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Article

Predictive Factors for Oral Immune Modulation in Cow Milk Allergy

1
Department of Allergology and Immunology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj Napoca, Romania
2
Department of Allergology, “Octavian Fodor” Institute of Gastroenterology and Hepatology, 400162 Cluj Napoca, Romania
3
Department of Pharmacology, Toxicology and Clinical Pharmacology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400337 Cluj Napoca, Romania
4
Department of Anesthesiology, Intensive Care, Emergency and Pain Medicine, Hospital of Villingen-Schwenningen, 78056 Villingen-Schwenningen, Germany
5
Department of Pediatric Pneumology, Pediatric Hospital, 400371 Cluj Napoca, Romania
6
First Internal Medical Department, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology, 540139 Târgu Mureș, Romania
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Academic Editor: Francisco J. Pérez-Cano
Nutrients 2022, 14(3), 494; https://doi.org/10.3390/nu14030494
Received: 4 December 2021 / Revised: 14 January 2022 / Accepted: 19 January 2022 / Published: 23 January 2022
(This article belongs to the Special Issue Immunomodulation by Food: A Tool for Mitigating Allergic Disease)
Aim: The present study analyzed clinical and biological factors that might predict achievement of tolerance in patients with IgE-mediated cow milk allergy (CMA). Method: Seventy patients with IgE-mediated CMA (44.24 ± 24.16 months) were included in the study. The patients were evaluated clinically through skin prick test and sIgE to whole milk, casein, beta-lactoglobulin and alpha-lactalbumin. An eviction diet of 6 months was established, followed by oral food challenge test (OFC) and oral immunotherapy (OIT) with baked milk for 6 months. The tolerance was assessed after 2 years follow up. Results: Thirty percent of patients presented anaphylaxis of different degrees of severity as first manifestation of CMA. Sixty-two patients followed OIT or an accelerated reintroduction of milk. Ten patients (14.28%) did not obtain tolerance to milk within 2 years. A larger wheal in SPT and higher sIgE to milk, casein and betalactoglobulin were noted in patients with positive OFC. A basal level of <2.5 kU/l for sIgE to milk and <11.73 kU/l for sIgE to caseins predicted the occurrence of tolerance in patients with all types of clinical manifestations, including anaphylaxis. Conclusion: Basal levels of sIgE to milk and casein may help to identify patients that could become tolerant to milk. View Full-Text
Keywords: casein; cow milk allergy; oral immunotherapy; oral tolerance casein; cow milk allergy; oral immunotherapy; oral tolerance
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MDPI and ACS Style

Muntean, I.A.; Bocsan, I.C.; Wiest, L.K.; Pintea, I.; Dobrican, C.T.; Duca, E.; Ureche, C.; Buzoianu, A.D.; Deleanu, D. Predictive Factors for Oral Immune Modulation in Cow Milk Allergy. Nutrients 2022, 14, 494. https://doi.org/10.3390/nu14030494

AMA Style

Muntean IA, Bocsan IC, Wiest LK, Pintea I, Dobrican CT, Duca E, Ureche C, Buzoianu AD, Deleanu D. Predictive Factors for Oral Immune Modulation in Cow Milk Allergy. Nutrients. 2022; 14(3):494. https://doi.org/10.3390/nu14030494

Chicago/Turabian Style

Muntean, Ioana A., Ioana C. Bocsan, Lena K. Wiest, Irena Pintea, Carmen T. Dobrican, Emanuela Duca, Corina Ureche, Anca D. Buzoianu, and Diana Deleanu. 2022. "Predictive Factors for Oral Immune Modulation in Cow Milk Allergy" Nutrients 14, no. 3: 494. https://doi.org/10.3390/nu14030494

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