[Protein hydrolysates: hypoallergenic milks and extensively hydrolyzed formulas. Immuno-allergic basis for their use in prevention and treatment of milk allergy].
Allergy to milk has an estimated incidence of 2.5%. Hypoallergenic milks are partial hydrolysates of proteins with lactose. Extensive hydrolysates of casein are mainly small peptides and do not include lactose in their formula. A primary allergenicity as well as a cross-sensitivity are shown for all partial hydrolysates. Even extensive hydrolysates have a weak potential of cross-allergy. The prevention of cow's milk allergy in infants at peculiar risk, born from atopic parents, is based on breast-feeding and/or partial or extensive hydrolysates. There is no conclusive evidence for the usefulness of eviction of dairy products during pregnancy or during the period of breast-feeding. The treatment needs exclusively extensive casein hydrolysates ensuring a 90% protection with 95% confidence intervals. Predictive prick tests in certain cases may help the choice of another hydrolysate. Severe cases with failure to thrive or multiple food intolerance require an amino-acid based formula (Neocate). A rational diversification of the diet is advised in order to prevent the onset of a multiple food intolerance syndrome which could avert from the recovery of cow milk allergy.
Moneret-Vautrin
D A
DA
Faculté de médecine, université de Nancy 1 Henri-Poincaré, service de médecine interne, immunologie clinique et allergologie, hôpital central, avenue du Maréchal-de Lattre-de-Tassigny, 54035 Nancy, France. a.moneret-vautrin@chu-nancy.fr
Hatahet
R
R
Kanny
G
G
D000818:Animals; D001942:Breast Feeding; D002417:Cattle; D006801:Humans; D007223:Infant; D007225:Infant Food / Q000009:adverse effects; D007428:Intradermal Tests; D016269:Milk Hypersensitivity / Q000178:diet therapy* / Q000276:immunology; D008894:Milk Proteins / Q000009:adverse effects / Q000276:immunology; D011492:Protein Hydrolysates / Q000008:administration & dosage*
D008894:Milk Proteins; D011492:Protein Hydrolysates