Persistent Cow Research Articles

Primary prevention of food allergy in children

Pediatricians and allergists have noted a recent increase in cases of food allergy and anaphylaxis to peanuts and nuts, affecting very young children with worrying consequences in terms of quality of life. Children suffering from persistent cow's milk protein allergies that do not heal spontaneously are at very high risk of a fatal accident. Based on the findings of these studies, recommendations for primary prevention are made.

Comprehensive Care and Education Can Improve Nutritional and Growth Outcomes in Children with Persistent Cow's Milk, Egg, or Peanut Allergies: A Five-Year Follow-Up Study of Nutritional Status.

Data suggest that food allergies greatly impact a child's health and growth due to inadequate nutrient intake. Our study aimed to establish the long-term outcome of children with food allergies compared to a control group. This study was a retrospective cohort study with longitudinal follow-up with a mean period of 4.85 years from the diagnosis to the last study visit. The patients' nutritional intake was assessed using a three-day food diary and analysed by a dietitian. Patients (61 boys and 33 girls, mean age 6.9 years) had a single food allergy including 21 patients with cow's milk, 34 with egg, and 39 with peanut allergies. The control group included 36 children (19 boys and 17 girls, mean age 8.03 years). Blood analysis was performed on all participants. Data from our study showed that patients with cow's milk, egg or peanut allergies had normal growth and achieved catch-up growth from the diagnosis until the last study visit. In the cow's milk allergy group, the allergy was shown to affect calcium intake (p < 0.05), while egg and peanut allergies did not impact the dietary intake of nutrients. None of the investigated food allergies affected blood results (p < 0.05). In the present study, we showed that single food allergies do not compromise growth in children if they are provided with appropriate support and that the affected children reach catch-up growth from the diagnosis.

PSXII-2 Lactation Persistence Analysis and Its Genetic Correlations with Productive, Reproductive, and Health Traits in the First Two Parities in Lucerna Cattle

Abstract Lactation persistency (LP) is a trait of economic relevance in dairy cattle since persistent cows are more profitable by presenting fewer diseases, requiring fewer inputs, and having better reproductive performance. Therefore, the main objective of this study was to estimate genetic relationships between lactation persistency for mastitis (MT), calving interval (CI), and 305–day milk yield (305M) in first and second Lucerna cattle lactations. Records from 67,952 test–day milk, 7,100 CI, and 1,074 clinical-mastitis evaluations from two Colombian farms of Creole dual-purpose cattle were considered. Five three-parameter equations, as reported in previous literature, were graphically and statistically evaluated for fitting a lactation curve (LC) for each parity. The goodness-of-fit criteria included AIC, BIC, RSS, and R2. The most appropriate equation was identified and implemented for predicting 305M for 4,620 lactations (2,716 and 1,904 from first and second parity, respectively) for which LP was estimated. Bi-trait animal models between LP-MT, LP-CI, and LP-M305 for each parity were executed in the BLUPF90+ software (AI-REML algorithm) to estimate heritabilities (h2) and genetic correlations (GC). Fixed effects of herd, year of calving, season of calving, b0 lactation parameter, and age at calving were included. Estimates of goodness-of-fit criteria for all LC equations varied between R2 (0.29 – 0.68), BIC (132,322 – 207,415), AIC (132,289 – 207,389), and RSS (188,231 – 414,007). The incomplete gamma equation best satisfied the goodness-of-fit-criteria and drew the most accurate LC in both parities. Due to the low data density in this work, estimates involving MT and CI had increased standard deviations; therefore, the interpretation should be considered cautiously. The h2 estimates were 0.0 and 0.24 for MT, 0.02 and 0.09 for CI, 0.18 and 0.36 for M305, and 0.14 and 0.15 for LP, for the first and second parity, respectively. The GC estimates were -0.24 and -0.41 for LP–M305, 0.31 – 0.35 for LP–CI, and -0.76 for LP–MT for each parity, respectively. The results of this study suggest that LP could be considered as a selection target in the farms’ breeding program since desirable relationships were found with all evaluated traits for the first and second parity.

