Determination of allergenicity to three cow's milk hydrolysates and an amino acid‐derived formula in children with cow's milk allergy

Determination of allergenicity to three cow's milk hydrolysates and an amino acid‐derived... Background Products based on hydrolysed cow milk proteins or amino acid mixtures are recommended in children with cow's milk hypersensitivity. However, some children who are allergic to cow's milk and who clinically react to substitute milk formulas have been observed. Objective To determine the tolerance and allergenicity of protein hydrolysate or amino acid‐derived formulas in children with IgE‐mediated cow's milk allergy. Methods Twenty children with positive cow's milk challenges, positive skin prick tests and/or serum‐specific IgE antibodies to cow's milk were selected. Oral challenges, skin prick tests and serum‐specific IgE antibodies to extensively hydrolysed whey formula, partially hydrolysed whey formula, extensively hydrolysed casein formula and amino acid‐derived formula were performed. Results Five out of 17 (5/17) children reacted to partially hydrolysed whey formula, (3/16) to extensively hydrolysed whey formula, (2/10) to amino acid‐derived formula, (1/16) to extensively hydrolysed casein formula. Only extensively hydrolysed casein formula was tolerated by at least 90% (with 95% confidence intervals) of children. Hydrolysates provoked early and delayed clinical reactions, amino acid mixtures only delayed reactions. Partially hydrolysed whey formula elicited a significantly higher number of positive skin prick test reactions than other formulas. Two children had specific IgE antibodies to extensively hydrolysed whey formula, one to partially hydrolysed whey formula, one to extensively hydrolysed casein formula and none to amino acid‐derived formula. Conclusion In this study, none of the cow's milk substitutes has been found to be non‐allergenic. Our results suggest that in children with IgE‐mediated cow's milk allergy, the first ingestions of extensively hydrolysed cow's milk protein formulas require strict medical supervision because of immediate reactions. This is not the case for amino acid‐derived formula. Moreover, our data suggest that treatment of children allergic to cow's milk with cow's milk substitutes should be monitored for several days to document tolerance. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Clinical & Experimental Allergy Wiley

Determination of allergenicity to three cow's milk hydrolysates and an amino acid‐derived formula in children with cow's milk allergy

Loading next page...
 
/lp/wiley/determination-of-allergenicity-to-three-cow-s-milk-hydrolysates-and-an-WAG2v3kq8t
Publisher
Wiley
Copyright
Copyright © 2002 Wiley Subscription Services, Inc., A Wiley Company
ISSN
0954-7894
eISSN
1365-2222
DOI
10.1046/j.0022-0477.2001.01262.x
Publisher site
See Article on Publisher Site

Abstract

Background Products based on hydrolysed cow milk proteins or amino acid mixtures are recommended in children with cow's milk hypersensitivity. However, some children who are allergic to cow's milk and who clinically react to substitute milk formulas have been observed. Objective To determine the tolerance and allergenicity of protein hydrolysate or amino acid‐derived formulas in children with IgE‐mediated cow's milk allergy. Methods Twenty children with positive cow's milk challenges, positive skin prick tests and/or serum‐specific IgE antibodies to cow's milk were selected. Oral challenges, skin prick tests and serum‐specific IgE antibodies to extensively hydrolysed whey formula, partially hydrolysed whey formula, extensively hydrolysed casein formula and amino acid‐derived formula were performed. Results Five out of 17 (5/17) children reacted to partially hydrolysed whey formula, (3/16) to extensively hydrolysed whey formula, (2/10) to amino acid‐derived formula, (1/16) to extensively hydrolysed casein formula. Only extensively hydrolysed casein formula was tolerated by at least 90% (with 95% confidence intervals) of children. Hydrolysates provoked early and delayed clinical reactions, amino acid mixtures only delayed reactions. Partially hydrolysed whey formula elicited a significantly higher number of positive skin prick test reactions than other formulas. Two children had specific IgE antibodies to extensively hydrolysed whey formula, one to partially hydrolysed whey formula, one to extensively hydrolysed casein formula and none to amino acid‐derived formula. Conclusion In this study, none of the cow's milk substitutes has been found to be non‐allergenic. Our results suggest that in children with IgE‐mediated cow's milk allergy, the first ingestions of extensively hydrolysed cow's milk protein formulas require strict medical supervision because of immediate reactions. This is not the case for amino acid‐derived formula. Moreover, our data suggest that treatment of children allergic to cow's milk with cow's milk substitutes should be monitored for several days to document tolerance.

Journal

Clinical & Experimental AllergyWiley

Published: Jan 1, 2002

References

You’re reading a free preview. Subscribe to read the entire article.


DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Search

Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly

Organize

Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.

Access

Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

DeepDyve

Freelancer

DeepDyve

Pro

Price

FREE

$49/month
$360/year

Save searches from
Google Scholar,
PubMed

Create folders to
organize your research

Export folders, citations

Read DeepDyve articles

Abstract access only

Unlimited access to over
18 million full-text articles

Print

20 pages / month

PDF Discount

20% off