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Non ige milk allergy

Julia Upton, Anna Nowak-Wegrzyn
Baked milk (BM) and baked egg (BE) diets are increasingly used in the management of milk and egg allergy, rather than avoidance. Children with tolerance versus reactivity to BM and BE may have smaller skin prick test and lower specific IgE, and BM-tolerant children have less basophil reactivity and more peripheral T regulatory cells. However, most milk- and egg-allergic children tolerate BM and BE and an individual's reactivity is unpredictable. Non-reactivity is due to conformational changes in the allergens...
March 8, 2018: Clinical Reviews in Allergy & Immunology
Carina Venter, Trevor Brown, Rosan Meyer, Joanne Walsh, Neil Shah, Anna Nowak-Węgrzyn, Tong-Xin Chen, David M Fleischer, Ralf G Heine, Michael Levin, Mario C Vieira, Adam T Fox
[This corrects the article DOI: 10.1186/s13601-017-0162-y.].
2018: Clinical and Translational Allergy
Zhi Wan, Heather P Ostendorff, Ziying Liu, Lynda C Schneider, Kenneth J Rothschild, Mark J Lim
Multiplex serological immunoassays, such as implemented on microarray or microsphere-based platforms, provide greater information content and higher throughput, while lowering the cost and blood volume required. These features are particularly attractive in pediatric food allergy testing to facilitate high throughput multi-allergen analysis from finger- or heel-stick collected blood. However, the miniaturization and microfluidics necessary for creating multiplex assays make them highly susceptible to the "matrix effect" caused by interference from non-target agents in serum and other biofluids...
2018: PloS One
Alicia Isabel Pascual Pérez, Alejandra Méndez Sánchez, Óscar Segarra Cantón, Beatriz Espin Jaime, Santiago Jiménez Treviño, Carlos Bousoño García, Juan José Díaz Martín
INTRODUCTION: Food allergy is an increasing health problem in the developed world. Cow's milk protein is the main cause of food allergy in infants. Without an appropriate diagnostic workup, there is a high risk of both over- and underdiagnosis and therefore, over and undertreatment. The objective of our study was to analyze the variability in cow's milk protein allergy (CMPA) management by pediatric gastroenterologists in Spain. METHODS: A fifty item questionnaire, including open and closed items in a Likert's scale from 0 to 5, was drafted and distributed through the Spanish Society for Pediatric Gastroenterology, Hepatology and Nutrition (SEGHNP) e-mail list...
January 9, 2018: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
David C A Candy, Marleen T J Van Ampting, Manon M Oude Nijhuis, Harm Wopereis, Assad M Butt, Diego G Peroni, Yvan Vandenplas, Adam T Fox, Neil Shah, Christina E West, Johan Garssen, Lucien F Harthoorn, Jan Knol, Louise J Michaelis
BackgroundPrebiotics and probiotics (synbiotics) can modify gut microbiota and have potential in allergy management when combined with amino-acid-based formula (AAF) for infants with cow's milk allergy (CMA).MethodsThis multicenter, double-blind, randomized controlled trial investigated the effects of an AAF-including synbiotic blend on percentages of bifidobacteria and Eubacterium rectale/Clostridium coccoides group (ER/CC) in feces from infants with suspected non-IgE-mediated CMA. Feces from age-matched healthy breastfed infants were used as reference (healthy breastfed reference (HBR)) for primary outcomes...
December 6, 2017: Pediatric Research
Stephanie A Leonard
PURPOSE OF REVIEW: The purpose of this review is to update what is currently known about the major non-IgE-mediated food allergies: food protein-induced enterocolitis syndrome (FPIES), food protein-induced allergic proctocolitis (FPIAP), and food protein-induced enteropathy (FPE). These conditions are similar in that symptoms are regulated to the gastrointestinal tract; therefore understanding their specific features is important for diagnosis and management. RECENT FINDINGS: The most progress has been made in understanding FPIES with several recent large cohorts being described...
November 14, 2017: Current Allergy and Asthma Reports
Theresa A Bingemann, Puja Sood, Kirsi M Järvinen
Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy that usually presents in infancy. Cow's milk, soy, and grains are the most common food triggers. FPIES can present as a medical emergency with symptoms including delayed persistent emesis or diarrhea that can lead to severe dehydration and hemodynamic instability with abnormal laboratory markers. Diagnosis can often be made based on clinical history and noted improvement in symptoms once the suspected triggers have been removed from the diet, with oral food challenge as the gold standard for confirmation of diagnosis in unclear cases...
