Immunomodulating properties of protein hydrolysates for application in cow's milk allergy

Kiewiet, Mensiena B. G.; Gros, Marjan; Neerven, R. J. Joost van; Faas, Marijke M.; Vos, Paul de

doi:10.1111/pai.12354

Cited by 37 publications

(36 citation statements)

References 67 publications

(74 reference statements)

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“…However, is important to underline that it is not possible to make general statements on the immunomodulatory effects of hydrolysates alone or in combination with probiotics. Every hydrolysate is unique because materials and production methods differ among available hypoallergenic formulas , and immunoregulatory effects elicited by probiotics are strain‐specific . This variability underscores the importance of specific peptides and probiotic strains present in hypoallergenic formulas.…”

Section: Discussionmentioning

confidence: 99%

Extensively hydrolyzed casein formula alone or with L. rhamnosus GG reduces β‐lactoglobulin sensitization in mice

Aitoro

Simeoli

Amoroso

et al. 2017

Pediatric Allergy Immunology

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Section: Discussionmentioning

confidence: 99%

Extensively hydrolyzed casein formula alone or with L. rhamnosus GG reduces β‐lactoglobulin sensitization in mice

Aitoro

Simeoli

Amoroso

et al. 2017

Pediatric Allergy Immunology

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“…The CoMiSS™ score can contribute to quantify clinical improvement. Hydrolysates strengthen the epithelial barrier, modulate T-cell differentiation and decrease inflammation [ 26 ]. Some studies suggest a role for hydrolysates in manipulating pathogen recognition receptors signaling as underlying mechanism.…”

Section: Treatmentmentioning

confidence: 99%

“…Peptides from hydrolysates have been shown to bind to TLR2 and TLR4 and influence cytokine production in epithelial cells and macrophages. Current insight suggests that hydrolysates may actively participate in modulating the immune responses in subjects with and those at risk to develop CMA [ 26 ]. If the symptoms do not improve, then CMA is unlikely.…”

Section: Treatmentmentioning

confidence: 99%

Prevention and Management of Cow’s Milk Allergy in Non-Exclusively Breastfed Infants

Vandenplas

2017

Nutrients

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Introduction: The prevention and management of cow milk allergy (CMA) is still debated. Since CMA is much less frequent in breastfed infants, breastfeeding should be stimulated. Method: Literature was searched using databases to find original papers and reviews on this topic. Results: Hydrolysates with a clinical proof of efficacy are recommended in the prevention and treatment of CMA. However, not all meta-analyses conclude that hydrolysates do prevent CMA or other atopic manifestations such as atopic dermatitis. There are pros and cons to consider partially hydrolysed protein as an option for starter infant formula for each non-exclusively breastfed infant. A challenge test is still recommended as the most specific and sensitive diagnostic test, although a positive challenge test does not proof that the immune system is involved. The Cow Milk Symptom Score (CoMiSS™) is an awareness tool that enables healthcare professionals to better recognize symptoms related to the ingestion of cow milk, but it still needs validation as diagnostic tool. The current recommended elimination diet is a cow milk based extensive hydrolysate, although rice hydrolysates or soy infant formula can be considered in some cases. About 10 to 15% of infants allergic to cow milk will also react to soy. Mainly because of the higher cost, amino acid based formula is reserved for severe cases. There is no place for infant formula with intact protein from other animals as cross-over allergenicity is high. During recent years, attention focused also on the bifidogenic effect of prebiotics and more recently also on human milk oligosaccharides. A bifidogenic gastrointestinal microbiome may decrease the risk to develop allergic disease. The addition of probiotics and prebiotics to the elimination diet in treatment may enhance the development of tolerance development. Conclusion: Breastfeeding is the best way to feed infants. Cow milk based extensive hydrolysates remain the first option for the treatment of CMA for the majority of patients, while amino acid formulas are reserved for the most severe cases. Rice hydrolysates and soy infant formula are second choice options. Partial hydrolysates with clinical proof of efficacy are recommended in some guidelines in the prevention of CMA and allergic disease in at risk infants, and may be considered as an option as protein source in starter infant formula.

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“…Barbosa et al [18] 2000 34 9 247 14 Semerci et al [19] 2017 35 5 250 15 Haider et al [20] 2017 29 54 257…”

Section: Discussionmentioning

confidence: 99%

Perforated appendicitis in a preterm neonate: A case report with literature review

Bose

Wakeman

2017

CSS

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Neonatal appendicitis is a rare entity, with a mortality rate that has decreased in past decades but remained high. Of cases reported in the literature, more than 50% occur in preterm neonates, and none have been diagnosed preoperatively. Here, we report the case of a female infant of 27-4/7 weeks' gestational age, who presented with perforated appendicitis on day of life (DOL) 30. She was thought to have medically refractory necrotizing enterocolitis (NEC), but was found, instead, to have perforated appendicitis during an exploratory laparotomy. A thorough literature search indicates she is the second youngest neonate to survive perforated appendicitis to date.

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Immunomodulating properties of protein hydrolysates for application in cow's milk allergy

Cited by 37 publications

References 67 publications

Extensively hydrolyzed casein formula alone or with L. rhamnosus GG reduces β‐lactoglobulin sensitization in mice

Extensively hydrolyzed casein formula alone or with L. rhamnosus GG reduces β‐lactoglobulin sensitization in mice

Prevention and Management of Cow’s Milk Allergy in Non-Exclusively Breastfed Infants

Perforated appendicitis in a preterm neonate: A case report with literature review

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