title: Cross-sensitization between milk proteins: reactivity to a "kosher" epitope?
abstract: BACKGROUND
  Immunoglobulin E-mediated allergy to cow's milk protein represents a major problem for infants who are not breast fed. A search for substitute milks revealed a cross-allergenicity to milk derived from goat and sheep but not to milk from a mare. We noted that the cow, goat and sheep species are both artiodactyls and ruminants, defining them as kosher animals, in contrast to the mare.
  
  
  OBJECTIVE
  To determine whether patients with IgE-mediated cow's milk allergy are cross-sensitized to milk from other species such as the deer, ibex, buffalo, pig and camel.
  
  
  METHODS
  Patients with a clinical history consistent with IgE-mediated cow's milk protein allergy were tested by skin-prick test to validate the diagnosis. They were then evaluated by skin-prick test for cross-sensitization to milk-derived proteins from other species.
  
  
  RESULTS
  All patients allergic to cow's milk tested positive by skin-prick test for cross-reactivity to deer, Ibex and buffalo (n = 24, P = 0). In contrast, only 5 of the 24 patients (20.83%) tested positive to pig milk and only 2 of 8 (25%) to camel's milk. Cross-sensitization to soy milk was noted in 4 of 23 patients (17.39%), although they all tolerated oral ingestion of soy-containing foods.
  
  
  CONCLUSIONS
  A significant cross-sensitization to milk proteins derived from kosher animals exists in patients allergic to cow's milk protein, but far less so compared to the milk proteins from non-kosher animals tested. Patients with proven IgE-mediated allergy to cow's milk can utilize the above findings to predict suitable alternative sources of milk.
authors.affiliation: Institute of Allergy and Immunology, Assaf Harofeh Medical Center, Zerifin, Israel. ykatz@post.tau.ac.il
authors.forename: Yitzhak
authors.initials: Y
authors.lastname: Katz
authors.forename: Michael R
authors.initials: MR
authors.lastname: Goldberg
authors.forename: Galia
authors.initials: G
authors.lastname: Zadik-Mnuhin
authors.forename: Moshe
authors.initials: M
authors.lastname: Leshno
authors.forename: Eli
authors.initials: E
authors.lastname: Heyman
mesh_terms: D000818:Animals; D002020:Buffaloes; D002162:Camelus; D002417:Cattle; D002675:Child, Preschool; D003429:Cross Reactions; D003670:Deer; D005260:Female; D006801:Humans; D007223:Infant; D007599:Judaism; D008297:Male; D016269:Milk Hypersensitivity / Q000276:immunology*; D008894:Milk Proteins / Q000276:immunology*; D012882:Skin Tests; D041942:Soy Milk; D013552:Swine
chemical_list: D008894:Milk Proteins