered by introduction of egg. Th2 responses at 4months of age predicted egg allergy at 12months, suggesting that this could be used as a biomarker to select infants for early prevention and management strategies.

Atopic Dermatitis and Food Allergy: An Associated Genetic Burden

Background: The association with food allergy (FA) in children with atopic dermati tis (AD) confronts the allergists with one of their most genetic challenges. The fluctuating clinical course of the diseases and the large variety of the environmental triggering factors make the identification of the offending food(s) rather difficult. Since foods are common triggering factors of AD in infancy and in childhood, it would seem obvious that elimination diets should be useful in the identification of the offending food(s) in these patients. Objective: Historical information re ferred by parents and elimination diets are rarely helpful for the identifica tion of the offending foods and only double-blind placebo-controlled oral food challenges (DBPCOFC) are useful for the di agnosis. The diagnosis of FA in infancy and in childhood is a chal lenge both for the pediatrician and allergist because it can be easily ac com plished only when there is a relation between the ingestion of the of fending food(s) and the onset of the symptoms, and when it can be demonst rated that these symp toms are the consequence of an immunological reac tion. How ever, the underlying immunologic mechanisms may be difficult to doc ument, and the only immunologic mechanism easily to prove in current practice is the IgEmediated one. Conclusion: In this article we analyze the first steps in achieving the diag nosis of FA. The manifestations due to FA, including cow’s milk (CM) allergy (CMA), are common also to other diseases, and in addition no reliable labo ratory tests are available, therefore the diagnosis should be done on a prov en demonstration that the symptoms are correlated to the ingestion of the specific food, and that the diagnostic tests indicate an immunologic pathoge nesis.

新生児–乳児消化管アレルギー, クラスター分類について

新生児–乳児消化管アレルギーは2000年前後から急激な増加をみている. 症状は嘔吐, 血便, 下痢, 腹部膨満などがあるが, 体重増加不良が唯一の症状のこともある. 非即時型の食物アレルギーによって起こる消化管炎症が本態である. 食物特異的IgE抗体が主体ではないため, 精度の高い診断検査がないこと, また欧米の類縁疾患と臨床像が異なる患者が多いことから, 診断治療が遅れ, 重大事象に至ることもある. 消化管は食道からはじまり直腸に至る. 本症はさまざまな病変を示すが, いくつかのグループに分かれるのではないかと仮説を立て, クラスター分析を行ったところ, 嘔吐と血便の有無によって4つの患者グループ (クラスター) に分かれた. すなわち, 嘔吐と血便を起こすクラスター1, 嘔吐があり血便のないクラスター2, 嘔吐も血便もないクラスター3, 嘔吐がなく血便があるクラスター4である. これらのクラスターはそれぞれ検査結果にも特徴があり, 単なるフェノタイプではなくエンドタイプとさえいえる. 診断治療を行ううえで有用な分類である.

Does concurrent breastfeeding alongside the introduction of solid food prevent the development of food allergy?

The timing of introduction of solid food on the subsequent development of food allergy is under debate and the role of concurrent breastfeeding is unclear. The aim of the present study was to investigate the role of solid food introduction whilst concurrently breastfeeding on food allergy outcome, with a specific focus on cows' milk allergy. Prospectively collected infant feeding data from a birth cohort were analysed. Participants with histories suggestive of food allergy underwent diagnostic food challenges. Children with food allergy were matched to control participants for age and sex. Mann-Whitney U tests, χ2, Fisher exact tests and logistic regression calculations were undertaken. A total of thirty-nine food-allergic children and seventy-eight matched controls were identified, including twenty-two cows' milk-allergic children and forty-four matched controls. The control group introduced solid food earlier than the food-allergic group (P<0·05). There was no effect of concurrent breastfeeding alongside cows' milk introduction or other food allergens on the development of food allergy. Due to small numbers, it was not possible to explore differences for food allergy phenotype. We have therefore found no evidence that introducing solids, or food allergens, whilst breastfeeding has an allergy-preventative effect; however, the results should be interpreted with caution due to sample size. Recommendations regarding infant feeding and food allergy should be carefully considered. Although breastfeeding should be promoted for many health reasons, larger studies looking at the introduction of food allergens on the development of food allergy are needed to make a final conclusion.

Does LEAP change the screening paradigm for food allergy in infants with eczema?

