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

Carucci, Laura R.; Coppola, Serena; Luzzetti, Anna; Voto, Luana; Giglio, Veronica; Paparo, Lorella; Nocerino, Rita; Canani, Roberto Berni

doi:10.3389/falgy.2021.676200

Cited by 11 publications

(11 citation statements)

References 91 publications

(122 reference statements)

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“…The main indirect effects are mediated by the gut microbiome (GM), that being the first organ met dietary factors, is strongly influenced by them. Thus, GM modulated by diet, shapes the immune system development and function 1,2 …”

Section: Figurementioning

confidence: 99%

“…Thus, GM modulated by diet, shapes the immune system development and function. 1,2 At the gastrointestinal (GI) tract level, the lymphoid tissue dis-| 261 NEWS & VIEWS: GROUNDBREAKING DISCOVERIES IN CLINICAL AND BASIC SCIENCE sIgA production opens the way for innovative approaches in the immunonutrition field and may also contribute to the dysbiosis development observed in obese patients; but further studies are needed to explore this exciting hypothesis.…”

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confidence: 99%

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Derived cholesterol metabolites and sIgA production: A novel intriguing link

Carucci,

Berni Canani

2023

Allergy

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The importance of diet in dynamically shaping the immune response was introduced a few years ago with the concept of 'Immunonutrition', highlighting the ability of selected dietary factors to directly or indirectly modulate the immune system development and function. The main indirect effects are mediated by the gut microbiome (GM), that being the first organ met dietary factors, is strongly influenced by them. Thus, GM modulated by diet, shapes the immune system development and function. 1,2 At the gastrointestinal (GI) tract level, the lymphoid tissue dis-| 261 NEWS & VIEWS: GROUNDBREAKING DISCOVERIES IN CLINICAL AND BASIC SCIENCE sIgA production opens the way for innovative approaches in the immunonutrition field and may also contribute to the dysbiosis development observed in obese patients; but further studies are needed to explore this exciting hypothesis.

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Section: Figurementioning

confidence: 99%

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confidence: 99%

Derived cholesterol metabolites and sIgA production: A novel intriguing link

Carucci,

Berni Canani

2023

Allergy

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“…Cow's milk allergy (CMA) is one of the most common food allergies and one of the most expensive allergic diseases in the pediatric age with significant cost for the families and health care systems. [1][2][3][4][5] The avoidance of cow milk proteins is the hallmark of the management. 6 While breastmilk remains the ideal nutrient source in children with CMA, if breastfeeding is not available, the patient must be fed a special formula adapted to CMA dietary management, during infancy and later, if the disease persists.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The step‐down approach in children with cow's milk allergy: Results of a randomized controlled trial

Nocerino

Coppola

Carucci

et al. 2023

Allergy

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BackgroundThe Step‐Down Approach for Cow's Milk Allergy (SDACMA) trial evaluated the tolerability and the rate of immune tolerance acquisition in CMA children starting dietary treatment with amino acid‐based formula (AAF) and then switching to EHCF containing the probiotic Lacticaseibacillus rhamnosus GG (EHCF + LGG).MethodsRandomized controlled trial involving IgE‐mediated CMA children receiving AAF from at least 4 weeks. EHCF + LGG tolerance was evaluated by the results of double‐blind placebo‐controlled food challenge (DBPCFC). Subjects tolerating EHCF + LGG were randomly allocated to remain on AAF, or to switch to EHCF + LGG. Immune tolerance acquisition to cow's milk proteins was evaluated with DBPCFC after 12 months of treatment. Allergy screening tests and body growth were also monitored.ResultsSixty IgE‐mediated CMA children were enrolled. The proportion of children treated with AAF who resulted tolerant to the first exposure of EHCF + LGG was 0.98 (exact 95% CI 0.91–0.99). The rate of the immune tolerance acquisition to cow milk proteins after 12 months treatment was higher in the EHCF + LGG (0.48, 95% exact CI 0.29–0.67, n/N = 14/29) than in the AAF group (0.03, 95% exact CI 0.001–0.17, n/N = 1/30). There was an absolute benefit increase (ABI) of tolerance rate equal to 0.45 (95% CI 0.23–0.63, Newcombe method 10) for EHCF + LGG versus AAF, corresponding to a NNT of 2 (2–4, Bender's method). A normal body growth pattern was observed in the two study groups.ConclusionIn IgE‐mediated CMA children the step‐down from AAF to EHCF + LGG is well tolerated and could facilitate the immune tolerance acquisition.

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“…Cow's milk protein allergy (CMPA) is a relevant problem worldwide with lifelong implications for health. With an estimated prevalence up to 3% it is one of the most common food allergies and one of the main causes of food-induced anaphylaxis in the pediatric age ( 1 ). The mainstay of the CMPA treatment is the elimination from the diet of cow's milk proteins.…”

Section: Introductionmentioning

confidence: 99%

Body growth assessment in children with IgE-mediated cow's milk protein allergy fed with a new amino acid-based formula

et al. 2022

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BackgroundAmino acid-based formula (AAF) is a relevant dietary option for non-breastfed children. The present study was designed to evaluate the body growth pattern in cow's milk protein allergy (CMPA) children treated for 6 months with a new AAF.MethodsThis was an open-label, single arm study evaluating body growth pattern in immunoglobulin E (IgE)-mediated CMPA infants receiving a new AAF for 6 months. The outcomes were anthropometry (weight, length, head circumference), adherence to the study formula and occurrence of adverse events (AEs).ResultsFifteen children [all Caucasian and born at term; 53.3% born with spontaneous delivery; 80% male; 80% with familial allergy risk; mean age (±SD) 3 ± 2.5 months at IgE-mediated CMPA diagnosis; mean age (±SD) 16.7 ± 5.9 months at enrolment, mean total serum IgE (±SD) 298.2 ± 200.4 kU/L] were included and completed the 6-month study. Data from fifteen age- and sex-matched healthy controls were also adopted as comparison. At baseline, all CMPA patients were weaned and were receiving the new AAF. All 15 patients completed the 6-month study period. For the entire CMPA pediatric patients’ cohort, from baseline to the end of the study period, the body growth pattern resulted within the normal range of World Health Organization (WHO) growth references and resulted similar to healthy controls anthropometric values. The formula was well tolerated. The adherence was optimal and no AEs related to AAF use were reported.ConclusionsThe new AAF ensured normal growth in subjects affected by IgE-mediated CMPA. This formula constitutes another suitable safe option for the management of pediatric patients affected by CMPA.

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

Cited by 11 publications

References 91 publications

Derived cholesterol metabolites and sIgA production: A novel intriguing link

Derived cholesterol metabolites and sIgA production: A novel intriguing link

The step‐down approach in children with cow's milk allergy: Results of a randomized controlled trial

Body growth assessment in children with IgE-mediated cow's milk protein allergy fed with a new amino acid-based formula

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