Asthmatic Response to Milk Ingestion Challenge in Adults: A Comparison of the Open and Double-Blind Challenges

Pelikán, Z

doi:10.1159/000345130

Cited by 5 publications

(6 citation statements)

References 73 publications

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“…The five types of asthmatic response induced by food ingestion challenge in bronchial asthma patients, described in this as well as in our previous papers [7,19,[23][24][25]84], may be comparable with the basic types of the asthmatic response to the bronchial challenge with inhalant allergens [76][77][78][79].…”

Section: Discussionsupporting

confidence: 69%

“…Some investigators suggested a possible participation of immune-complexes, whereas others presumed involvement of IgE antibodies and/or various modifications of the IgEmediated hypersensitivity mechanisms. In the DYAR to food ingestion challenge, described already by usin the past [7,19,23,84], which is analogical to the DYAR induced by inhalant allergens [78,79] the involvement of the cell-mediated hypersensitivity mechanism(s) could be presumed. Nevertheless, there is still a great dearth of structural information and research data concerning the exact role and the mode of involvement of immunological mechanisms in the particular types of the food-induced asthmatic response in large group of well-defined and diagnosed patients with bronchial asthma.…”

Section: Discussionmentioning

confidence: 97%

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Protective Effects of Oral Disodium Cromoglycate on the Asthmatic Responses Induced by Food Allergy

Pelikán¹

2014

J Allergy Therr

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Background:The food allergy can also participate in the pathological mechanism underlying the bronchial asthma. This should ultimately be confirmed by food ingestion challenge combined with monitoring of lung function (FVC and FEV 1 ), demonstrating the particular types of asthmatic response to ingested foods. The oral disodium cromoglygate (DSCG, Nalcrom ® ) has been shown to be effective drug in prevention of food allergy.Methods: In 62 randomly selected patients with bronchial asthma developing 62 asthmatic responses to food ingestion challenge (17 immediate, IAR, p<0.01; 21 late, LAR, p<0.001; 8 dual late, DLAR, p<0.05; 11 delayed, DYAR, p<0.05; and 5 dual delayed DDYAR, p<0.05), the food ingestion challenges have been repeated twice, after the pretreatment with oral DSCG and after pretreatment with oral placebo. The study was performed according the double-blind, placebo-matched, cross-over design. Results:The DSCG, administered orally in a daily dose of 4×200 mg starting 2 weeks before and continuing through the challenge day up to 3 days after the challenge, as compared with placebo, protected highly significantly the IAR (p<0.001), and the LAR (p<0.001), protected distinctly significantly the DLAR (p<0.01) and significantly the DYAR (p<0.05) and DDYAR (p<0.05). However, the distribution of the protective effects of oral DSCG on the particular types of asthmatic response to ingested foods has varied. The oral placebo was fully ineffective (p>0.2). No differences in the DSCG protective effects were observed with respect to the individual foods (p>0.2). Conclusions:It can be concluded that the food allergy can causally be involved in some patients with bronchial asthma, resulting in development of various types of asthmatic response. The asthmatic responses to food ingested can effectively be prevented by pretreatment with disodium cromoglycate administered orally in a daily dose of 4x 200 mg. If necessary the treatment with oral DSCG can be combined with other treatments, such as elimination diet and/or other additional drugs, e.g. β 2 -sympathomimetics or other drugs.

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 97%

Protective Effects of Oral Disodium Cromoglycate on the Asthmatic Responses Induced by Food Allergy

Pelikán¹

2014

J Allergy Therr

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“…Food allergy should be investigated in the case of rapid onset, unexpected asthma attacks related to food exposure ( 56 ). Anyway, exacerbations can occur not only immediately after food intake but also, rarely, in the late phase, even after 24 h ( 65 ). Furthermore, it should be taken into account that additives ( 66 , 67 ) may trigger bronchospasm, too.…”

Section: Managementmentioning

confidence: 99%

Asthma and Food Allergy in Children: Is There a Connection or Interaction?

