Sensitization to human milk

Abstract

IgE reactivity to human milk in milk-allergic patients can be due to cross- sensitization and genuine sensitization to human milk and may cause allergic symptoms. IgE-mediated sensitization to human milk is common in milk-allergic patients and may require diagnostic testing and monitoring.

Visualization of clustered IgE epitopes on α-lactalbumin

“…The high degree of sequence homology of a-La might explain the cross-reactivity of IgE antibodies from patients with CM allergy, even including the human protein. 21,22 IgE cross-reactivities have also been reported for caseins from different mammalian species in human subjects allergic to CM. 23 We expressed a-La in E coli and demonstrated that the recombinant allergen represents a folded protein that exhibited a remarkable thermal stability.…”

Mammalian milk allergy: clinical suspicion, cross-reactivities and diagnosis

“…Indeed, the first case of IgE-mediated allergy to endogenous human milk protein described a young father who showed contact urticaria upon exposure to breast milk, but not cow's milk, had specific IgE antibodies to human but not bovine ALA [49]. Schulmeister et al [50] found IgE antibodies to human milk in more than 80% of the tested cow's milkallergic patients. Both cross-reactive IgE-reactive human antigens such as ALA and noncross-reactive human milk antigens were identified, and immediate-type skin reactions could be elicited with human milk.…”

“…1 Clinical cross-reactivity between milk from cow and other mammalian species that are phylogenetically either close or far-related DBPCFC, double-blind, placebo-controlled food challenge; SPT, skin prick test. ÃCross-reactivity with cow's milk; # clinical cross-reactivity suggested [50,51]; ## no clinical studies available.…”

Presence of functional, autoreactive human milk‐specific IgE in infants with cow's milk allergy

“…This case raises the possibility of a primary sensitization to human milk proteins. In a study by Schulmeister et al [21], CMA subjects demonstrated IgE reactivity to cross-reactive as well as non-cross-reactive human milk proteins, and immediate type skin reactions were elicited using SPT with both native and boiled human milk. However, the clinical significance of these findings remains unclear.…”

“…One limitation of our study is that we did not perform clinical studies to verify reactivity to human milk in our subjects utilizing either skin testing with human ALA, as reported by Schulmeister et al [21], or oral challenges with human milk after feeding with tolerated formula. However, the fact that symptoms subsided only after breastfeeding was discontinued in all six patients who failed to respond to maternal milk elimination further suggests that endogenous milk proteins may have played a role in the persistence of symptoms.…”