A Structured Gradual Exposure Protocol to Baked and Heated Milk in the Treatment of Milk Allergy

Efron, Adi; Zeldin, Yuri; Gotesdyner, Leora; Stauber, Tali; Maoz-Segal, Ramit; Binson, Inga; Dinkin, Mira; Dinkowitz, Larisa; Shahar, Danit R.; Deutch, Michal; M, Yaron; Nevet, Ayelet; Reshef, Avner; Agmon‐Levin, Nancy; Kenett, Ron S.; Kidon, Mona

doi:10.1016/j.jpeds.2018.07.091

Cited by 12 publications

(11 citation statements)

References 34 publications

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“…Similarly, Efron and colleagues showed that gradual incorporation of milk in various forms (from extensively heated and cooked milk to fresh milk) significantly reduced the time and age of IgE CMA resolution. The median age at resolution was 36 ± 3.1 months in the intervention group compared with 98± 12.3 months in the controls (CMP-free diet children) ( 83 ).…”

Section: Active Diet Therapy: From Substitutive Formula To Oral Immun...mentioning

confidence: 89%

“…Although the milk ladder was initially proposed for children with non-IgE-mediated CMA (34), several studies have shown excellent results when used in children with IgE CMA (81)(82)(83).…”

Section: Driving Immune System Function Through Baked Milk Products and Milk Laddermentioning

confidence: 99%

“…Based on these studies a safer milk ladder approach could be proposed. In detail, the first exposure of any new more allergenic food containing CMP should be performed under medical supervision and could represent a more safety strategy compared to initial home introduction ( 82 , 83 ).…”

Section: Active Diet Therapy: From Substitutive Formula To Oral Immun...mentioning

confidence: 99%

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Immunonutrition for Pediatric Patients With Cow's Milk Allergy: How Early Interventions Could Impact Long-Term Outcomes

et al. 2021

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Cow's milk allergy (CMA) is one of the most common food allergies and one of the main causes of food-induced anaphylaxis in the pediatric age. Moreover, up to 45% of CMA children develop other atopic manifestations later in life, a phenomenon commonly named atopic march. Thus, CMA imposes a significant cost to health care systems as well as to families, and has emerged as one of the most expensive allergic diseases. The immunonutrition strategy builds its foundation on the ability of selected dietary factors to modulate immune system development and function. Recent studies highlighted the potential of immunonutrition in the management of CMA. This review is focused on the mechanisms and long-term clinical outcomes of the immunonutrition approach in children with CMA.

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Section: Active Diet Therapy: From Substitutive Formula To Oral Immun...mentioning

confidence: 89%

“…Although the milk ladder was initially proposed for children with non-IgE-mediated CMA (34), several studies have shown excellent results when used in children with IgE CMA (81)(82)(83).…”

Section: Driving Immune System Function Through Baked Milk Products and Milk Laddermentioning

confidence: 99%

Section: Active Diet Therapy: From Substitutive Formula To Oral Immun...mentioning

confidence: 99%

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Immunonutrition for Pediatric Patients With Cow's Milk Allergy: How Early Interventions Could Impact Long-Term Outcomes

et al. 2021

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“…Calvo and Berti et al conducted OIT on the youngest set of patients, children aged less than 1 year [ 64 , 65 ]. Martorell et al’s study included children aged 2–3 years, and Efron et al’s included children aged 1–4 years [ 66 , 67 ]. The remaining studies were conducted on children above age 4.…”

Section: Oral Immunotherapymentioning

confidence: 99%

“…However, they found decreased resolution time and age in patients in the treatment group as compared to the control group [ 78 ]. In Kauppila et al’s subjects, 56% could maintain daily milk intake post protocol [ 67 ]. Gruzelle et al noted desensitization of 43% of their patients to baked milk, and Takahashi et al reported SU in 21% [ 74 , 79 ].…”

Section: Oral Immunotherapymentioning

confidence: 99%

‘Early Introduction’ of Cow’s Milk for Children with IgE-Mediated Cow’s Milk Protein Allergy: A Review of Current and Emerging Approaches for CMPA Management

et al. 2023

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IgE-mediated cow’s milk protein allergy (CMPA) is one of the most prevalent food allergies in early childhood. Though the cornerstone of management involves the strict avoidance of milk products while awaiting natural tolerance, research increasingly shows that the rates of resolution are slowing down. Therefore, there is a need to explore alternative pathways to promote tolerance to cow’s milk in pediatric populations. This review aims to combine and appraise the scientific literature regarding the three CMPA management methods: avoidance, the milk ladder, and oral immunotherapy (OIT) and their outcomes in terms of efficacy, safety, and immunological effects. Cow’s milk (CM) avoidance virtually protects against allergic reaction until natural tolerance occurs, with hypoallergenic substitutes available in the market, but accidental ingestion represents the main issue for this strategy. Introduction to baked milk using the milk ladder was designed, with most CMPA patients successfully completing the ladder. Similar to baked milk treatment, many OIT protocols also demonstrated decreased IgE and increased IgG4 levels post protocol, as well as a reduction in wheal size diameter. Though these strategies are shown to be safe and effective in CMPA, future clinical trials should compare the safety and effectiveness of these three management strategies.

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Helping reviewers assess statistical analysis: A case study from analytic methods

Kenett

Francq²

2022

Analytical Science Advances

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Analytic methods development, like many other disciplines, relies on experimentation and data analysis. Determining the contribution of a paper or report on a study incorporating data analysis is typically left to the reviewer's experience and good sense, without reliance on structured guidelines. This is amplified by the growing role of machine learning driven analysis, where results are based on computer intensive algorithm applications. The evaluation of a predictive model where cross validation was used to fit its parameters adds challenges to the evaluation of regression models, where the estimates can be easily reproduced. This lack of structure to support reviews increases uncertainty and variability in reviews. In this paper, aspects of statistical assessment are considered. We provide checklists for reviewers of applied statistics work with a focus on analytic method development. The checklist covers six aspects relevant to a review of statistical analysis, namely: (1) study design, (2) algorithmic and inferential methods in frequentism analysis, (3) Bayesian methods in Bayesian analysis (if relevant), (4) selective inference aspects, (5) severe testing properties and (6) presentation of findings. We provide a brief overview of these elements providing references for a more elaborate treatment. The robustness analysis of an analytical method is used to illustrate how an improvement can be achieved in response to questions in the checklist. The paper is aimed at both engineers and seasoned researchers.

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A Structured Gradual Exposure Protocol to Baked and Heated Milk in the Treatment of Milk Allergy

Cited by 12 publications

References 34 publications

Immunonutrition for Pediatric Patients With Cow's Milk Allergy: How Early Interventions Could Impact Long-Term Outcomes

Immunonutrition for Pediatric Patients With Cow's Milk Allergy: How Early Interventions Could Impact Long-Term Outcomes

‘Early Introduction’ of Cow’s Milk for Children with IgE-Mediated Cow’s Milk Protein Allergy: A Review of Current and Emerging Approaches for CMPA Management

Helping reviewers assess statistical analysis: A case study from analytic methods

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