Chemically Defined Formulas, Symbiotics and Cow’s Milk Protein Allergy

Cow milk protein allergy (CMPA) becoming a major public health issue that has attracted the attention of health professionals and researchers. This paper aimed to review the important aspects of both IgE and IgG types of cow’s milk protein allergy in terms of prevalence, clinical manifestation, risk factors, other health-related issues and nutritional therapy proposed for such allergies in the adult and pediatric population in Saudi Arabia. A search on “cow’s milk allergy” was done using PubMed, Google Scholar and Scopus Engine for published papers between 1993 and 2020 to find studies yielding knowledge on that context. The prevalence of cow’s milk protein allergy (CMPA) among infants is now in the range of 2–3%. This type of allergy is also detected in adulthood but less frequently. CMPA is defined as an immunological reaction to specific proteins in milk. CMPA is classified based on its type as an immunoglobulin E (IgE)-mediated form and an immunoglobulin G (IgG)-mediated form, each type representing different immunological pathways. The presence of Genetic aspects, family history and short duration of breastfeeding in the infant are among the risk factors contributing to this form of allergy. Its manifestations mainly present as skin presentation, followed by the gastrointestinal and respiratory presentation in most cases in addition to a life-threatening anaphylactic reaction that may occur in 12% of cases. food allergy committees have developed strict diagnosis criteria, including blood testing for food-specific immunoglobulin E (sIgE), a skin prick test and double-blind placebo-controlled food challenges (DBPCFC) as the gold standard. A diet free of cow’s milk protein (CMP) allergen and including the appropriate alternative milk formula is the first line of prevention recommended by many organizations and food allergy experts. As for Saudi Arabia, more research and clinical trials are required to discuss the various aspects of adult and pediatric CMPA and to provide a better understanding along with good control strategies implementation.

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Immunological biomarkers changes during diet therapy in children with food allergy

Rossiiskii Allergologicheskii ZHurnal ◽

10.36691/rja510 ◽

2015 ◽

Vol 12 (1) ◽

pp. 73-78

Author(s):

I V Vorozhko ◽

T B Sentsova ◽

V A Revyakina ◽

O O Chernyak ◽

S N Denisova

Keyword(s):

Food Allergy ◽

Milk Protein ◽

Goat Milk ◽

Specific Ige ◽

Diet Therapy ◽

Cow’S Milk ◽

Igg Antibodies ◽

Cow's Milk ◽

Cow’S Milk Protein ◽

Different Sources

Immunological estimating of different diet therapy types became currently very important. The aim of this work was to study the changes of immunological biomarkers during usage of formulas based on different sources of protein in children with food allergy and to assess and predict the effectiveness of diet therapy. The study included 66 children with food allergy in age from 1,5 months to 1,5 years. Observed children were divided into three groups depending on the type of formulas used. The dynamics of immunoregulatory substances (IL-5, TGF β 1, IL-10, IL-4, IL-2, IL-13, Eotaxin3), and allergenspecific IgE and IgG antibodies to cow’s milk protein, α-lactoglobulin, β-laktoglobulin, casein, soy and goat’s milk during diet therapy were evaluated. Observation duration was 28-30 days. The differences in the dynamics of the investigated parameters depending on the type of formula were revealed. Thus, the use of formula based on cow’s milk hydrolysates revealed their primarily effect on cytokines IL-2, IL-5 and growth factor TGF β ; the use of formula based on soy protein revealed combined effect on humoral immunity (allergen specific IgE and IgG antibodies) and IL-5; the use of formula based on goat milk characterized decreased levels of allergenspecific IgG antibodies to the cow’s milk protein and its fractions, reduced allergen specific IgE antibody concentrations to cow’s milk protein and α-lactoglobulin, decreased levels of IL-5, and, exclusive for this formula - reduction of IL-4 level. Accordingly, the assessment of immunological biomarkers can be used to personalize diet therapy in children with food allergy.

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Microbiota and Derived Parameters in Fecal Samples of Infants with Non-IgE Cow’s Milk Protein Allergy under a Restricted Diet

Nutrients ◽

10.3390/nu10101481 ◽

2018 ◽

Vol 10 (10) ◽

pp. 1481 ◽

Cited By ~ 15

Author(s):

María Díaz ◽

Lucía Guadamuro ◽

Irene Espinosa-Martos ◽

Leonardo Mancabelli ◽

Santiago Jiménez ◽

...

