Yogurt is tolerated by the majority of children with IgE-mediated cow’s milk allergy
Main Article Content
Keywords
Cow’s milk allergy, Yogurt, Oral food challenge, Tolerance
Abstract
Background: Children with IgE-mediated cow’s milk allergy (IgE-CMA) with gastrointestinal symptoms tolerate yogurt at 100%. Yogurt tolerance in children with IgE-CMA with urticaria and anaphylaxis was 7%.
Methods: We enrolled children with IgE-CMA with cutaneous, respiratory, gastrointestinal and anaphylactic symptoms. All performed prick by prick (PbP) and oral food challenge (OFC) with yogurt. Some children performed also an OFC with CM mixed with wheat flour and baked, baked liquid CM, parmesan.
Results: 34 children were enrolled, 31/34 (91%) with systemic adverse reaction after ingestion of CM (systemic CMA), 3/34 (9%) with isolated contact urticaria (ICU CMA). PbP with yogurt was negative only in one patient. OFC with yogurt was passed (that is, the OFC was negative) by 20/31 (64%) of the children with systemic CMA. 10/11 (91%) of the patients who failed OFC (that is, the OFC was positive) with yogurt were positive to SPT with casein vs. 8/20 (40%) of the patients who passed it (p = 0.018). None of the 19 children who passed OFC with yogurt failed all OFC with processed CM forms other than yogurt that tested vs. 4/8 among those who failed OFC with yogurt (p = 0.006). The rub test with yogurt was negative in 1/3 (33%) of the patients with ICU CMA.
Conclusions: The results of our study are placed alongside others already present in the literature and concerning other methods of processing CM proteins and help to reduce the dietary restrictions of the majority of children with systemic IgE-CMA.
References
2. Lemon-Mulé H, Sampson HA, Sicherer SH, Shreffler WG, Noone S, Nowak-Wegrzyn A. Immunologic changes in children with egg allergy ingesting extensively heated egg. J Allergy Clin Immunol. 2008;122:977-83.
3. Alessandri C, Sforza S, Palazzo P, Lambertini F, Paolella S, Zennaro D, et al. Tolerability of a fully maturated cheese in cow’s milk allergic children: biochemical, immunochemical, and clinical aspects. PLoS One. 2012;7:e40945.
4. Bu G, Luo Y, Chen F, Liu K, Zhu T. Milk processing as a tool to reduce cow’s milk allergenicity: a mini-review. Dairy Sci Technol. 2013;93:211-23.
5. Bu G, Luo Y, Zhang Y, Chen F. Effects of fermentation by lactic acid bacteria on the antigenicity of bovine whey proteins. J Sci Food Agric. 2010;90:2015-20.
6. Tzvetkova I, Dalgalarrondo M, Danova S, Iliev I, Ivanova I, Chobert J-M, et al. Hydrolysis of major dairy proteins by lactic acid bacteria from Bulgarian yogurts. J Food Biochem. 2007;31:680-702.
7. Pescuma M, Hébert EM, Rabesona H, Drouet M, Choiset Y, Haertlé T, et al. Proteolytic action of Lactobacillus delbrueckii subsp. bulgaricus CRL 656 reduces antigenic response to bovine-lactoglobulin. Food Chem. 2011;127:487-92.
8. Poza-Guedes P, Barrios Y, González Pérez R, Sánchez-Machín I, Franco A, Matheu V. Yogurt in the treatment of -lactoglobulininduced gastrointestinal cow’s milk allergy. J Invest Allergol Clin Immunol. 2016;26:327-9.
9. Uncuoglu A, Yologlu N, Simsek IE, Uyan ZS, Aydogan M. Tolerance to baked and fermented cow’s milk in children with IgEmediated and non-IgE-mediated cow’s milk allergy in patients under two years of age. Allergol Immunopathol. 2017;45:560-6.
10. Heinzerling L, Mari A, Bergmann KC, Bresciani M, Burbach G, Darsow U, et al. The skin prick test - European standards. Clin Transl Allergy. 2013;3:3.
11. Sampson HA, Gerth van Wijk R, Bindslev-Jensen C, Sicherer S, Teuber SS, Burks AW, et al. Standardizing double-blind, placebo-controlled oral food challenges: American Academy of Allergy, Asthma & Immunology-European Academy of Allergy and Clinical Immunology PRACTALL consensus report. J Allergy Clin Immunol. 2012;130:1260-74.
12. Sampson HA, Munoz-Furlong ˜ A, Campbell RL, Adkinson NF Jr, Bock SA, Branum A, et al. Second symposium on the definition and management of anaphylaxis: summary report - second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium. Ann Emerg Med. 2006;47:373-80.
13. Miceli Sopo S, Greco M, Monaco S, Bianchi A, Cuomo B, Liotti L, et al. Matrix effect on baked milk tolerance in children with IgE cow milk allergy. Allergol Immunopathol (Madr). 2016;44:517-23.
