Sensitization to serum albumins in children allergic to cow's milk and epithelia

Abstract

Patients with persistent milk allergy and specific immunoglobulin E (IgE) to bovine serum albumin (BSA) have a greater risk of rhinoconjunctivitis and asthma because of animal dander. To prove the cross-reactivity between serum albumin (SA) of different mammals in milk, meat, and epithelia and determine if heat treatment of meats decrease the allergenicity of albumins. The study was performed using SDS-PAGE and IgE-immunoblotting using sera from eight patients sensitized to milk, BSA, and animal danders. Sera from non-allergic and only animal dander allergic subjects served as a control. With one exception, all patients' sera recognized SA in different meats (beef, lamb, deer, and pork), epithelia (dog, cat, and cow), and cow's milk. Some patients even were only sensitized to SA in meat and epithelia. Danders' allergic only recognized other proteins in epithelia but not SA. No patients reacted to SA from heated meat extracts. Serum albumin is an important allergen involved in milk, meat, and epithelia allergy. The first contact with SA was through cow's milk and patients developed sensitization to epithelia SA even without direct contact with animals. Patients with both BSA and cow's milk allergy must avoid raw meats and furry pets.

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

“…Given the potential for cross-reactivity based on serum albumin present in milk, meat and epithelia of different mammals, Vicente-Serrano et al [53] examined whether patients with persistent CMA showed sensitization to serum albumin in animal dander. Seven of eight patients sensitized to milk, BSA and animal dander recognized serum albumin in different meats (beef, lamb, deer and pork), epithelia (dog, cat and cow) and cow's milk, although all the patients were tolerant to heated meats, and their sera showed no recognition of heated meat extracts.…”

Common food allergens and their IgE-binding epitopes

“…90e92 There is cross-reactivity between serum albumin from cow, sheep, deer, pig, dog, and cat (meat and/or epithelia) 90 ; therefore, albumins are implicated as panallergens in mammals. Although bovine serum albumin is the major allergen in beef allergy, 93 bovine serum albumin-specific IgE is found in only 3.8% of patients with cow's milk allergy.…”

Role of Sensitization to Mammalian Serum Albumin in Allergic Disease

“…In view of the reported cross-reactivity between SAs from mammals, even if they are phylogenetically distinct [41], the diagnostic work-up in meat-allergic individuals should always include tests with meats from different mammals, and the use of alternative meats should always be carefully evaluated on an individual basis. Furthermore, due to cross-reactivity phenomena, children with persistent milk allergy and BSA sensitization show an increased risk of clinically relevant sensitization to animal dander [14]. …”

“…This mechanism could explain the odd phenomenon in which some atopic patients develop allergic sensitization to mammalian allergens in the absence of contact with the animals [14].…”