title: Allergenicity of milk protein hydrolysate formulae in children with cow's milk allergy.
abstract: Cow's milk protein hydrolysate formulae have been developed to lower or eliminate the allergenicity of cow's milk proteins, and to reduce the antigenic load and the risk of sensitization. Cross-reactivity between different hydrolysate formulae and cow's milk proteins has been demonstrated. We have studied 20 children (median age 31 months, range 15-76 months) with a history of IgE-mediated cow's milk allergy. All the children had immediate allergic respiratory and/or cutaneous and/or gastro-intestinal reactions to cow's milk ingestion. In addition, the children had positive prick skin tests and positive RAST to cow's milk. Prick skin test, RAST, and double-blind placebo controlled food challenges were performed with three different hydrolysate formulae: a casein hydrolysate formula and two whey formulae, one partially and one extensively hydrolyzed. All 20 children had immediate allergic reactions after the challenge test with cow's milk. Only 2/20 children had a positive challenge test with a casein hydrolysate formula (Alimentum): one developed asthma and one urticaria. Two of the 15 children challenged with an extensively hydrolysed whey formula (Profylac) developed perioral erythema. Nine out of 20 children had a positive challenge test with a partially hydrolysed whey formula (Nidina H.A.): four developed asthma, three urticaria and two lip oedema. All children had positive prick skin tests to cow's milk proteins (casein and/or lactalbumin); 9 to Nidina H.A.; 3 to Profylac, and 3 to Alimentum. Specific IgE antibodies to cow's milk were present in all children; in 13 to Nidina H.A., in 4 to Profylac, and in 3 to Alimentum.
authors.affiliation: Department of Paediatrics, University of Rome La Sapienza, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Ragno
authors.forename: P G
authors.initials: PG
authors.lastname: Giampietro
authors.forename: G
authors.initials: G
authors.lastname: Bruno
authors.forename: L
authors.initials: L
authors.lastname: Businco
mesh_terms: D000485:Allergens / Q000276:immunology*; D002364:Caseins / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D003429:Cross Reactions; D006801:Humans; D006868:Hydrolysis; D007073:Immunoglobulin E / Q000378:metabolism; D007223:Infant; D007225:Infant Food / Q000009:adverse effects*; D016269:Milk Hypersensitivity / Q000276:immunology*; D008894:Milk Proteins / Q000737:chemistry / Q000276:immunology*; D011492:Protein Hydrolysates / Q000276:immunology*; D000067816:Whey Proteins
chemical_list: D000485:Allergens; D002364:Caseins; D008894:Milk Proteins; D011492:Protein Hydrolysates; D000067816:Whey Proteins; C026375:trypticase-soy broth; D007073:Immunoglobulin E