et al. 2016

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This review explores the relationship between food allergy and asthma. They can share the same risk factors, such as parental allergy, atopic eczema, and allergen sensitization, and they often coincide in the same child. Coexistence may negatively influence the severity of both conditions. However, it remains to be determined whether food allergy may directly affect asthma control. An early food sensitization in the first year of life can predict the onset of asthma. Furthermore, asthmatic symptoms could rarely be caused by ingestion or inhalation of the offending food. Asthma caused by food allergy is severe and may be associated with anaphylactic symptoms. Therefore, an accurate identification of the offending foods is necessary in order to avoid exposure. Patients should be instructed to treat asthmatic symptoms quickly and to use self-injectable epinephrine.

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“…Nguyen also reported not having observed any acute or delayed deterioration of pulmonary functions among 25 atopic asthmatic adults exposed to cow's milk versus placebo [32]. Of note, asthmatic patients with known milk allergy [33]. Nevertheless, our study excluded children with present known allergy to cow's milk.…”

Section: Discussionmentioning

confidence: 76%

“…Of note, asthmatic patients with known milk allergy act differently. Eighty-six percent of asthmatic adults with bronchial asthma and p ositive skin tests for milk developed a positive asthmatic response to milk challenge measured by spirometry [ 33 ]. Nevertheless, our study excluded children with present known allergy to cow’s milk.…”

Section: Discussionmentioning

confidence: 99%

Respiratory effects of acute milk consumption among asthmatic and non-asthmatic children: a randomized controlled study

Koren¹,

Domany

Gut

et al. 2020

BMC Pediatr

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Background A commonly held public belief is that cow’s milk products increase mucus production and respiratory symptoms. Dietary milk elimination is often attempted despite lack of evidence. Our objective was to investigate whether a single exposure to cow’s milk is associated with respiratory symptoms and changes in pulmonary functions in asthmatic and non-asthmatic children. Methods We conducted a prospective double blind, placebo-controlled trial on non-asthmatic and asthmatic children aged 6–18 years evaluated at a pediatric pulmonology unit. The children were randomly challenged with cow’s milk or soy milk substitute. Symptoms, spirometry, fractional-exhaled nitric-oxide (FeNO), and pulse oximetry findings were obtained at baseline and at 30, 60, 90, and 120 min following challenge. A two-way ANCOVA (with repeated measures when required) was used to compare the performances of all groups and subgroups over time. The outcome measures of each participant were compared to his/her own variables over time and in relation to his/her baseline values. In case of missing data points, missingness analysis was performed using Little’s missing completely at random (MCAR) test. Results Fifty non-asthmatic children (26 assigned to the cow’s milk group and 24 to the soy substitute group), and 46 asthmatic children (22 in the cow’s milk group and 24 in the soy substitute group) were enrolled. Age, gender, and body mass index Z-score were comparable between the two groups. No changes in symptoms, spirometry, FeNO, or oxygen saturation measurements were observed following challenge in any of the participants in both groups, at any time point compared to baseline. Conclusions A single exposure to cow’s milk is not associated with symptoms, bronchial inflammation, or bronchial constriction in both non-asthmatic and asthmatic children. Our findings do not support the strict elimination of dairy products from a child’s diet for the prevention of respiratory symptoms. Trial registration This study was approved by the Tel Aviv Sourasky Medical Center Institutional Review Board and the Israeli Ministry of Health review board (Helsinki Committee, NIH #NCT02745899). Registered April 2016 https://clinicaltrials.gov/ct2/show/NCT02745899?cond=milk+asthma&rank=1.

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Asthmatic Response to Milk Ingestion Challenge in Adults: A Comparison of the Open and Double-Blind Challenges

Cited by 5 publications

References 73 publications

Protective Effects of Oral Disodium Cromoglycate on the Asthmatic Responses Induced by Food Allergy

Protective Effects of Oral Disodium Cromoglycate on the Asthmatic Responses Induced by Food Allergy

Asthma and Food Allergy in Children: Is There a Connection or Interaction?

Respiratory effects of acute milk consumption among asthmatic and non-asthmatic children: a randomized controlled study

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