Peptide size profile and residual immunogenic milk protein or peptide content in extensively hydrolyzed infant formulas

Nutten, Sophie; Maynard, Françoise; Järvi, Anette; Rytz, Andréas; Simons, Peter J.; Heine, Ralf G.; Kuslys, Martinas

doi:10.1111/all.14098

Cited by 26 publications

(35 citation statements)

References 9 publications

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“…Therefore, clinicians should limit its use for extremely severe cases and when eHF is not tolerated, which is supported by this study findings (9,25,26). Not all hydrolysed infant formulas are the same (12,13). Their hypoallergenicity depends on the specific condition of the hydrolysis process (i.e., duration, temperature, type of enzyme used etc.…”

Section: Discussionsupporting

confidence: 64%

“…The other subject was mixed-fed with a standard infant formula for 3 months (age 13 weeks) until he developed the first symptoms. All three infants were mixed-fed and none Age at which CMA can be reintroduced (mean, range months) 13.4 (12)(13)(14)(15)(16)(17) of their mothers had to follow a dairy elimination diet for improvement of symptoms. Several guidelines (10,11,24,37,38), suggest an AAF as the 1st choice for the management of FPIES.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, their efficacy in the management of patients with different CMPA phenotypes may differ and therefore should be assessed individually. In a recent study, Frisolac AC, an Extensively Hydrolysed Caseinbased Formula produced by FrieslandCampina, did not induce proinflammatory cytokines response or T-cell proliferation in blood of allergic patients (12,13). These characteristics may be an important factor for successful management of non-IgE-mediated enteropathies, as limiting the production of proinflammatory cytokines secreted by T-cells may in turn help to decrease the intestinal permeability, considered to be a potential pathomechanism (14).…”

Section: Introductionmentioning

confidence: 97%

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Nutritional Management With a Casein-Based Extensively Hydrolysed Formula in Infants With Clinical Manifestations of Non-IgE-Mediated CMPA Enteropathies and Constipation

Sekkidou¹,

Muhardi²,

Constantinou

et al. 2021

Front. Allergy

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Background: The majority of mixed-fed infants with non-IgE-mediated cow's milk protein allergy (CMPA) enteropathies are managed with an extensively hydrolysed cow's milk based infant formula (eHF). Given the high variability in peptide distribution of available eHFs, it is important to understand the suitability of a specific product in the management of distinct phenotypes.Objective: To assess the symptom resolution of various phenotypes of clinical manifestations of CMPA enteropathies and constipation managed by a casein-based eHF.Methods: The data of 20 full-term infants (n = 15 with non-IgE-mediated CMPA and n = 5 with constipation) attending a paediatric allergy clinic in Cyprus and managed with a casein-based eHF were retrospectively analysed.Results: Based on the clinical symptoms and history, infants were classified into the following phenotypes: (a) 11/15 (73.3%) FPIAP, (b) 3/15 (20%) FPIES, and (c) 1/15 (6.7%) severe diarrhoea. Overall, 14 (93.3%) patients were successfully managed with the casein-based eHF and 1 (6.7%) required an AAF. This formula was effective in 91% of patients with FPIAP, in 100% with FPIES and with diarrhoea. Three (60%) patients with constipation responded to the eHF.Conclusion: This case-series report supports the efficacy of a particular casein-based eHF for the nutritional management of non-IgE mediated CMPA enteropathies.

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Section: Discussionsupporting

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

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Nutritional Management With a Casein-Based Extensively Hydrolysed Formula in Infants With Clinical Manifestations of Non-IgE-Mediated CMPA Enteropathies and Constipation

Sekkidou¹,

Muhardi²,

Constantinou

et al. 2021

Front. Allergy

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“…By providing the pHF in between AAF or eHF and full cow’s milk as part of a step-down approach in the management of CMA, it is postulated that the children might achieve tolerance to CMP sooner ( 49 ). There are differences between eHFs in the degree of hydrolysis, which affects the distribution of peptide size ( 127 ).…”

Section: Step-down Approach To Build Early Tolerance In Re-introducing Intact Cow’s Milk Proteinmentioning

confidence: 99%

“…Common casein-based eHF generally have a high degree of hydrolysis (eg 37%) and 80% of peptide less than 500Da, 10% of peptides between 500-1000 Da and 10% of peptides larger than 1kDA ( 127 ). On the other hand, the majority of eHF whey-based formulas have a lower degree of hydrolysis (e.g.…”

Section: Step-down Approach To Build Early Tolerance In Re-introducing Intact Cow’s Milk Proteinmentioning

confidence: 99%

Strategies and Future Opportunities for the Prevention, Diagnosis, and Management of Cow Milk Allergy

Zepeda-Ortega¹,

Goh

Xepapadaki

et al. 2021

Front. Immunol.

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The prevalence of food allergy has increased over the last 20-30 years, including cow milk allergy (CMA) which is one of the most common causes of infant food allergy. International allergy experts met in 2019 to discuss broad topics in allergy prevention and management of CMA including current challenges and future opportunities. The highlights of the meeting combined with recently published developments are presented here. Primary prevention of CMA should start from pre-pregnancy with a focus on a healthy lifestyle and food diversity to ensure adequate transfer of inhibitory IgG- allergen immune complexes across the placenta especially in mothers with a history of allergic diseases and planned c-section delivery. For non-breastfed infants, there is controversy about the preventive role of partially hydrolyzed formulae (pHF) despite some evidence of health economic benefits among those with a family history of allergy. Clinical management of CMA consists of secondary prevention with a focus on the development of early oral tolerance. The use of extensive Hydrolysate Formulae (eHF) is the nutrition of choice for the majority of non-breastfed infants with CMA; potentially with pre-, probiotics and LCPUFA to support early oral tolerance induction. Future opportunities are, among others, pre- and probiotics supplementation for mothers and high-risk infants for the primary prevention of CMA. A controlled prospective study implementing a step-down milk formulae ladder with various degrees of hydrolysate is proposed for food challenges and early development of oral tolerance. This provides a more precise gradation of milk protein exposure than those currently recommended.

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Nutritional management of infants with food allergies

Netting,

McWilliam,

Groetch

2024

Encyclopedia of Food Allergy

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Peptide size profile and residual immunogenic milk protein or peptide content in extensively hydrolyzed infant formulas

Cited by 26 publications

References 9 publications

Nutritional Management With a Casein-Based Extensively Hydrolysed Formula in Infants With Clinical Manifestations of Non-IgE-Mediated CMPA Enteropathies and Constipation

Nutritional Management With a Casein-Based Extensively Hydrolysed Formula in Infants With Clinical Manifestations of Non-IgE-Mediated CMPA Enteropathies and Constipation

Strategies and Future Opportunities for the Prevention, Diagnosis, and Management of Cow Milk Allergy

Nutritional management of infants with food allergies

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