Anaphylaxis after ingestion of a recently introduced hydrolyzed whey protein formula

Ellis, Mark H.; Short, Jeffery A.; Heiner, Douglas C.

doi:10.1016/s0022-3476(05)81849-9

Cited by 107 publications

(37 citation statements)

References 8 publications

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“…Moreover, peptides from hydrolysed milk show both reduced immunogenicity (Cordle et al 1991) and seem to induce oral tolerance without elicitating antibody response (Enomoto et al 1993). However, despite of excessive hydrolysis, intact cow milk proteins may persist in hypoantigenic formulae mostly in low degree hydrolysates (M akinen-Kiljunen and Sorva 1993) and elicit severe clinical reactions in highly sensitized individuals (Ellis et al 1991;Saylor and Bahna 1991).…”

Section: Discussionmentioning

confidence: 99%

Antigenicity for Humans of Cow Milk Caseins, Casein Hydrolysate and Casein Hydrolysate Fractions

Nentwich¹,

Szépfalusi²,

Kunz³

et al. 2004

Acta Vet. Brno

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Nentwich I., Szépfalusi Zs., Kunz C., Spuergin P., Urbanek R.: Antigenicity for Humans of Cow Milk Caseins, Casein Hydrolysate and Casein Hydrolysate Fractions. Acta Vet. Brno 2004, 73: 291-298. Cow milk casein consists of several fractions each of which have different structure and differing antigenicity. The aim of the study was to investigate the capacity of cow milk casein, casein fractions, casein hydrolysate and its fractions to bind human IgG antibodies (antigenicity).Whole cow milk, bovine casein, α-casein native and dephosphorylated, β-and κ-casein, further a casein hydrolysate and its fractions were incubated in a IgG-ELISA assay with sera from five patients with cow milk intolerance and a pooled control serum from milk drinking healthy individuals.In healthy controls, predominantly β-caseins, both commercial and chromatographically separated, contained the strongest antigenic epitopes. In milk intolerant infants, however, κ -casein along with β-caseins was the strongest antigen. The antigenicity of the casein hydrolysate compared to nonhydrolysed casein was reduced down to 18.5 and 41.8% measured with patient and control sera, respectively. There were traces of intact protein in the hydrolysate. Antigenicity of the casein hydrolysate fractions reached only 24 to 44% of the antigenicity of the whole hydrolysate. Although their antigenicity roughly correlated with their molecular weight, only negligible differences among particular fractions were found.Cow milk beta-casein is the strongest antigen in healthy controls while kappa-casein possesses the high antigenicity in the milk intolerant individuals. For milk intolerant individuals, the tested casein hydrolysate was approximately 5 times less antigenic compared to whole casein. Antigenicity of the hydrolysate fractions were lower than that of the whole hydrolysate. Identification of cow milk caseins and its fractions with the highest bindnig capacity for human IgG antibodies is important for manufacturing of antigen-reduced formulas based on casein hydrolysates.

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Section: Discussionmentioning

confidence: 99%

Antigenicity for Humans of Cow Milk Caseins, Casein Hydrolysate and Casein Hydrolysate Fractions

Nentwich¹,

Szépfalusi²,

Kunz³

et al. 2004

Acta Vet. Brno

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“…This data showed that whey-hydrolysate formulas can trigger severe anaphylactic reactions in children with an IgEmediated CMA [66]. Later, other cases of anaphylactic reactionswere reported in infants with IgE-mediated CMA fed hydrolysate formulas [67][68][69]. Confirmation of this is by a recent study which demonstrated residual casein epitopesin all the hypoallergenic formulas tested: Alfa-Rè, Pregomin, Beba HA [65].…”

Section: Austin Publishing Groupmentioning

confidence: 76%

In 2532 Children we Report the Developmental Factors Influencing the Development of Atopic Diseases