February 2018: Immunology and Allergy Clinics of North America
Marlotte M Vonk, Mara A P Diks, Laura Wagenaar, Joost J Smit, Raymond H H Pieters, Johan Garssen, Betty C A M van Esch, Léon M J Knippels
BACKGROUND: Oral immunotherapy (OIT) is a promising therapeutic approach to treat food allergic patients. However, there are some concerns regarding its safety and long-term efficacy. The use of non-digestible oligosaccharides might improve OIT efficacy since they are known to directly modulate intestinal epithelial and immune cells in addition to acting as prebiotics. AIM: To investigate whether a diet supplemented with plant-derived fructo-oligosaccharides (FOS) supports the efficacy of OIT in a murine cow's milk allergy model and to elucidate the potential mechanisms involved...
2017: Frontiers in Immunology
T A Gonzaga, F A Alves, M F A Cheik, C P de Barros, E R M A Rezende, G R S Segundo
BACKGROUND: The food atopy patch (APT) test has been used in previous studies to help the diagnosis of non-IgE mediated food allergies (FA). The aim of this study was to evaluate the efficacy of different cow's milk APT preparations to predict oral tolerance in children with previous non-IgE-mediated cow's milk allergy (CMA) diagnosis. METHODS: Thirty-two patients non-IgE-mediated CMA diagnosed by oral food challenge (OFC) were enrolled to perform APT with three different cow's milk preparations (fresh, 2% in saline solution, 2% in petrolatum) and comparing with a new OFC after at least three months of diet exclusion...
October 11, 2017: Allergologia et Immunopathologia
Barbara Cuomo, Giovanni Cosimo Indirli, Annamaria Bianchi, Stefania Arasi, Davide Caimmi, Arianna Dondi, Stefania La Grutta, Valentina Panetta, Maria Carmen Verga, Mauro Calvani
BACKGROUND: The diagnosis of IgE-mediated cow's milk allergy is often based on anamnesis, and on specific IgE (sIgE) levels and/or Skin Prick Tests (SPT), which have both a good sensitivity but a low specificity, often causing positive results in non-allergic subjects. Thus, oral food challenge is still the gold standard test for diagnosis, though being expensive, time-consuming and possibly at risk for severe allergic reactions. AIM: The aim of the present study was to perform a systematic review of the studies that have so far analyzed the positive predictive values for sIgE and SPT in the diagnosis of allergy to fresh and baked cow's milk according to age, and to identify possible cut-offs that may be useful in clinical practice...
October 12, 2017: Italian Journal of Pediatrics
Paul Netts, Louise J Michaelis
General Practitioners suffer from guideline fatigue. They come fast and furious in many complicated forms. Cow's milk allergy (CMA) is one of the most common presentations of food allergy seen in early childhood presenting to primary and secondary care. The early and accurate diagnosis continues to be highlighted in many countries worldwide. International surveys have found that primary care clinicians would like clearer explanations for the options for the diagnosis of CMA and in so doing a means to increase their understanding of management options for both IgE and Non IgE mediated CMA...
2017: Clinical and Translational Allergy
Noora Helin, Kaija-Leena Kolho, Erik Qvist, Mika Mäkelä, Laura Merras-Salmio
OBJECTIVES: To evaluate the current well-being and dietary restrictions in children six years after food challenge confirmed diagnosis of non-IgE cow's milk protein allergy, compared to peers with gastrointestinal symptoms but negative food challenge. To evaluate the diagnostic process retrospectively. METHODS: Internet-based survey for mothers whose children underwent six years ago the double-blind, placebo-controlled food challenge for cow's milk because of gastrointestinal symptoms causing suspicion of non-IgE cow's milk protein allergy...
September 16, 2017: Journal of Pediatric Gastroenterology and Nutrition
K A Pang, K P Pang, E B Pang, Y N Tan, Y H Chan, J K Siow
OBJECTIVE: To describe the prevalence of food allergy in Asian patients with allergic rhinitis. STUDY DESIGN: A non-randomized prospectively collected patients over a three year period, with complaints of nose congestion, rhinorrhea and/or nasal discharge. RESULTS: There were 435 patients enrolled, 213 children and 222 adults. The children group had a high prevalence of allergen specific IgE to Dermatophagoides pteryonysinus (70%), Dermatophagoides farina (69%), and Blomia tropicalis (55%); followed by dogs (32%), cats (19%) and cockroaches (19%)...
August 2017: Medical Journal of Malaysia
Carina Venter, Trevor Brown, Rosan Meyer, Joanne Walsh, Neil Shah, Anna Nowak-Węgrzyn, Tong-Xin Chen, David M Fleischer, Ralf G Heine, Michael Levin, Mario C Vieira, Adam T Fox
Cow's milk allergy (CMA) is one of the most common presentations of food allergy seen in early childhood. It is also one of the most complex food allergies, being implicated in IgE-mediated food allergy as well as diverse manifestations of non-IgE-mediated food allergy. For example, gastrointestinal CMA may present as food protein induced enteropathy, enterocolitis or proctocolitis. Concerns regarding the early and timely diagnosis of CMA have been highlighted over the years. In response to these, guideline papers from the United Kingdom (UK), Australia, Europe, the Americas and the World Allergy Organisation have been published...
