Current Allergy and Asthma Reports

, Volume 12, Issue 6, pp 630–640 | Cite as

IgE-Mediated Cow’s Milk Allergy in Children

Pediatric Allergy and Immunology (JM Portnoy and CE Ciaccio, Section Editors)


The age at which the majority of children outgrow cow’s milk allergy now appears to be later than previously reported. Recent studies have attempted to elucidate factors that may help prevent cow’s milk allergy, assess markers of persistence, and evaluate the usefulness of new diagnostic methods. Strict avoidance of cow’s milk has been the mainstay of treatment. However, given the potential nutritional, social, and immunologic ramifications of cow’s milk elimination from a child’s diet, there has been a focus on reevaluating this therapeutic approach.


Cow’s milk Cow’s milk allergy Food allergy Immunotherapy Baked milk IgE mediated Children Pediatrics 



Dr. Kim has received salary support from the National Institutes of Health and the Stone Family and has received payment for giving lectures from the Food Allergy and Anaphylaxis Network. Dr. Huang reported no potential conflicts of interest relevant to this article.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Rona RJ, Keil T, Summers C, Gislason D, Zuidmeer L, Sodergren E, et al. The prevalence of food allergy: a meta-analysis. J Allergy Clin Immunol. 2007;120(3):638–46. Epub 2007/07/14.PubMedCrossRefGoogle Scholar
  2. 2.
    Heine RG, Elsayed S, Hosking CS, Hill DJ. Cow's milk allergy in infancy. Curr Opin Allergy Clin Immunol. 2002;2(3):217–25. Epub 2002/06/05.PubMedCrossRefGoogle Scholar
  3. 3.
    Host A. Cow's milk protein allergy and intolerance in infancy. Some clinical, epidemiological and immunological aspects. Pediatr Allergy Immunol: Off Publ Eur Soc Pediatr Allergy Immunol. 1994;5(5 Suppl):1–36. Epub 1994/01/01.Google Scholar
  4. 4.
    Jarvinen KM, Chatchatee P. Mammalian milk allergy: clinical suspicion, cross-reactivities and diagnosis. Curr Opin Allergy Clin Immunol. 2009;9(3):251–8. Epub 2009/05/05.PubMedCrossRefGoogle Scholar
  5. 5.
    Host A, Halken S. A prospective study of cow milk allergy in Danish infants during the first 3 years of life. Clinical course in relation to clinical and immunological type of hypersensitivity reaction. Allergy. 1990;45(8):587–96. Epub 1990/11/01.PubMedCrossRefGoogle Scholar
  6. 6.
    Saarinen KM, Juntunen-Backman K, Jarvenpaa AL, Kuitunen P, Lope L, Renlund M, et al. Supplementary feeding in maternity hospitals and the risk of cow's milk allergy: a prospective study of 6209 infants. J Allergy Clin Immunol. 1999;104(2 Pt 1):457–61. Epub 1999/08/19.PubMedCrossRefGoogle Scholar
  7. 7.
    Schrander JJ, van den Bogart JP, Forget PP, Schrander-Stumpel CT, Kuijten RH, Kester AD. Cow's milk protein intolerance in infants under 1 year of age: a prospective epidemiological study. Eur J Pediatr. 1993;152(8):640–4. Epub 1993/08/01.PubMedCrossRefGoogle Scholar
  8. 8.
    • Osborne NJ, Koplin JJ, Martin PE, Gurrin LC, Lowe AJ, Matheson MC, et al. Prevalence of challenge-proven IgE-mediated food allergy using population-based sampling and predetermined challenge criteria in infants. J Allergy Clin Immunol. 2011;127(3):668–76. e1-2. Epub 2011/03/08. This population-based study of 2,848 one-year-old infants in Australia provided cow’s milk allergy prevalence data.PubMedCrossRefGoogle Scholar
  9. 9.
    Osterballe M, Hansen TK, Mortz CG, Host A, Bindslev-Jensen C. The prevalence of food hypersensitivity in an unselected population of children and adults. Pediatr Allergy Immunol: Off Publ Eur Soc Pediatr Allergy Immunol. 2005;16(7):567–73. Epub 2005/10/22.Google Scholar
  10. 10.