Comparison of fixed and random regression models for the analysis of milk production traits in South African Holstein dairy cattle under two production systems

Fixed regression model (FRM) analyses that consider only fixed, non-genetic effects to vary over the lactation are currently used for genetic evaluation of production traits in South African Holstein. With random regression models (RRM), the random animal and permanent environmental effects are allowed to also vary over the lactation. Hence, RRM can account for an individual component representing changes during the lactation i.e., its persistency (PERS), enabling selection for more persistent cows. Also, test-day (TD) records used for genetic evaluations come from cows in contrasted production systems. The main ones rely on full pasture (PAST) or a total mixed ration (TMR), a choice often depending on local average rainfall where herds are situated. TD records from herds were divided into 2 datasets based on the production system (PAST or TMR). REML was used to analyze production for each of the first 3 lactations under different multiple-lactation models for milk, butterfat and protein production, as well as butterfat and protein percentage. Various FRM were compared to the current FRM officially used for genetic evaluation in South Africa (saFRM). A FRM that cumulates different curves over the lactation for different fixed effects was retained based on results in the PAST dataset and was also applied to the TMR dataset. This model was then broadened to an alternative RRM (aRRM) combining for each lactation an average production and a PERS effect, after which it was compared to the current saFRM under both production systems. The aRRM for both PAST and TMR had a better goodness of fit than the current saFRM for all traits except protein percentage. The mean squared error of aRRM was lower for all traits. Generally, aRRM heritability estimates (h2) were higher than with the saFRM at the beginning and end of lactation for most traits in PAST while being mostly higher during late lactation in TMR. Overall, the h2 in PAST were mostly higher than in TMR for all traits. Estimates of between-lactations genetic correlations for average production from the aRRM were generally higher. Within-lactations genetic correlations between average production and PERS for TMR from the aRRM were negative and stronger than for PAST. The extra source of information from the aRRM enables a genetic prediction of PERS and is expected to increase accuracy of genetic predictions. Different genetic parameters between the 2 production systems may denote a genotype x environment interaction.

Risk factors for discontinuing oral immunotherapy in children with persistent cow milk allergy.

BackgroundThere are no universally accepted criteria for discontinuing milk oral immunotherapy (MOIT) in patients with persistent cow milk allergy (CMA) and little data are available on predictive risk factors for dropping out from oral immunotherapy (OIT), due to allergic reactions or other reasons.MethodsWe retrospectively reviewed clinical records of patients with persistent severe CMA undergoing MOIT in a tertiary care center hospital to investigate risk factors associated with discontinuation of OIT. Persistent and severe allergy was defined as the history of systemic reactions and any milk protein‐specific IgE level >85 kU/ml. All patients were first admitted for an in‐hospital rush phase eventually followed by an at‐home dose increase. We evaluated the effect of various factors on two primary outcomes: the highest dose of milk ingested during the in‐hospital rush phase and during the home OIT phase.ResultsWe identified 391 patients, of whom 131 met the inclusion criteria for the retrospective study, 54 females and 77 males. Data of the home OIT phase were available for 104 patients (27%).Regarding the home OIT outcome, an association for having a cow milk avoiding diet was found with reaching a dose below 10 ml during the in‐hospital rush phase (relative risks [RR]: 2.33, confidence interval [CI]: 0.85; 6.42), an age above than 10 years from the time of admission (RR: 3.29, CI: 0.85; 12.73), and a higher total number of reactions occurred during the hospitalization (RR: 1.54, CI: 1.02; 2.32), whereas the presence of respiratory reactions with wheezing (RR: 1.93, CI: 0.49; 7.61) and an IM adrenaline use was related to a higher risk of having an OIT still in progress (RR: 5.47, CI: 0.33; 7.73).ConclusionsIn this cohort of children with persistent CMA undergoing OIT who presented with respiratory reactions with wheezing, the development of anaphylaxis with the need for IM adrenaline, and age above 10 years were predictors of poor long‐term outcome.