2017: Clinical and Translational Allergy
Marine Michelet, Dominique Schluckebier, Laetitia-Marie Petit, Jean-Christoph Caubet
Food protein-induced enterocolitis syndrome (FPIES) is a potentially severe presentation of non-IgE-mediated gastrointestinal food allergy (non-IgE-GI-FA) with heterogeneous clinical manifestations. Acute FPIES is typically characterized by profuse vomiting and lethargy, occurring classically 1-4 hours after ingestion of the offending food. When continuously exposed to the incriminated food, a chronic form has been described with persistent vomiting, diarrhea, and/or failure to thrive. Although affecting mainly infants, FPIES has also been described in adults...
2017: Journal of Asthma and Allergy
A Uncuoglu, N Yologlu, I E Simsek, Z S Uyan, M Aydogan
BACKGROUND: IgE-mediated cow's milk allergy (CMA) has been shown consistent in milder heated-milk tolerant and severe heated-milk reactant groups in patients older than two years. Little is known whether fermentation of milk gives rise to similar clinical phenotypes. We aimed to determine the influence of extensively heated and fermented cow's milk on the IgE-mediated and non-IgE-mediated CMA in children younger than two years. METHODS: Subjects followed with the diagnosis of IgE-mediated and non-IgE-mediated CMA for at least six months underwent unheated milk challenge...
November 2017: Allergologia et Immunopathologia
Zbigniew Bartuzi, Renata Rodrigues Cocco, Antonella Muraro, Anna Nowak-Węgrzyn
PURPOSE OF REVIEW: We sought to describe the available evidence supporting the utilization of the molecular allergen analysis (MAA) for diagnosis and management of cow milk protein allergy (CMPA). RECENT FINDINGS: Cow milk proteins are among the most common food allergens in IgE- and non-IgE-mediated food allergic disorders in children. Most individuals with CMPA are sensitized to both caseins and whey proteins. Caseins are more resistant to high temperatures compared to whey proteins...
July 2017: Current Allergy and Asthma Reports
Chiara Sacco, Serena Perna, Donatella Vicari, Marco Alfò, Carl-Peter Bauer, Ute Hoffman, Johannes Forster, Fred Zepp, Antje Schuster, Ulrich Wahn, Thomas Keil, Susanne Lau, Paolo Maria Matricardi
BACKGROUND: Previous studies of serum total IgE (t-IgE) were not able to discriminate well-enough atopic from non-atopic subjects, that is, with or without serum-specific IgE antibodies to allergens. OBJECTIVES: To model growth curves of the total IgE levels in children without atopic sensitization (hereafter defined as "normal" t-IgE levels) and to test their usefulness in predicting atopic sensitization. METHODS: The German Multicentre Allergy Study (MAS), a birth cohort with 1314 recruited newborns, began in 1990 and examined the participants until age 20 years...
September 2017: Pediatric Allergy and Immunology
Francesca Mori, Antonella Cianferoni, Alice Brambilla, Simona Barni, Lucrezia Sarti, Neri Pucci, Maurizio de Martino, Elio Novembre
Oral immunotherapy (OIT) has been introduced as a new immune-modulating treatment under investigation for food allergies. The aim of our study was to evaluate the success of OIT in a cohort of children with milk allergy. These children underwent OIT in a clinical practice and were followed for up to ten years. The secondary endpoint was to describe the main adverse events during OIT and compare them to those reported in the literature. Eighty-two milk-allergic children started OIT. According to the OIT endpoint reached after one year, all of the children enrolled in the study were divided into four groups: complete desensitization; partial desensitization; step down; and stop groups...
March 1, 2017: International Journal of Immunopathology and Pharmacology
Valentina Pecora, Giusi Prencipe, Rocco Valluzzi, Lamia Dahdah, Antonella Insalaco, Antonella Cianferoni, Fabrizio De Benedetti, Alessandro Fiocchi
BACKGROUND: An increasing number of infants are diagnosed with food protein-induced enterocolitis syndrome (FPIES), a non-IgE-mediated food allergy. Until now, T-cell, food-specific mechanisms have been hypothesized. METHODS: Sixteen children (11M, 5F), affected by FPIES from cow's milk, wheat, fruit, rice, and others, experienced 25 acute episodes managed at our emergency department (ED) and eight FPIES reactions during oral food challenges (OFC). We compared the laboratory data in resting conditions, in the absence of infectious diseases, with data collected during the 25 acute ED episodes (blood samples drawn at 2-12 hours) and the eight positive OFCs (three samples at 2, 6, and 12 hours)...
August 2017: Pediatric Allergy and Immunology
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