    Jarvinen KM, Sicherer SH, Sampson HA, Nowak-Wegrzyn A. Use of multiple doses of epinephrine in food-induced anaphylaxis in children. J Allergy Clin Immunol. 2008;122(1):133–8. Epub 2008/06/13.PubMedCrossRefGoogle Scholar
  11. 11.
    Du Toit G. Food-dependent exercise-induced anaphylaxis in childhood. Pediatr Allergy Immunol: Off Publ Eur Soc Pediatr Allergy Immunol. 2007;18(5):455–63. Epub 2007/07/10.Google Scholar
  12. 12.
    Wal JM. Bovine milk allergenicity. Ann Allergy Asthma Immunol. 2004;93(5 Suppl 3):S2–11. Epub 2004/11/26.PubMedCrossRefGoogle Scholar
  13. 13.
    Restani P, Ballabio C, Di Lorenzo C, Tripodi S, Fiocchi A. Molecular aspects of milk allergens and their role in clinical events. Anal Bioanal Chem. 2009;395(1):47–56. Epub 2009/07/07.PubMedCrossRefGoogle Scholar
  14. 14.
    Docena GH, Fernandez R, Chirdo FG, Fossati CA. Identification of casein as the major allergenic and antigenic protein of cow's milk. Allergy. 1996;51(6):412–6. Epub 1996/06/01.PubMedGoogle Scholar
  15. 15.
    Natale M, Bisson C, Monti G, Peltran A, Garoffo LP, Valentini S, et al. Cow's milk allergens identification by two-dimensional immunoblotting and mass spectrometry. Mol Nutr Food Res. 2004;48(5):363–9. Epub 2005/01/27.PubMedCrossRefGoogle Scholar
  16. 16.
    Gaudin JC, Rabesona H, Choiset Y, Yeretssian G, Chobert JM, Sakanyan V, et al. Assessment of the immunoglobulin E-mediated immune response to milk-specific proteins in allergic patients using microarrays. Clin Exp Allergy. 2008;38(4):686–93. Epub 2008/03/01.PubMedCrossRefGoogle Scholar
  17. 17.
    Chen WL, Hwang MT, Liau CY, Ho JC, Hong KC, Mao SJ. Beta-lactoglobulin is a thermal marker in processed milk as studied by electrophoresis and circular dichroic spectra. J Dairy Sci. 2005;88(5):1618–30. Epub 2005/04/15.PubMedCrossRefGoogle Scholar
  18. 18.
    Ehn BM, Ekstrand B, Bengtsson U, Ahlstedt S. Modification of IgE binding during heat processing of the cow's milk allergen beta-lactoglobulin. J Agric Food Chem. 2004;52(5):1398–403. Epub 2004/03/05.PubMedCrossRefGoogle Scholar
  19. 19.
    Nowak-Wegrzyn A, Bloom KA, Sicherer SH, Shreffler WG, Noone S, Wanich N, et al. Tolerance to extensively heated milk in children with cow's milk allergy. J Allergy Clin Immunol. 2008;122(2):342–7. 7 e1-2. Epub 2008/07/16.PubMedCrossRefGoogle Scholar
  20. 20.
    • Jyonouchi S, Abraham V, Orange JS, Spergel JM, Gober L, Dudek E, et al. Invariant natural killer T cells from children with versus without food allergy exhibit differential responsiveness to milk-derived sphingomyelin. J Allergy Clin Immunol. 2011;128(1):102–9. e13. Epub 2011/04/05. This study introduced a novel mechanism in cow’s milk allergy. Milk sphingomyelin was shown to induce invariant natural kill T-cell activation and T H 2 cytokine production that is more exuberant in children with IgE-mediated CMA.PubMedCrossRefGoogle Scholar
  21. 21.
    Fiocchi A, Terracciano L, Bouygue GR, Veglia F, Sarratud T, Martelli A, et al. Incremental prognostic factors associated with cow's milk allergy outcomes in infant and child referrals: the Milan Cow's Milk Allergy Cohort study. Ann Allergy Asthma Immunol. 2008;101(2):166–73. Epub 2008/08/30.PubMedCrossRefGoogle Scholar
  22. 22.