The endocrine and epigenetic impact of persistent cow milk consumption on prostate carcinogenesis

This review analyzes the potential impact of milk-induced signal transduction on the pathogenesis of prostate cancer (PCa). Articles in PubMed until November 2021 reporting on milk intake and PCa were reviewed. Epidemiological studies identified commercial cow milk consumption as a potential risk factor of PCa. The potential impact of cow milk consumption on the pathogenesis of PCa may already begin during fetal and pubertal prostate growth, critical windows with increased vulnerability. Milk is a promotor of growth and anabolism via activating insulin-like growth factor-1 (IGF-1)/phosphatidylinositol-3 kinase (PI3K)/AKT/mechanistic target of rapamycin complex 1 (mTORC1) signaling. Estrogens, major steroid hormone components of commercial milk of persistently pregnant dairy cows, activate IGF-1 and mTORC1. Milk-derived signaling synergizes with common driver mutations of the PI3K/AKT/mTORC1 signaling pathway that intersect with androgen receptor, MFG-E8, MAPK, RUNX2, MDM4, TP53, and WNT signaling, respectively. Potential exogenously induced drivers of PCa are milk-induced elevations of growth hormone, IGF-1, MFG-E8, estrogens, phytanic acid, and aflatoxins, as well as milk exosome-derived oncogenic microRNAs including miR-148a, miR-21, and miR-29b. Commercial cow milk intake, especially the consumption of pasteurized milk, which represents the closest replica of native milk, activates PI3K-AKT-mTORC1 signaling via cow milk’s endocrine and epigenetic modes of action. Vulnerable periods for adverse nutrigenomic impacts on prostate health appear to be the fetal and pubertal growth periods, potentially priming the initiation of PCa. Cow milk-mediated overactivation of PI3K-AKT-mTORC1 signaling synergizes with the most common genetic deviations in PCa, promoting PCa initiation, progression, and early recurrence.

Persistent Cow’s Milk Allergy Is Associated With Decreased Childhood Growth: A Longitudinal Study

KA Robbins, RA Wood, CA Keet. J Allergy Clin Immunol . 2020;145(2):713–716.e4 To determine the long-term effects of persistent cow’s milk (CM) or peanut (PN) and/or tree nut allergy (TN) on growth past childhood age. A retrospective chart review of 191 children with persistent IgE–mediated allergy to CM or PN and/or TN at age 9 seen at the John Hopkins Pediatric Allergy Clinic from November 1994 to March 2015. Patients adhered to a strict elimination diet and had clinic visits between the ages of 2–4, 5–8, and 9–12 years. Clinical data and anthropometric measurements were collected at all visits for patients …

L’immunothérapie orale au lait de vache : expérience d’un service de pédiatrie à Alger

Oral immunotherapy (OIT) has been recognized as a promising treatment for persistent cow's milk allergy (CMA). The objective of this study is to analyze the clinical, biological and evolutionary characteristics of patients on OIT. MethodsProspective study carried out in the pediatric ward A at the Béni Messous University Hospital in Algiers, which concerned all the children followed for CMA and in whom an OIT was practiced. ResultsOne hundred and twenty-eight patients were followed for mediated CMA IgE of which 38 needed an OIT (22.8 %), 24 boys and 14 girls, median age 4.8 years (1.5–10.5), the initial dose was between 0.6 and 100ml, baked milk was used in all patients, 52.6 % of which was baked in a wheat matrix. The mean duration of ITO was 17.5 months with an average healing age of 6.5 years. A high level of IgE specific to cow's milk and particularly to casein was correlated with a more advanced healing age. 55.2 % had associated asthma. Single organ allergic reactions have been reported without adrenaline need except in one patient. ConclusionThe results are encouraging, 63 % consumption more than 200ml/day, the others are on a personalized therapeutic escalation. The kinetics of specific IgE and ST were used to guide the OIT. Although incidents were infrequent, vigilance was required during the ITO.

Persistent cow’s milk allergy is associated with decreased childhood growth: A longitudinal study

Persistent cow’s milk allergy is associated with decreased childhood growth: A longitudinal study

Outcome of oral immunotherapy for persistent cow's milk allergy from 11years of experience in Finland.