The LEAP randomized controlled trial provides the first direct evidence that delayed introduction of peanut in an infant's diet significantly increases the risk of peanut allergy. However, as often is the case in ground-breaking research, the LEAP study raises almost as many questions as it resolves. Although the quality of design and excellence in study execution is unquestioned, the particular difficulty this study raises is how to generalize results from a trial of high-risk infants, which screened infants for the presence of peanut allergy prior to peanut introduction, to the general population. Although many existing infant feeding guidelines already allow for the introduction of allergenic foods from 4 to 6months of age irrespective of co-existent risk factors for peanut allergy, these will now need to be revised to more strongly state that avoidance may be harmful. Interim guidelines have already been published which incorporate these recommendations. However, the question as to how to achieve timely introduction of peanut into an infant's diet in a safe and cost-effective way, particularly in high-risk infants, remains unresolved.

Principles of personalized diet therapy of cow’s milk allergy in children

Cow’s milk allergy protein (CMPA) is the leading cause of food allergy in infants and young children. The personalized diet prescription, providing individual medical nutrition can be reliable guaranty of effective treatment for diverse range of CMPA symptoms. In spite of the fact that there are a lot of special infant formula in Russia, pediatricians and allergologists have difficulties in choosing appropriate diet. The suggested algorithm of individual option of extensively hydrolyzed proteinbased formula for CMPA patients will help doctors to optimize diet.

Food Allergy in Infants With Atopic Dermatitis: Limitations of Food-Specific IgE Measurements.

Children with atopic dermatitis (AD) have a higher risk for development of food allergies. The objective of this study was to examine incidence of food allergy development in infants with AD and the predictive value of food-antigen-specific immunoglobulin E measurements. This trial examined the long-term safety and efficacy of pimecrolimus cream 1% in >1000 infants (3-18 months) with mild-to-severe AD without a history of food allergy. Food allergy development was followed throughout a 36-month randomized double-blind phase followed by an open-label (OL) phase up to 33 months. Additionally, sIgE for cow's milk, egg white, peanut, wheat, seafood mix, and soybean was measured by ImmunoCAP at baseline, end of the double-blind phase, and end of OL phase. By the end of the OL phase, 15.9% of infants with AD developed at least 1 food allergy; allergy to peanut was most common (6.6%), followed by cow's milk (4.3%) and egg white (3.9%). Seafood, soybean, and wheat allergies were rare. Levels of sIgE for milk, egg, and peanut increased with severity of AD, as determined by Investigator's Global Assessment score. We assigned sIgE decision points for the 6 foods and tested their ability to predict definite food allergy in this population. Positive predictive values for published and newly developed sIgE decision points were low (<0.6 for all values tested). In a large cohort of infants at risk for development of food allergy, sIgE levels were not clinically useful for predicting food allergy development.

The overall and fat composition of milk of various species

Milk, an essential source of offspring nourishment, varies in it’s composition and properties significantly across species. In human nutrition, fresh milk and dairy products are valuable sources of protein, fat and energy, and are an important part of daily meals. Most of the world’s milk production (85 %) comes from cows followed by buffaloes, goats, ewes, mares and donkeys. However milk related food allergies in infants may be a reason for health problems and may cause a decrease in milk. The objective of this paper was to give an overview of the overall composition of milk and fat from different species in comparison to women milk. Regarding the overall milk composition remarkable differences in energy content, fat, lactose, protein and ash of the various milks were found, but also some similarities among milk from ruminants and non-ruminants were detected. The structures of fat globule membranes were similar among non-ruminants and women milk, while the milk fat globule structure in ruminants differed significantly. The size of fat globules was significantly different between species and highly correlated to the milk fat content, regardless of the specie. The amount of triacylglycerols was notably higher, while the amount of free fatty acids and phospholipids was notably lower in milk from ruminants and women compared to milk from mares and donkeys. The triacylglycerol structure in women and non-ruminantsˈ was similar. The percentage of saturated and monounsaturated fatty acids was lower, while the unsaturated fatty acid content was higher in milk from non-ruminants, with a remarkably higher percentage of C-18:2 and C-18:3. The cholesterol content was similar in women and ruminantsˈ milk, but lower in that of non-ruminants. This review indicates that milk from non-ruminants could be more suitable for human nourishment than milk from ruminants.