    Bishop JM, Hill DJ, Hosking CS. Natural history of cow milk allergy: clinical outcome. J Pediatr. 1990;116(6):862–7. Epub 1990/06/01.PubMedCrossRefGoogle Scholar
  23. 23.
    Skripak JM, Matsui EC, Mudd K, Wood RA. The natural history of IgE-mediated cow's milk allergy. J Allergy Clin Immunol. 2007;120(5):1172–7. Epub 2007/10/16.PubMedCrossRefGoogle Scholar
  24. 24.
    Elizur A, Rajuan N, Goldberg MR, Leshno M, Cohen A, Katz Y. Natural course and risk factors for persistence of IgE-mediated cow's milk allergy. Journal Pediatr. 2012. Epub 2012/04/07.Google Scholar
  25. 25.
    Allen KJ, Davidson GP, Day AS, Hill DJ, Kemp AS, Peake JE, et al. Management of cow's milk protein allergy in infants and young children: an expert panel perspective. J Paediatr Child Health. 2009;45(9):481–6. Epub 2009/08/26.PubMedCrossRefGoogle Scholar
  26. 26.
    Sampson HA. Update on food allergy. J Allergy Clin Immunol. 2004;113(5):805–19. quiz 20. Epub 2004/05/08.PubMedCrossRefGoogle Scholar
  27. 27.
    Host A, Halken S, Jacobsen HP, Christensen AE, Herskind AM, Plesner K. Clinical course of cow's milk protein allergy/intolerance and atopic diseases in childhood. Pediatr Allergy Immunol: Off Publ Eur Soc Pediatr Allergy Immunol. 2002;13 Suppl 15:23–8. Epub 2003/04/12.Google Scholar
  28. 28.
    Kvenshagen B, Halvorsen R, Jacobsen M. Adverse reactions to milk in infants. Acta Paediatr. 2008;97(2):196–200. Epub 2008/02/08.PubMedCrossRefGoogle Scholar
  29. 29.
    Venter C, Pereira B, Grundy J, Clayton CB, Roberts G, Higgins B, et al. Incidence of parentally reported and clinically diagnosed food hypersensitivity in the first year of life. J Allergy Clin Immunol. 2006;117(5):1118–24. Epub 2006/05/06.PubMedCrossRefGoogle Scholar
  30. 30.
    Bock SA, Munoz-Furlong A, Sampson HA. Further fatalities caused by anaphylactic reactions to food, 2001–2006. J Allergy Clin Immunol. 2007;119(4):1016–8. Epub 2007/02/20.PubMedCrossRefGoogle Scholar
  31. 31.
    Pumphrey RS. Fatal anaphylaxis in the UK, 1992–2001. Novartis Found Symp. 2004;257:116–28. discussion 28–32, 57–60, 276–85. Epub 2004/03/18.PubMedCrossRefGoogle Scholar
  32. 32.
    Sampson HA, Mendelson L, Rosen JP. Fatal and near-fatal anaphylactic reactions to food in children and adolescents. N Engl J Med. 1992;327(6):380–4. Epub 1992/08/06.PubMedCrossRefGoogle Scholar
  33. 33.
    Levy MB, Goldberg MR, Nachshon L, Tabachnik E, Katz Y. Lessons from cases of mortality due to food allergy in Israel: cow's milk protein should be considered a potentially fatal allergen. Isr Med Assoc J. 14(1):29–33. Epub 2012/05/26.Google Scholar
  34. 34.
    •• Fleisher DM, Perry T, Atkins A, Wood RA, Burks W, Jones SM, et al. Allergic reactions to foods in preschool-aged children in a prospective observational food allergy study. Pediatrics. 2012. Epub June 25, 2012. This prospective, five-site observational study of 512 infants with CMA reported that allergic reactions were most frequently triggered by milk. They also reported that reaction severity was not statistically different between those induced by peanuts and those induced by milk. Google Scholar
  35. 35.
    Fiocchi A, Schunemann HJ, Brozek J, Restani P, Beyer K, Troncone R, et al. Diagnosis and Rationale for Action Against Cow's Milk Allergy (DRACMA): a summary report. J Allergy Clin Immunol. 2010;126(6):1119–28. e12. Epub 2010/12/08.PubMedCrossRefGoogle Scholar
  36. 36.
