Oral Desensitisation in Cow Milk Allergy: Immunological Findings

Abstract

In the literature there are several reports dealing with the possibility of a desensitising treatment in food allergy, but there are very few studies concerning the immunological mechanisms of oral desensitisation. We studied the immunological modifications in four children who underwent oral desensitisation with cow milk. Four children with cow milk allergy underwent oral desensitisation according to a standardized protocol. Total IgE, eosinophilic cationic protein in serum, and specific IgE and IgG 4 to a-lactalbumin, to f3-lactoglobulin and to casein were determined at the beginning of the treatment and after 6, 12 and 18 months in the 4 children treated. All the 4 treated patients successfully completed the treatment. SpecificIgE to casein showed a significant reduction (p<O.OI), while specific IgG 4 to a-lactalbumin (p<O.02), to 13-lactoglobulin (p<O.OI) and to casein (p<O.OI) showed a significant increase. Total IgE, eosinophilic cationic protein, and specific IgE to a-lactalbumin and to f3-lactoglobulin did not show any significant modification. Control patients did not show any immunological modification and still had a positive double-blind, placebo-controlled food challenge.These results make us think that oral desensitisation in food allergy occurs with the same mechanisms of traditional desensitising treatments for respiratory and insect sting allergies.

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