Milk and Soy Allergy

Abstract

SYNOPSIS Cow’s milk allergy (CMA) affects 2% to 3% of young children and presents with a wide range of immunoglobulin E (IgE-) and non-IgE-mediated clinical syndromes, which have a significant economic and lifestyle impact. Definitive diagnosis is based on a supervised oral food challenge (OFC), but convincing clinical history, skin prick testing, and measurement of cow’s milk (CM)-specific IgE can aid in the diagnosis of IgE-mediated CMA and occasionally eliminate the need for OFCs. It is logical that a review of CMA would be linked to a review of soy allergy, as soy formula is often an alternative source of nutrition for infants who do not tolerate cow’s milk. The close resemblance between the proteins from soy and other related plants like peanut, and the resulting cross-reactivity and lack of predictive values for clinical reactivity, often make the diagnosis of soy allergy far more challenging. This review examines the epidemiology, pathogenesis, clinical features, natural history and diagnosis of cow’s milk and soy allergy. Cross-reactivity and management of milk allergy are also discussed.

Emerging trends in nutraceutical applications of whey protein and its derivatives

“…Respiratory allergies include asthma, rhinitis, wheezing, coughing, and laryngeal edema (Hochwallner et al 2014). Gastrointestinal upsets like diarrhea, abdominal pain, nausea, vomiting are observed (Kattan et al 2011). Also, the milk ingestion can provoke anaphylactic reactions in sensitive infants (Ameratunga and Woon 2010).…”

Vegetable Proteins: Non-sensitizing Encapsulation Agents for Bioactive Compounds

“…The acute reaction causes activation of mast cells and basophils releasing histamine, leukotrienes, and other mediators known to be responsible for the wheal and flare reaction occurring in the skin and at various muco sal sites including the eye, nose, lung, and gastrointestinal tract [7]. The IgE-mediated reac tion occur immediately or within 1-2 h of ingestion, whereas non-IgE-mediated reactions generally have a delayed onset beyond 2 h of ingestion [42].…”

“…The IgE-mediated reaction in skin includes hives and angioedema, whereas the gastrointestinal manifestations include mouth and lip pruritus, abdominal pain, vomiting, and diarrhea. On the other hand, a variety of respiratory tract symptoms that generally involve IgE-mediated responses, includes rhinorrhea and wheez ing, whereas isolated asthma or rhinitis are unusual [42]. Further, the IgE-mediated food allergy may cause the dietary protein-induced syndromes such as enteropathy and entero colitis.…”

“…These in turn, cause profuse vomiting, diarrhea, dehydration and lethargy. Other syndromes include proctocolitis, gastroesophageal reflux, infantile colic, constipation and the Heiner syndrome [42].…”

Cow’s milk allergy

“…Heating, cooking and fermentation may influence the amount milk allergen in the processed food item 21 . Thus, tolerance to processed foods per se may not exclude allergy to milk in the form of liquid, powder or ice cream.…”