    Panel NI-SE, Boyce JA, Assa’ad A, Burks AW, Jones SM, Sampson HA, et al. Guidelines for the diagnosis and management of food allergy in the United States: report of the NIAID-sponsored expert panel. J Allergy Clin Immunol. 2010;126(6 Suppl):S1–58. Epub 2010/12/16.Google Scholar
  37. 37.
    Perry TT, Matsui EC, Kay Conover-Walker M, Wood RA. The relationship of allergen-specific IgE levels and oral food challenge outcome. J Allergy Clin Immunol. 2004;114(1):144–9. Epub 2004/07/09.PubMedCrossRefGoogle Scholar
  38. 38.
    Hill DJ, Heine RG, Hosking CS. The diagnostic value of skin prick testing in children with food allergy. Pediatr Allergy Immunol: Off Publ Eur Soc Pediatr Allergy Immunol. 2004;15(5):435–41. Epub 2004/10/16.Google Scholar
  39. 39.
    Sampson HA. Utility of food-specific IgE concentrations in predicting symptomatic food allergy. J Allergy Clin Immunol. 2001;107(5):891–6. Epub 2001/05/10.PubMedCrossRefGoogle Scholar
  40. 40.
    Garcia-Ara C, Boyano-Martinez T, Diaz-Pena JM, Martin-Munoz F, Reche-Frutos M, Martin-Esteban M. Specific IgE levels in the diagnosis of immediate hypersensitivity to cows' milk protein in the infant. J Allergy Clin Immunol. 2001;107(1):185–90. Epub 2001/01/10.PubMedCrossRefGoogle Scholar
  41. 41.
    Wang J, Godbold JH, Sampson HA. Correlation of serum allergy (IgE) tests performed by different assay systems. J Allergy Clin Immunol. 2008;121(5):1219–24. Epub 2008/02/05.PubMedCrossRefGoogle Scholar
  42. 42.
    Hamilton RG, Mudd K, White MA, Wood RA. Extension of food allergen specific IgE ranges from the ImmunoCAP to the IMMULITE systems. Ann Allergy Asthma Immunol. 2011;107(2):139–44. Epub 2011/08/02.PubMedCrossRefGoogle Scholar
  43. 43.
    Kim TE, Park SW, Cho NY, Choi SY, Yong TS, Nahm BH, et al. Quantitative measurement of serum allergen-specific IgE on protein chip. Exp Mol Med. 2002;34(2):152–8. Epub 2002/06/28.PubMedGoogle Scholar
  44. 44.
    Noh G, Ahn HS, Cho NY, Lee S, Oh JW. The clinical significance of food specific IgE/IgG4 in food specific atopic dermatitis. Pediatr Allergy Immunol: Off Publ Eur Soc Pediatr Allergy Immunol. 2007;18(1):63–70. Epub 2007/02/14.Google Scholar
  45. 45.
    Ott H, Baron JM, Heise R, Ocklenburg C, Stanzel S, Merk HF, et al. Clinical usefulness of microarray-based IgE detection in children with suspected food allergy. Allergy. 2008;63(11):1521–8. Epub 2008/10/18.PubMedCrossRefGoogle Scholar
  46. 46.
    •• Ito K, Futamura M, Moverare R, Tanaka A, Kawabe T, Sakamoto T, et al. The usefulness of casein-specific IgE and IgG4 antibodies in cow's milk allergic children. Clin Mol Allergy: CMA. 2012;10(1):1. Epub 2012/01/04. In this study, casein IgE was deemed the best discriminating test in children with CMA.PubMedCrossRefGoogle Scholar
  47. 47.
    Garcia-Ara MC, Boyano-Martinez MT, Diaz-Pena JM, Martin-Munoz MF, Martin-Esteban M. Cow's milk-specific immunoglobulin E levels as predictors of clinical reactivity in the follow-up of the cow's milk allergy infants. Clin Exp Allergy. 2004;34(6):866–70. Epub 2004/06/16.PubMedCrossRefGoogle Scholar
  48. 48.