The safety and efficacy of long-term milk oral immunotherapy (OIT) in Finnish children with persistent cow's milk allergy (CMA) were evaluated in an open-label, non-randomized study. During the 11-year study, 296 children aged 5years or older with immunoglobulin E (IgE)-mediated CMA started milk OIT. Follow-up data were collected at three time points: the post-buildup phase, 1year thereafter, and at the cross-sectional long-term follow-up between January 2016 and December 2017. Patients were divided according to baseline milk-specific IgE (sIgE) level and by the amount of milk consumption at the long-term follow-up. The high-dose group consumed ≥2dL of milk daily, while the failure group consumed <2dL of milk or were on a milk-avoidance diet. Out of the initial study group, 244/296 (83%) patients participated in the long-term follow-up. Among these patients, 136/244 (56%) consumed ≥2dL of milk daily. The median follow-up time was 6.5years. Of the recorded markers and clinical factors, the baseline milk sIgE level was most associated with maintaining milk OIT (P<0.001). Respiratory symptoms in the post-buildup phase increased the risk of treatment failure (OR 3.5, 95% CI: 1.5-8.1, P=0.003) and anaphylaxis (OR 14.3, 95% CI: 1.8-114, P=0.01). More than half of the patients were able to maintain the targeted milk dose in their daily diet. Baseline milk sIgE level and reactivity during the early treatment stage strongly predicted the long-term outcome and safety of milk OIT.

Persistent Cow’s Milk Allergy is Associated with Decreased Growth: A Longitudinal Study

Persistent Cow’s Milk Allergy is Associated with Decreased Growth: A Longitudinal Study

Anaphylaxis to cutaneous exposure to bovine colostrum based cream

Children who are highly sensitive to milk may also have severe allergic reactions after exposure to cow's milk proteins(CMP) through a different administration route than the oral one. We describe the case of a 16-year-old Caucasian boy with a clinical history of persistent cow's milk allergy (CMA), who developed one episode of anaphylaxis following cutaneous application of a bovine colostrum containing cream to a surgical wound. UniCAP testing showed a significant elevation in specific IgE antibodies to whey milk proteins. Until now, only three cases of anaphylaxis following cutaneous application of products containing milk proteins were available in the scientific literature.

Alterations of lymphocyte subpopulations and TGF-β in children with transient or persistent cow’s milk allergy

ABSTRACT The aim of the study was to evaluate changes in surface receptor expression of B and T lymphocytes and concentration of TGF-β in children who either developed tolerance to cow’s milk protein (CMP) or manifested persistent cow’s milk allergy (CMA). The study involved 30 patients with CMA who underwent an open food challenge after 12 months of milk-free diet. After the milk challenge, decreased concentration of CD19+CD23+ was observed in children who acquired tolerance to CMP, in comparison with the test before cow’s milk (CM) challenge (42.2% vs. 29.1%, p = .006). The same group demonstrated lower concentration of TGF-β than patients with persistent allergy (median 37.9 pg/ml vs. 52.8 pg/ml, p = .003, respectively). Moreover, before CM challenge, higher percentage of CD3+CD8+CD28+CD152+ cells (median 2.88% vs. 1.2%, p = .03) and CD3+CD4+CD25+CD62L+ (median 42.3% vs. 13.4%, p = .032) was noted in children who acquired tolerance to CMP, in comparison with subjects who remained allergic to CMP.

Eosinophilic Esophagitis: Latent Disease in Patients with Anaphylactic Reaction to Cow's Milk

