, Volume 395, Issue 1, pp 47-56

Molecular aspects of milk allergens and their role in clinical events

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Milk allergy is the most frequent food allergy in childhood. Even though cases of newly developed milk allergy in adulthood are known, this allergy is less frequent in adults since it is normally outgrown by children during the first years of life. One of the reasons why allergy to cow’s milk shows its highest prevalence in children is its early introduction into the diets of babies when breast feeding is not possible. The major allergens are caseins and β-lactoglobulin, but allergies to other minor proteins (immunoglobulins, bovine serum albumin) have also been reported. Milk allergenicity can be reduced by various treatments (mainly hydrolysis), meaning that formulas based on cow’s milk can often be safely fed to children allergic to milk proteins. Cross-reactivity has been described between different mammalian milks and between milk and meat or animal dander. Cross-contamination can result from inadequate cleaning of industrial equipment and constitutes a hidden danger for allergic subjects who unknowingly ingest milk proteins.


Involvement (expressed as percentage of total subjects) of the most abundant milk proteins in the sensitization of 80 children allergic to cow’s milk. The upper panel includes all positive responses, even minor ones; data in the lower panel are restricted to the most severe positive responses (see text for details). SPT, skin prick test; CAP, CAP test; IMM, immunoblotting; alpha-LA, α-lactalbumin; beta-LG, β-lactoglobulin; cas, caseins; BSA, bovine serum albumin