    Fiocchi A, Restani P, Riva E. Beef allergy in children. Nutrition. 2000;16(6):454–7. Epub 2000/06/28.PubMedCrossRefGoogle Scholar
  49. 49.
    Werfel SJ, Cooke SK, Sampson HA. Clinical reactivity to beef in children allergic to cow's milk. J Allergy Clin Immunol. 1997;99(3):293–300. Epub 1997/03/01.PubMedCrossRefGoogle Scholar
  50. 50.
    Osborn DA, Sinn J. Formulas containing hydrolysed protein for prevention of allergy and food intolerance in infants. Cochrane Database Syst Rev. 2006;(4):CD003664. Epub 2006/10/21.Google Scholar
  51. 51.
    Lowe AJ, Hosking CS, Bennett CM, Allen KJ, Axelrad C, Carlin JB, et al. Effect of a partially hydrolyzed whey infant formula at weaning on risk of allergic disease in high-risk children: a randomized controlled trial. J Allergy Clin Immunol. 2011;128(2):360–5. e4. Epub 2011/06/24.PubMedCrossRefGoogle Scholar
  52. 52.
    von Berg A, Filipiak-Pittroff B, Kramer U, Link E, Bollrath C, Brockow I, et al. Preventive effect of hydrolyzed infant formulas persists until age 6 years: long-term results from the German Infant Nutritional Intervention Study (GINI). J Allergy Clin Immunol. 2008;121(6):1442–7. Epub 2008/06/10.CrossRefGoogle Scholar
  53. 53.
    von Berg A, Koletzko S, Filipiak-Pittroff B, Laubereau B, Grubl A, Wichmann HE, et al. Certain hydrolyzed formulas reduce the incidence of atopic dermatitis but not that of asthma: three-year results of the German Infant Nutritional Intervention Study. J Allergy Clin Immunol. 2007;119(3):718–25. Epub 2007/01/24.CrossRefGoogle Scholar
  54. 54.
    von Berg A, Koletzko S, Grubl A, Filipiak-Pittroff B, Wichmann HE, Bauer CP, et al. The effect of hydrolyzed cow's milk formula for allergy prevention in the first year of life: the German Infant Nutritional Intervention Study, a randomized double-blind trial. J Allergy Clin Immunol. 2003;111(3):533–40. Epub 2003/03/19.CrossRefGoogle Scholar
  55. 55.
    Christie L, Hine RJ, Parker JG, Burks W. Food allergies in children affect nutrient intake and growth. J Am Diet Assoc. 2002;102(11):1648–51. Epub 2002/11/27.PubMedCrossRefGoogle Scholar
  56. 56.
    Tiainen JM, Nuutinen OM, Kalavainen MP. Diet and nutritional status in children with cow's milk allergy. Eur J Clin Nutr. 1995;49(8):605–12. Epub 1995/08/01.PubMedGoogle Scholar
  57. 57.
    Carvalho NF, Kenney RD, Carrington PH, Hall DE. Severe nutritional deficiencies in toddlers resulting from health food milk alternatives. Pediatrics. 2001;107(4):E46. Epub 2001/05/23.PubMedCrossRefGoogle Scholar
  58. 58.
    Nguyen J, Cazassus F, Atallah A, Baba N, Sibille G, Coriatt D. [Kwashiorkor after an exclusion diet for eczema]. Presse Med. 2001;30(30):1496–7. Epub 2001/11/20. Kwashiorkor apres regime d'eviction pour eczema.PubMedGoogle Scholar
  59. 59.
    Novembre E, Leo G, Cianferoni A, Bernardini R, Pucci N, Vierucci A. Severe hypoproteinemia in infant with AD. Allergy. 2003;58(1):88–9. Epub 2003/02/13.PubMedCrossRefGoogle Scholar
  60. 60.
    Host A, Koletzko B, Dreborg S, Muraro A, Wahn U, Aggett P, et al. Dietary products used in infants for treatment and prevention of food allergy. Joint Statement of the European Society for Paediatric Allergology and Clinical Immunology (ESPACI) Committee on Hypoallergenic Formulas and the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee on Nutrition. Arch Dis Child. 1999;81(1):80–4. Epub 1999/06/18.PubMedCrossRefGoogle Scholar
  61. 61.
