Allergenicity of milk protein hydrolysate formulae in children with cow's milk allergy

Abstract

Cow's milk protein hydrolysate formulae have been developed to lower or eliminate the allergenicity of cow's milk proteins, and to reduce the antigenic load and the risk of sensitization. Cross-reactivity between different hydrolysate formulae and cow's milk proteins has been demonstrated. We have studied 20 children (median age 31 months, range 15-76 months) with a history of IgE-mediated cow's milk allergy. All the children had immediate allergic respiratory and/or cutaneous and/or gastro-intestinal reactions to cow's milk ingestion. In addition, the children had positive prick skin tests and positive RAST to cow's milk. Prick skin test, RAST, and double-blind placebo controlled food challenges were performed with three different hydrolysate formulae: a casein hydrolysate formula and two whey formulae, one partially and one extensively hydrolyzed. All 20 children had immediate allergic reactions after the challenge test with cow's milk. Only 2/20 children had a positive challenge test with a casein hydrolysate formula (Alimentum): one developed asthma and one urticaria. Two of the 15 children challenged with an extensively hydrolysed whey formula (Profylac) developed perioral erythema. Nine out of 20 children had a positive challenge test with a partially hydrolysed whey formula (Nidina H.A.): four developed asthma, three urticaria and two lip oedema. All children had positive prick skin tests to cow's milk proteins (casein and/or lactalbumin); 9 to Nidina H.A.; 3 to Profylac, and 3 to Alimentum. Specific IgE antibodies to cow's milk were present in all children; in 13 to Nidina H.A., in 4 to Profylac, and in 3 to Alimentum.

Immunogenicity and allergenicity of 2S, 7S and 11S soy protein fractions

“…Surprisingly, a variety of adverse reactions have been reported involving soy proteins (Cook, 1960;Sampson, 1991), including allergenicity of soybean protein fractions (Ratner, 1955;Shibasaki et al, 1980;Burks et al, 1988;Codina et al, 2003). The prevalence of a concomitant intolerance to soy in the allergy to cow milk is between 0% and 63% with high levels in the enterocolitis/enteropathy syndromes not associated with IgE (Van Sickle et al, 1985;Bock, Atkins, 1990;Ragno et al, 1993;Burks et al, 1994;Harikul et al, 1995). However, the true prevalence of allergy to soy proteins in documented allergies to proteins in cow milk is not yet well established (Kuitunen et al, 1975;Jakobsson, Lindberg, 1979;Zeiger et al, 1999;Ahn et al, 2003).…”

Environmental Factors Urging the Development of Atopic Diseases in 75 Children

“…According to recent studies, extensively casein hydrolysate formulas are safer [71,72]. Generally, CM hydrolysate formulas are well tolerated by infants with gastrointestinal symptoms caused by CM intolerance and who do not have IgE antibodies to CM proteins.…”

Allergenicity of Milk Proteins

“…This criterion could be encountered by milk proteins that have undergone extensive hydrolysis partially to cleave amino acids [178][179][180]. In contrast, formulas with moderately reduced allergenicity (partially hydrolyzed) are not recommended for the treatment of allergies because of the high amounts of residual allergens [181]. The low quantity of native proteins or residual high molecular mass peptides may produce adverse effects in highly sensitive patients.…”