Keyword(s):

Food Allergy ◽

Milk Protein ◽

Transforming Growth Factor ◽

Cow’S Milk ◽

Control Group ◽

Microbiota Composition ◽

Fecal Samples ◽

Cow's Milk ◽

Healthy Infants ◽

Cow’S Milk Protein

Cow’s milk protein allergy (CMPA) is the most common food allergy in infancy. Non-IgE mediated (NIM) forms are little studied and the responsible mechanisms of tolerance acquisition remain obscure. Our aim was to study the intestinal microbiota and related parameters in the fecal samples of infants with NIM-CMPA, to establish potential links between type of formula substitutes, microbiota, and desensitization. Seventeen infants between one and two years old, diagnosed with NIM-CMPA, were recruited. They were all on an exclusion diet for six months, consuming different therapeutic protein hydrolysates. After this period, stool samples were obtained and tolerance development was evaluated by oral challenges. A control group of 10 age-matched healthy infants on an unrestricted diet were included in the study. Microbiota composition, short-chain fatty acids, calprotectin, and transforming growth factor (TGF)-β1 levels were determined in fecal samples from both groups. Infants with NIM-CMPA that consumed vegetable protein-based formulas presented microbiota colonization patterns different from those fed with an extensively hydrolyzed formula. Differences in microbiota composition and fecal parameters between NIM-CMPA and healthy infants were observed. Non-allergic infants showed a significantly higher proportion of Bacteroides compared to infants with NIM-CMPA. The type of protein hydrolysate was found to determine gut microbiota colonization and influence food allergy resolution in NIM-CMPA cases.

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Prevention and treatment of food allergy gastrointestinal manifestations in infants; allergy to cow's milk protein

ScienceRise Medical Science ◽

10.15587/2519-4798.2016.86502 ◽

2016 ◽

Vol 0 (12 (8)) ◽

pp. 4-9

Author(s):

Тетяна Вікторівна Починок ◽

Владислава Дмитрівна Барзилович ◽

Анастасія Дмитрівна Барзилович

Keyword(s):

Food Allergy ◽

Milk Protein ◽

Cow’S Milk ◽

Gastrointestinal Manifestations ◽

Cow's Milk ◽

Prevention And Treatment ◽

Cow’S Milk Protein ◽

Treatment Of Food Allergy

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Custos diretos dos responsáveis pelos pacientes portadores de alergia alimentar à proteína do leite de vaca em uma unidade básica de saúde em Belém / Direct costs of responsible for patients with food allergy to cow's milk protein in a basic health unit in Belém

Brazilian Journal of Health Review ◽

10.34119/bjhrv3n5-108 ◽

2020 ◽

Vol 3 (5) ◽

pp. 12684-12699

Author(s):

Kamylly Reina Carneiro de Mendonça ◽

Luíza Pinheiro Nascimento ◽

Isabela Blosfeld Mansour ◽

Anna Luiza Fonseca Siqueira da Silva ◽

Ana Laura Nobre e Nobre ◽

...

Keyword(s):

Food Allergy ◽

Milk Protein ◽

Direct Costs ◽

Cow’S Milk ◽

Health Unit ◽

Cow's Milk ◽

Basic Health ◽

Cow’S Milk Protein

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Allergy to cow’s milk protein

Pediatrician (St Petersburg) ◽

10.17816/ped73153-156 ◽

2016 ◽

Vol 7 (3) ◽

pp. 153-156 ◽

Cited By ~ 1

Author(s):

Natalia B Platonova

Keyword(s):

Atopic Dermatitis ◽

Food Allergy ◽

Milk Protein ◽

Clinical Manifestations ◽

Allergic Diseases ◽

Maternity Hospital ◽

Cow’S Milk ◽

Cow's Milk ◽

Cow’S Milk Protein ◽

Inhalant Allergens

The prevalence of allergic diseases is increasing year by year. Atopic dermatitis (AD) - the earliest clinical manifestation of atopy. By definition, atopic dermatitis is the allergic skin disease that occurs usually in early childhood in individuals with hereditary predisposition to atopic diseases having a chronic relapsing course, age characteristics of the location and morphology of the foci of inflammation, characterized by pruritus and caused hypersensitivity as to allergens, and to nonspecific irritants. Food and inhalant allergens play an important role in the formation of atopic dermatitis. The protein of cow’s milk is one of the first products to which developing sensitization. This is especially important for children in their first year of life. During this period neonatologists of the maternity hospital and precinct pediatricians are very important to assess the risk of a child’s food allergy and, if necessary, artificial feeding or supplementary feeding to recommend an artificial mixture, taking into account evaluation results. The proper purpose depends largely on whether the risk is realized or not, as well as the effectiveness of treatment in the presence of existing clinical manifestations, because a rational diet is the guiding principle of therapy of atopic dermatitis in infants. Unfortunately, precinct pediatricians do not always assess the situation correctly. The article gives a clinical case, an example of which analyzed the most typical errors made when bottle-fed infants with food allergy to cow’s milk protein.

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