    Kemp AS, Hill DJ, Allen KJ, Anderson K, Davidson GP, Day AS, et al. Guidelines for the use of infant formulas to treat cows milk protein allergy: an Australian consensus panel opinion. Med J Aust. 2008;188(2):109–12. Epub 2008/01/22.PubMedGoogle Scholar
  62. 62.
    Vandenplas Y, Koletzko S, Isolauri E, Hill D, Oranje AP, Brueton M, et al. Guidelines for the diagnosis and management of cow's milk protein allergy in infants. Arch Dis Child. 2007;92(10):902–8. Epub 2007/09/27.PubMedCrossRefGoogle Scholar
  63. 63.
    Jarvinen KM, Makinen-Kiljunen S, Suomalainen H. Cow's milk challenge through human milk evokes immune responses in infants with cow's milk allergy. J Pediatr. 1999;135(4):506–12. Epub 1999/10/13.PubMedCrossRefGoogle Scholar
  64. 64.
    Lifschitz CH, Hawkins HK, Guerra C, Byrd N. Anaphylactic shock due to cow's milk protein hypersensitivity in a breast-fed infant. J Pediatr Gastroenterol Nutr. 1988;7(1):141–4. Epub 1988/01/01.PubMedCrossRefGoogle Scholar
  65. 65.
    American Academy of Pediatrics. Committee on Nutrition. Hypoallergenic infant formulas. Pediatrics. 2000;106(2 Pt 1):346–9. Epub 2000/08/02.Google Scholar
  66. 66.
    Durham SR, Walker SM, Varga EM, Jacobson MR, O'Brien F, Noble W, et al. Long-term clinical efficacy of grass-pollen immunotherapy. N Engl J Med. 1999;341(7):468–75. Epub 1999/08/12.PubMedCrossRefGoogle Scholar
  67. 67.
    Goldberg A, Confino-Cohen R. Bee venom immunotherapy - how early is it effective? Allergy. 2010;65(3):391–5. Epub 2009/10/21.PubMedCrossRefGoogle Scholar
  68. 68.
    Lerch E, Muller UR. Long-term protection after stopping venom immunotherapy: results of re-stings in 200 patients. J Allergy Clin Immunol. 1998;101(5):606–12. Epub 1998/05/26.PubMedCrossRefGoogle Scholar
  69. 69.
    Muller U, Thurnheer U, Patrizzi R, Spiess J, Hoigne R. Immunotherapy in bee sting hypersensitivity. Bee venom versus wholebody extract. Allergy. 1979;34(6):369–78. Epub 1979/12/01.PubMedCrossRefGoogle Scholar
  70. 70.
    Nelson HS. Advances in upper airway diseases and allergen immunotherapy. J Allergy Clin Immunol. 2004;113(4):635–42. Epub 2004/04/22.PubMedCrossRefGoogle Scholar
  71. 71.
    Norman PS. Immunotherapy: 1999–2004. J Allergy Clin Immunol. 2004;113(6):1013–23. quiz 24. Epub 2004/06/23.PubMedCrossRefGoogle Scholar
  72. 72.
    Ross RN, Nelson HS, Finegold I. Effectiveness of specific immunotherapy in the treatment of allergic rhinitis: an analysis of randomized, prospective, single- or double-blind, placebo-controlled studies. Clin Ther. 2000;22(3):342–50. Epub 2000/08/30.PubMedCrossRefGoogle Scholar
  73. 73.
    Walker SM, Pajno GB, Lima MT, Wilson DR, Durham SR. Grass pollen immunotherapy for seasonal rhinitis and asthma: a randomized, controlled trial. J Allergy Clin Immunol. 2001;107(1):87–93. Epub 2001/01/10.PubMedCrossRefGoogle Scholar
  74. 74.
    Oppenheimer JJ, Nelson HS, Bock SA, Christensen F, Leung DY. Treatment of peanut allergy with rush immunotherapy. J Allergy Clin Immunol. 1992;90(2):256–62. Epub 1992/08/01.PubMedCrossRefGoogle Scholar
  75. 75.
