The effect of baked milk on accelerating unheated cow's milk tolerance: A control randomized clinical trial

Esmaeilzadeh, Hossein; Alyasin, Soheila; Haghighat, Mahmood; Nabavizadeh, Hesamodin; Esmaeilzadeh, Elmira; Mosavat, Fereshteh

doi:10.1111/pai.12958

Cited by 55 publications

(60 citation statements)

References 21 publications

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“…Children who tolerate baked milk and egg may have smaller skin prick test, lower specific IgE, less basophil reactivity, and more peripheral T regulatory cells [152]. Recently, a randomized controlled trial of baked milk ingestion did show a significant change in ability to eat unheated milk at the end of 1 year [153]. A high-dose rush OIT protocol in which egg-allergic children had a 5-day dose buildup followed by 5 months of eating an undercooked egg has been well tolerated and efficacious [2,154].…”

Section: Specific Immunotherapymentioning

confidence: 99%

New Perspectives in Food Allergy

Martinis

Sirufo

Suppa

et al. 2020

IJMS

152

130

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The improvement of the knowledge of the pathophysiological mechanisms underlying the tolerance and sensitization to food antigens has recently led to a radical change in the clinical approach to food allergies. Epidemiological studies show a global increase in the prevalence of food allergy all over the world and manifestations of food allergy appear increasingly frequent also in elderly subjects. Environmental and nutritional changes have partly changed the epidemiology of allergic reactions to foods and new food allergic syndromes have emerged in recent years. The deepening of the study of the intestinal microbiota has highlighted important mechanisms of immunological adaptation of the mucosal immune system to food antigens, leading to a revolution in the concept of immunological tolerance. As a consequence, new prevention models and innovative therapeutic strategies aimed at a personalized approach to the patient affected by food allergy are emerging. This review focuses on these new perspectives and their practical implications in the management of food allergy, providing an updated view of this complex pathology.

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Section: Specific Immunotherapymentioning

confidence: 99%

New Perspectives in Food Allergy

Martinis

Sirufo

Suppa

et al. 2020

IJMS

152

130

View full text Add to dashboard Cite

show abstract

“…There is significant interest in whether modified (baked) milk accelerates acquisition of tolerance to unheated milk . Recently, a randomized controlled trial (RCT) of baked milk ingestion did show a significant change in ability to eat unheated milk at the end of 1 year (88.1% (37/42) vs 66.7% (28/42) avoiding baked milk, P < .018) . An RCT of a slow progression schedule of baked milk prior to unheated milk for OIT, versus starting OIT with unheated milk surprisingly found the slow progression group trended to lower safety and efficacy outcomes.…”

Section: Clinical Markers and Procedural Factors Of Treatment Failurementioning

confidence: 99%

Recent developments and highlights in food allergy

Eiwegger

Hung

Diego

et al. 2019

Allergy

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The achievement of long-lasting, safe treatments for food allergy is dependent on the understanding of the immunological basis of food allergy. Accurate diagnosis is essential for management. In recent years, data from oral food challenges have revealed that routine allergy testing is poor at predicting clinical allergy for tree nuts, almonds in particular. More advanced antigen-based tests including component-resolved diagnostics and epitope reactivity may lead to more accurate diagnosis and selection of therapeutic intervention. Additional diagnostic accuracy may come from cellular tests such as the basophil activation test or mast cell approaches. In the context of clinical trials, cellular tests have revealed specific T-cell and B-cell populations that are more abundant in food-allergic individuals with distinct mechanistic features.Awareness of clinical markers, such as the ability to eat baked forms of milk and egg, continues to inform the understanding of natural tolerance development.Mouse models have allowed for investigation into multiple mechanisms of food allergy including modification of epithelial metabolism, and the induction of regulatory cell subsets and the microbiome. Increasing numbers of children who underwent food immunotherapy enlarged the body of evidence on mechanisms and predictors of treatment success. Experimental immunological markers in conjunction with clinical determinants such as lower age and lower initial specific IgE appear to be of benefit.More research on the optimal dose, preparation, and route of application integrating a high-level safety and efficacy is demanded. Alternatively, biologics blocking TSLP, IL-33, IL-4 and IL-13, or IgE may help to achieve that. K E Y W O R D Sallergy treatment, biologics, food allergy, immune tolerance, immunotherapy | 2357 EIWEGGER Et al.

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“…In 2018, a randomized controlled trial conducted on 84 patients with milk allergy demonstrated that a statistically significant higher percentage of patients who consumed baked products reached a tolerance to unheated milk versus patients not consuming baked products [83].…”

Section: Managementmentioning

confidence: 99%

Immunoglobulin E (IgE)-Mediated Food Allergy in Children: Epidemiology, Pathogenesis, Diagnosis, Prevention, and Management

et al. 2020

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A food allergy is an immunoglobulin E (IgE)-mediated hypersensitive reaction to food, which consists in the appearance of allergic symptoms; it can vary from common urticaria to even fatal anaphylaxis. The prevalence of food allergies has been increasing in the past twenty years and it represents a major public health problem in industrialized countries. The mechanism that leads to food allergies is the lack of immunologic and clinical tolerance to food allergens. The diagnosis of IgE-mediated food allergies is based on the combined use of a detailed medical history, in-vivo, and in-vitro research of specific IgE, the elimination diet, and the double-blind placebo-controlled food challenge. The only currently available treatment for allergies is the strict elimination diet. This type of attitude, which we could define as “passive”, does not overcome the risk of accidental reactions due to involuntary intake of the culprit food. For food allergy management, an “active” approach is urgently needed, such as specific allergen immunotherapy, which is currently under development and only used for research purposes. This article aims to give an updated review of IgE-mediated food allergies in pediatric populations in terms of epidemiology, pathogenesis, prevention, diagnosis, and management.

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The effect of baked milk on accelerating unheated cow's milk tolerance: A control randomized clinical trial

Abstract: Introducing baked milk products into the diet of patients with milk allergy can accelerate the tolerance of unheated milk in these patients. sIgE levels of milk, casein, and beta-lactoglobulin did not predict the tolerance of unheated milk.

Cited by 55 publications

References 21 publications

New Perspectives in Food Allergy

New Perspectives in Food Allergy

Recent developments and highlights in food allergy

Immunoglobulin E (IgE)-Mediated Food Allergy in Children: Epidemiology, Pathogenesis, Diagnosis, Prevention, and Management

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