Food allergy and eosinophilic esophagitis are a substantial and evolving public health issue. Clinicians should know the relationship between these diseases and how one may predispose to the other. This can help minimize misdiagnosis. The objective of this study was to assess esophageal eosinophilia and eosinophilic esophagitis frequency in patients with persistent cow's milk allergy and anaphylaxis manifestations. Patients with persistent cow's milk allergy with anaphylaxis manifestations were enrolled from 2012 through 2016 at the São Paulo University Hospital, Brazil. All of them were submitted to endoscopy despite the presence or absence of gastrointestinal symptoms. Demographics data, atopic comorbidities, medication use, endoscopic findings, and esophageal eosinophilia frequency were evaluated. Eighty-nine patients were selected. The median age was 8 years. It was observed that 34 of 89 patients (38.2%; 95% confidence interval [CI]: 28.14%-49.16%) presented with esophageal eosinophilia. Five patients (7.1%) presented proton pump inhibitor-responsive esophageal eosinophilia, and 10 patients (14.2%) presented eosinophilic esophagitis. We found that 29.4% were asymptomatic patients, 23.5% had nonspecific symptoms, 23.5% had persistent typical symptoms, and 23.5% had intermittent typical symptoms. There was an association with inflammatory endoscopy findings in 21 patients (61.7%). This description demands scientific attention because it is the highest frequency of esophageal eosinophilia yet described in a group of patients with cow's milk allergy presenting with anaphylaxis. Eosinophilic esophagitis is a condition that can coexist "silently" with an IgE-mediated food allergy and is most often underestimated and underdiagnosed.

Tolerance to baked milk in Brazilian children with persistent cow's milk allergy

Methods Patients with cow s milk allergy, over 4 years-old, were submitted to oral challenge with baked milk, from January to November, 2013, at Universidade de Sao Paulo, Brazil. The tested product was a muffin that contained 2,8 g milk protein and was baked at 350° F in an oven for 30 minutes. The challenge was made under physician supervision and at the first sign of allergy reaction it was discontinued, and the patient received the proper medical assistance.

Oral cow's milk immunotherapy: clinical and serological data in long‐term follow up

Oral food inmunotherapy is a promising therapeutic aproach in patients with persistent cow's milk allergy (CMA). Although it seems that these protocols show a better outcome in patients with “milder” symptoms (i.e. non anaphylactic reactions) there are controversial results in highly sensitized subjects. We select patients with persistent CMA and severe uncontrolled anaphylactic symptoms despite a correct restrictive diet. We performed a two-day desensitization procedure at the Pediatric Critical Care Unit in our Institution. The second phase was weekly scheduled in the Outpatient clinic to reach a final cumulative dose of 250 ml of undiluted milk. Clinical and serological date were collected every six month for a five-year period. Fifteen children (2-16 y.o.) were included. All children reached the final dose of 250 ml of undiluted milk in less than ten weeks. Clinical follow-up every 6 months remained during 5 years to register all adverse reactions and possible factors involved. Serological changes were obtained every six months during the subsequent five years, including specific IgE and IgG4. Anaphylactic CMA patients may benefit from rush oral Cow's Milk immunotherapy. Clinical and serological changes have been found both at early and long-term follow-up. Several factors were involved in reactions for temporary loss of tolerance.

Persistent cow′s milk allergy with attacks of anaphylaxis

The most common food protein causing allergy in infants and young children is cow's milk, but persistence of this allergy into adulthood is rare. It is estimated that 2-3% of the general population suffers from cow's milk allergy (CMA), but reports of anaphylaxis in adulthood are limited. This case report discusses persistence of CMA with several anaphylaxis episodes in a 12-year-old girl who had allergic reactions from 6 months of age. She is also unable to tolerate milk from all available animal sources including goat and sheep. Skin prick test was strongly positive at 10 mm at 7 years of age, with specific IgE cow's milk >100 kUA/L when she presented with anaphylaxis episodes 5 years later. Patient-specific management plans need to be in place to avoid and manage anaphylaxis, especially for patients who do not have easy access to healthcare.

Clinical Predictors for Favorable Outcomes in an Oral Immunotherapy Program for IgE-Mediated Cow's Milk Allergy.