    Nelson HS, Lahr J, Rule R, Bock A, Leung D. Treatment of anaphylactic sensitivity to peanuts by immunotherapy with injections of aqueous peanut extract. J Allergy Clin Immunol. 1997;99(6 Pt 1):744–51. Epub 1997/06/01.PubMedCrossRefGoogle Scholar
  76. 76.
    Skripak JM, Nash SD, Rowley H, Brereton NH, Oh S, Hamilton RG, et al. A randomized, double-blind, placebo-controlled study of milk oral immunotherapy for cow's milk allergy. J Allergy Clin Immunol. 2008;122(6):1154–60. Epub 2008/10/28.PubMedCrossRefGoogle Scholar
  77. 77.
    Longo G, Barbi E, Berti I, Meneghetti R, Pittalis A, Ronfani L, et al. Specific oral tolerance induction in children with very severe cow's milk-induced reactions. J Allergy Clin Immunol. 2008;121(2):343–7. Epub 2007/12/26.PubMedCrossRefGoogle Scholar
  78. 78.
    Martorell A, De la Hoz B, Ibanez MD, Bone J, Terrados MS, Michavila A, et al. Oral desensitization as a useful treatment in 2-year-old children with cow's milk allergy. Clin Exp Allergy. 2011;41(9):1297–304. Epub 2011/04/13.PubMedCrossRefGoogle Scholar
  79. 79.
    Morisset M, Moneret-Vautrin DA, Guenard L, Cuny JM, Frentz P, Hatahet R, et al. Oral desensitization in children with milk and egg allergies obtains recovery in a significant proportion of cases. A randomized study in 60 children with cow's milk allergy and 90 children with egg allergy. Eur Ann Allergy Clin Immunol. 2007;39(1):12–9. Epub 2007/03/23.PubMedGoogle Scholar
  80. 80.
    Pajno GB, Caminiti L, Ruggeri P, De Luca R, Vita D, La Rosa M, et al. Oral immunotherapy for cow's milk allergy with a weekly up-dosing regimen: a randomized single-blind controlled study. Ann Allergy Asthma Immunol. 2010;105(5):376–81. Epub 2010/11/09.PubMedCrossRefGoogle Scholar
  81. 81.
    Brozek JL, Terracciano L, Hsu J, Kreis J, Compalati E, Santesso N, et al. Oral immunotherapy for IgE-mediated cow's milk allergy: a systematic review and meta-analysis. Clin Exp Allergy. 42(3):363–74. Epub 2012/02/24.Google Scholar
  82. 82.
    Keet CA, Frischmeyer-Guerrerio PA, Thyagarajan A, Schroeder JT, Hamilton RG, Boden S, et al. The safety and efficacy of sublingual and oral immunotherapy for milk allergy. J Allergy Clin Immunol. 129(2):448–55, 55 e1-5. Epub 2011/12/02.Google Scholar
  83. 83.
    Dupont C, Kalach N, Soulaines P, Legoue-Morillon S, Piloquet H, Benhamou PH. Cow's milk epicutaneous immunotherapy in children: a pilot trial of safety, acceptability, and impact on allergic reactivity. J Allergy Clin Immunol. 2010;125(5):1165–7. Epub 2010/05/11.PubMedCrossRefGoogle Scholar
  84. 84.
    Scurlock AM, Burks AW, Jones SM. Oral immunotherapy for food allergy. Curr Allergy Asthma Rep. 2009;9(3):186–93. Epub 2009/04/08.PubMedCrossRefGoogle Scholar
  85. 85.
    • Nadeau KC, Schneider LC, Hoyte L, Borras I, Umetsu DT. Rapid oral desensitization in combination with omalizumab therapy in patients with cow's milk allergy. J Allergy Clin Immunol. 2011;127(6):1622–4. Epub 2011/05/07. In this pilot phase I study, omalizumab treatment combined with oral milk desensitization in children with CMA was found to permit rapid milk dose escalation in the majority of subjects..PubMedCrossRefGoogle Scholar
  86. 86.
    Kalliomaki M, Salminen S, Arvilommi H, Kero P, Koskinen P, Isolauri E. Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial. Lancet. 2001;357(9262):1076–9. Epub 2001/04/12.PubMedCrossRefGoogle Scholar
  87. 87.
