Anaphylaxis to cow's milk formula containing short-chain galacto-oligosaccharide

Chiang, Wen Chin; Huang, Chiung‐Hui; Llanora, Genevieve; Gerez, Irvin; Goh, Si Hui; Shek, Lynette Pei‐Chi; Nauta, Alma J.; Doorn, W. A. van; Bindels, Jacques; Ulfman, Laurien H.; Knipping, Karen; Delsing, Dianne J.; Knol, Edward F.; Lee, Bee Wah

doi:10.1016/j.jaci.2012.08.048

Cited by 45 publications

(54 citation statements)

References 24 publications

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“…As these, now, do not contain scGOS, anaphylactic reactions to scGOS can be prevented in both. There have been nine cases reported so far [4,5]. This geographic presence of these cases of GOS-related allergy to South East Asia is unusual.…”

Section: Discussionmentioning

confidence: 79%

“…All had a similar clinical presentation of symptoms within 30 min of ingestion, suggesting an IgE -mediated immediate allergy. This has been well discussed and investigated by Chiang [4].…”

Section: Discussionmentioning

confidence: 94%

“…All children and mothers affected [4,5], demonstrated positively, by the skin prick test to scGOS and those subjects tested to BAT, were positive for scGOS. However, it was thought that the primary sensitization was probably by another allergen though these tests were positive to the low [4] prebiotic scGOS. Soh, in his report on the 4 post natal lactating mothers [5] confirmed the positive skin prick tests and positive basophil activation tests to sc-oligosaccharides.…”

Section: Discussionmentioning

confidence: 95%

“…The Activation of the basophil activation (BAT) markers also showed dose-related responses to the milk formula supplemented with scGOS, scGOS alone, implicating scGOS as the allergen [4]. All children and mothers affected [4,5], demonstrated positively, by the skin prick test to scGOS and those subjects tested to BAT, were positive for scGOS. However, it was thought that the primary sensitization was probably by another allergen though these tests were positive to the low [4] prebiotic scGOS.…”

Section: Discussionmentioning

confidence: 97%

“…The Skin Prick tests were done to scGOS, patients' CMF [4] without scGOS, and long chain lc GOS [4] and the investigations point to the conclusion of an IgE-mediated mechanism, on the data showing these positive results to scGOS, and not to the other formula without scGOS supplementation [4]. The Activation of the basophil activation (BAT) markers also showed dose-related responses to the milk formula supplemented with scGOS, scGOS alone, implicating scGOS as the allergen [4].…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

An Asian Problem, Oligosaccharides in Cow’s Milk Formula (CMF) Causing Anaphylaxis in Older Children, 2 Years Above and Prenatal and Post Natal Mothers in Singapore

Giam¹

2017

J Allergy Ther

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SummaryI had been looking at Asian-only problems, and found this interesting, an "Oligosaccharides in milk causing anaphylaxis in some children and mothers" when oligosaccharide is safe in many other countries.Short chain Galacto-oligosaccharides (scGOS) or prebiotic is a carbohydrate, is made of short sugar chains limited to to seven or less in length, synthesized by B galactosidases [1]. Prebiotics in infants are suggested to have effects, as in animal studies [2] an impact on certain immune markers, and diminished allergic sensitization on young female mice and reduced allergic sensitivities like allergic asthma.Prebiotics are added as supplements into infant formula to boost the immune status of the children. It was unusual to develop anaphylaxis in this relatively safe-approved infant formula, and that these reactions can appear in children and adults, occurring mainly in South East Asia.

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Section: Discussionmentioning

confidence: 79%

“…All had a similar clinical presentation of symptoms within 30 min of ingestion, suggesting an IgE -mediated immediate allergy. This has been well discussed and investigated by Chiang [4].…”

Section: Discussionmentioning

confidence: 94%