MB Levy, A Elizur, MR Goldberg, L Nachshon, Y Katz. Ann Allergy Asthma Immunol. 2014;112(1):58–63.e1 The goal of this study was to assess the safety and efficacy of milk oral immunotherapy (OIT) in milk-allergic children and adults, including high-risk patients. The study included 280 Israeli patients, ages 4 to 27 years (median age: 7.5 years), with persistent cow’s milk allergy as defined by positive results on skin prick test and/or specific-serum IgE, positive oral food challenge, or history of clinical reaction with accidental exposure in the last 12 months. High-risk patients, including those with a history of anaphylaxis (as defined by involvement of at least …

Long-Term Follow Up In Cow's Milk Anaphylaxis After Successful Rush Oral Immunotherapy

RationaleOral food desensitization is a promising therapeutic aproach in patients with persistent cow’s milk allergy (CMA). Although it seems that these protocols show a better outcome in those afflicted with “milder” symptoms (i.e. non anaphylactic reactions) there are controversial results in highly sensitised subjects.MethodsPatients with persistent CMA and severe uncontrolled anaphylactic symptoms despite a correct restrictive diet. We performed a two-day desensitization procedure at the Pediatric Critical Care Unit in our Institution. Starting from a 1/100 milk dilution, the patients were progressively exposed to incresing doses ut to 4 ml of undiluted milk. The second phase of the current study was weekly scheduled in the Outpatient clinic to reach a final cumulative dose of 250 ml of undiluted milk. Clinical and serological date were collected every six month for a five-year period.ResultsTen children (2-15 y.o.) were included. All children reached the final dose of 250 ml of undiluted milk in less than ten weeks. Significant clinical and serological changes were obtained not only in the first six months but during the subsequent five years.ConclusionsHighly sensitised CMA patients may benefit from rush oral Cow’s Milk immunotherapy. Clinical and serological changes have been found both at early and long-term stages of the follow-up. RationaleOral food desensitization is a promising therapeutic aproach in patients with persistent cow’s milk allergy (CMA). Although it seems that these protocols show a better outcome in those afflicted with “milder” symptoms (i.e. non anaphylactic reactions) there are controversial results in highly sensitised subjects. Oral food desensitization is a promising therapeutic aproach in patients with persistent cow’s milk allergy (CMA). Although it seems that these protocols show a better outcome in those afflicted with “milder” symptoms (i.e. non anaphylactic reactions) there are controversial results in highly sensitised subjects. MethodsPatients with persistent CMA and severe uncontrolled anaphylactic symptoms despite a correct restrictive diet. We performed a two-day desensitization procedure at the Pediatric Critical Care Unit in our Institution. Starting from a 1/100 milk dilution, the patients were progressively exposed to incresing doses ut to 4 ml of undiluted milk. The second phase of the current study was weekly scheduled in the Outpatient clinic to reach a final cumulative dose of 250 ml of undiluted milk. Clinical and serological date were collected every six month for a five-year period. Patients with persistent CMA and severe uncontrolled anaphylactic symptoms despite a correct restrictive diet. We performed a two-day desensitization procedure at the Pediatric Critical Care Unit in our Institution. Starting from a 1/100 milk dilution, the patients were progressively exposed to incresing doses ut to 4 ml of undiluted milk. The second phase of the current study was weekly scheduled in the Outpatient clinic to reach a final cumulative dose of 250 ml of undiluted milk. Clinical and serological date were collected every six month for a five-year period. ResultsTen children (2-15 y.o.) were included. All children reached the final dose of 250 ml of undiluted milk in less than ten weeks. Significant clinical and serological changes were obtained not only in the first six months but during the subsequent five years. Ten children (2-15 y.o.) were included. All children reached the final dose of 250 ml of undiluted milk in less than ten weeks. Significant clinical and serological changes were obtained not only in the first six months but during the subsequent five years. ConclusionsHighly sensitised CMA patients may benefit from rush oral Cow’s Milk immunotherapy. Clinical and serological changes have been found both at early and long-term stages of the follow-up. Highly sensitised CMA patients may benefit from rush oral Cow’s Milk immunotherapy. Clinical and serological changes have been found both at early and long-term stages of the follow-up.

Cow's Milk Allergen Specific CD4+ T Cell Responses In Patients With Persistent Cow's Milk Allergy

Cow's Milk Allergen Specific CD4+ T Cell Responses In Patients With Persistent Cow's Milk Allergy