    •• Kim JS, Nowak-Wegrzyn A, Sicherer SH, Noone S, Moshier EL, Sampson HA. Dietary baked milk accelerates the resolution of cow's milk allergy in children. J Allergy Clin Immunol. 128(1):125–31 e2. Epub 2011/05/24. This study demonstrated that the addition of baked milk to the diet of children who tolerated such foods may accelerate the development of unheated milk tolerance, as compared wilth those who avoided milk strictly. Google Scholar
  88. 88.
    Nowak-Wegrzyn A, Fiocchi A. Rare, medium, or well done? The effect of heating and food matrix on food protein allergenicity. Curr Opin Allergy Clin Immunol. 2009;9(3):234–7. Epub 2009/05/16.PubMedCrossRefGoogle Scholar
  89. 89.
    Thomas K, Herouet-Guicheney C, Ladics G, Bannon G, Cockburn A, Crevel R, et al. Evaluating the effect of food processing on the potential human allergenicity of novel proteins: international workshop report. Food Chem Toxicol. 2007;45(7):1116–22. Epub 2007/03/31.PubMedCrossRefGoogle Scholar
  90. 90.
    Cooke SK, Sampson HA. Allergenic properties of ovomucoid in man. J Immunol. 1997;159(4):2026–32. Epub 1997/08/15.PubMedGoogle Scholar
  91. 91.
    Jarvinen KM, Beyer K, Vila L, Bardina L, Mishoe M, Sampson HA. Specificity of IgE antibodies to sequential epitopes of hen's egg ovomucoid as a marker for persistence of egg allergy. Allergy. 2007;62(7):758–65. Epub 2007/06/19.PubMedCrossRefGoogle Scholar
  92. 92.
    Jarvinen KM, Chatchatee P, Bardina L, Beyer K, Sampson HA. IgE and IgG binding epitopes on alpha-lactalbumin and beta-lactoglobulin in cow's milk allergy. Int Arch Allergy Immunol. 2001;126(2):111–8. Epub 2001/12/01.PubMedCrossRefGoogle Scholar
  93. 93.
    Wang J, Lin J, Bardina L, Goldis M, Nowak-Wegrzyn A, Shreffler WG, et al. Correlation of IgE/IgG4 milk epitopes and affinity of milk-specific IgE antibodies with different phenotypes of clinical milk allergy. J Allergy Clin Immunol. 125(3):695–702, e1- e6. Epub 2010/03/17.Google Scholar
  94. 94.
    Pelucchi C, Chatenoud L, Turati F, Galeone C, Moja L, Bach JF, et al. Probiotics supplementation during pregnancy or infancy for the prevention of atopic dermatitis: a meta-analysis. Epidemiology. 2012;23(3):402–14. Epub 2012/03/24.PubMedCrossRefGoogle Scholar
  95. 95.
    • Berni Canani R, Nocerino R, Terrin G, Coruzzo A, Cosenza L, Leone L, et al. Effect of Lactobacillus GG on tolerance acquisition in infants with cow's milk allergy: a randomized trial. J Allergy Clin Immunol. 2012;129(2):580–2. 2 e1-5. Epub 2011/11/15. This randomized study involving infants with strongly suspected cow’s milk allergy suggested that supplementation of extensively hydrolyzed casein formula with lactobacillus GG accelerates development of tolerance to cow's milk protein.PubMedCrossRefGoogle Scholar
  96. 96.
    • Savilahti EM, Viljanen M, Kuitunen M, Savilahti E. Cow's milk and ovalbumin-specific IgG and IgA in children with eczema: low beta-lactoglobulin-specific IgG4 levels are associated with cow's milk allergy. Pediatr Allergy Immunol: Off Publ Eur Soc Pediatr Allergy Immunol. 2012. Epub 2012/03/23. This study suggested that supplementation of extensively hydrolyzed casein formula with Lactobacillus GG accelerated the development of tolerance to cow’s milk in infants. Google Scholar
  97. 97.
    Karlsson MR, Rugtveit J, Brandtzaeg P. Allergen-responsive CD4+CD25+ regulatory T cells in children who have outgrown cow's milk allergy. J Exp Med. 2004;199(12):1679–88. Epub 2004/06/16.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Mount Sinai School of MedicineNew YorkUSA

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