Cantani¹

2017

Austin J Allergy

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Allergic asthma and rhinitis, Atopic Dermatitis (AD), urticaria and gastrointestinal allergy, are common diseases of infants and children. It was recently estimated that 14% of children suffer from AD, 8% from food allergy, and 12% from asthma [1,2]. The cumulated incidence of these diseases in adolescents has been estimated between 25-35%, while the prevalence is about 20% [3]. The phenotypic expression of these illnesses varies extensively, being very mild in some cases, severe in many, and even life threatening in others. Specific IgE antibodies to foods and positive challenge tests to a number of food allergens are frequently present in children with these disorders. Cow's Milk (CM) appears to be the most common offending food both in gastrointestinal (vomiting, diarrhea, etc) and in cutaneous manifestations (urticaria and AD). About 0.5-7% of infants suffer from more or less adverse reactions to CM [4]. Babies particularly of atopic parents are at high risk of developing atopic diseases; therefore they are defined as at-risk babies [5][6][7].conditions. It has been known for centuries that heredity plays an important role in the development of atopy. A child with a negative family history still has about a 5-15% risk of developing atopy. However, children with a parental history of atopic disease are at higher risk for the development of atopic symptoms. It has been found that if one parent is affected, the chances of an offspring being affected vary between 20 and 40%. If both parents are affected the figure increases up to 40-60%, and 50-80% if both show the same allergic manifestations. The risk of atopy in children who have an allergic sibling ranges between 25 and 35% [3,10].The importance of genetic factors is also demonstrated by other data:(I) children with positive family history for atopy develop allergic symptoms earlier than those with a negative family history [11], (II) The higher the incidence the higher the number of affected subjects in the same family [3].Notable differences exist in the so-called predisposition to atopic diseases, and further study appears to be necessary to better delineate the role played by genetic factors in the development of such disorders.In many allergic patients total serum IgE levels are found to be elevated, and it has been shown that a high total serum IgE level in infants is often associated with the subsequent development of atopic symptoms. Therefore, it was proposed that the measurement of IgE by PRIST testing in infants or at birth would have a predictive value in the atopy development. Several investigators have demonstrated that the risk of developing atopic diseases was very high when the cord IgE level was above 0.5 IU/ml [5,8,9,12].Our data shows that a newborn can be considered at risk for atopy when the cord IgE level is above 0.8 IU/ml [5]. We have also shown that neonates of non atopic parents (0.032 + 0

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“…This data showed that whey-hydrolysate formulas can trigger severe anaphylactic reactions in children with an IgE-mediated CMA [66]. Later, other cases of anaphylactic reactions were reported in infants with IgE-mediated CMA fed hydrolysate formulas [67][68][69].…”

Section: Discussionmentioning

confidence: 99%

Environmental Factors Urging the Development of Atopic Diseases in 75 Children

Cantani¹

2017

Int J Crit Care Emerg Med

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Prediction of atopic disorders is an important step and should be carried out by examining both genetic factors and neonatal conditions. It has been known for centuries that heredity plays an important role in the development of atopy. A child with a negative family history still has about a 5-15% risk of developing atopy. However, children with a parental history of atopic disease are at higher risk for the development of atopic symptoms.It has been found that if one parent is affected, the chances of an offspring being affected vary between 20 and 40%. If both parents are affected the figure increases up to 40-60%, and 50-80% if both show the same allergic manifestations. The risk of atopy in children who have an allergic sibling ranges between 25 and 35% [3][4][5][6][7][8][9][10].The importance of genetic factors is also demonstrated by other data: AbstractAllergic asthma and rhinitis, Atopic Dermatitis (AD), urticaria and gastrointestinal allergy, are common diseases of infants and children. It was recently estimated that 14% of children suffer from AD, 8% from food allergy, and 12% from asthma [1,2]. The cumulated incidence of these diseases in adolescents has been estimated between 25-35%, while the prevalence is about 20% [3]. The phenotypic expression of these illnesses varies extensively, being very mild in some cases, severe in many, and even life threatening in others. Specific IgE antibodies to foods and positive challenge tests to a number of food allergens are frequently present in children with these disorders. Cow's Milk (CM) appears to be the most common offending food both in gastrointestinal (vomiting, diarrhea, etc) and in cutaneous manifestations (urticaria and AD). About 0.5-7% of infants suffer from more or less adverse reactions to CM [4]. Babies particularly of atopic parents are at high risk of developing atopic diseases; therefore they are defined as at-risk babies [5][6][7].Atopy can interfere with a child's life at any age level, with varying severity. Intractable diarrhea due to CM Allergy (CMA) and AD are the most frequent in infants, where the clinical manifestations are more severe than in older children. Respiratory allergy and bronchial asthma can be serious illnesses in younger as well as in older children.The desire to understand the multifaceted problem of atopy has stimulated the clinicians' and academicians' imagination for decades. Therefore interest has been focused on methods for the prediction and prevention of atopy [5][6][7][8][9]. Prevention of IgE-mediated diseases relies on the skill necessary to overcome the natural forces unceasingly working to sensitize humans to produce IgE antibodies. The phenotypic expression of allergic disease ensues from an elaborate interrelationship between the atopy-prone genetic constitution of a child and the experienced environment that surrounds it. Prevention of atopy could potentially be met by selectively interfering with the genetic and environmental factors that appear to be responsible in concert for the final phenotypic exp...

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Anaphylaxis after ingestion of a recently introduced hydrolyzed whey protein formula

Cited by 107 publications

References 8 publications

Antigenicity for Humans of Cow Milk Caseins, Casein Hydrolysate and Casein Hydrolysate Fractions

Antigenicity for Humans of Cow Milk Caseins, Casein Hydrolysate and Casein Hydrolysate Fractions

In 2532 Children we Report the Developmental Factors Influencing the Development of Atopic Diseases

Environmental Factors Urging the Development of Atopic Diseases in 75 Children

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