title: Sensitization patterns of cow's milk and major components in young children with atopic dermatitis.
abstract: BACKGROUND
  Cow's milk (CM) is one of the most common food allergens in children with atopic dermatitis (AD), and the component-specific immunoglobulin E (component-IgE) measurement has recently become available.
  
  
  OBJECTIVE
  This study aimed to investigate the sensitization patterns to CM and 3 major components and their clinical values in young Korean children with AD.
  
  
  METHODS
  Cow's milk-specific IgE (CM-IgE), α-lactalbumin-specific IgE (ALA-IgE), β-lactoglobulin-specific IgE (BLG-IgE), and casein-specific IgE (Cas-IgE) levels from the sera of patients with AD were measured using the UniCAP™ system (Thermo Fisher Scientific, Sweden) and collected from January 2004 to December 2010. Patients ≥ 4 years of age were excluded from the analysis.
  
  
  RESULTS
  A total of 950 patients diagnosed with AD were ultimately enrolled in the study. Among them, 471 (49.6%) patients were sensitized to CM (CM-IgE[+], > 0.35 kU/L). Sensitization to casein (n = 349, 74.1%) was most common, followed by ALA (n = 283, 60.1%), and BLG (n = 245, 52.5%). Meanwhile, 95 patients had at least 2 follow-up tests. Eighty (84.2%) of these patients tested positive to CM, and the casein sensitization rate was the highest (n = 65, 81.3%). In addition, 479 (50.4%) patients were not sensitized to CM (CM-IgE[-], ≤ 0.35 kU/L) but 35 (7.3%) patients were sensitized to at least one component. Among them, a telephone survey was accessible in 21 cases. A total of 8 (38.1%) patients still suffered from adverse reactions after consuming milk and/or dairy foods.
  
  
  CONCLUSIONS
  Casein was the most commonly and persistently sensitized component in CM-IgE(+) children with AD. Measuring CM component IgE antibodies, especially Cas-IgE, is helpful for evaluating problematic allergens in young children with AD.
authors: Department of Pediatrics, Ajou University School of Medicine, Suwon 443-749, Korea.
authors: Jeong-Min
authors: JM
authors: Lee
authors: Jong-Seo
authors: JS
authors: Yoon
authors: Se-Ah
authors: SA
authors: Jeon
authors: Soo-Young
authors: SY
authors: Lee
keywords: Atopic dermatitis; Casein; Children; Cow's milk
references: Allergy. 1998 Nov;53(11):1013-22
references: 9860234
references: J Pediatr. 1988 Sep;113(3):447-51
references: 3411388
references: Pediatrics. 1998 Mar;101(3):E8
references: 9481027
references: J Allergy Clin Immunol. 2011 Mar;127(3):603-7
references: 21093026
references: Pediatrics. 1987 May;79(5):683-8
references: 3575022
references: JAMA. 1992 Nov 25;268(20):2840-4
references: 1433699
references: J Allergy Clin Immunol. 2001 May;107(5):891-6
references: 11344358
references: J Allergy Clin Immunol. 2001 Feb;107(2):379-83
references: 11174208
references: J Allergy Clin Immunol. 2002 Aug;110(2):293-7
references: 12170271
references: N Engl J Med. 1991 Apr 4;324(14):976-9
references: 2002820
references: Allergy. 2005;60 Suppl 79:19-24
references: 15842229
references: Nutrition. 2011 Feb;27(2):253-67
references: 21215925
references: J Allergy Clin Immunol. 2003 Jul;112(1):183-9
references: 12847497
references: J Allergy Clin Immunol. 2010 Mar;125(3):695-702, 702.e1-702.e6
references: 20226304
references: Clin Exp Allergy. 2010 Sep;40(9):1303-11
references: 20645999
references: J Allergy Clin Immunol. 2009 Apr;123(4):883-8
references: 19232704
references: Allergy. 1996 May;51(5):343-5
references: 8836341
references: Clin Exp Allergy. 1999 Apr;29(4):507-12
references: 10202365
references: J Korean Med Sci. 2004 Oct;19(5):716-23
references: 15483350
references: Ann Nutr Metab. 2011;59 Suppl 1:20-6
references: 22189253
references: J Allergy Clin Immunol. 2001 Jan;107(1):185-90
references: 11150010
references: J Allergy Clin Immunol. 2007 Sep;120(3):638-46
references: 17628647
references: Allergy. 1996 Jun;51(6):412-6
references: 8837665
references: Clin Exp Allergy. 1993 Feb;23(2):124-31
references: 8448679
references: Allergy. 1990 Nov;45(8):587-96
references: 2288394