The Role of Baked Egg and Milk in the Diets of Allergic Children

Robinson, Melissa L.; Lanser, Bruce J.

doi:10.1016/j.iac.2017.09.007

Cited by 20 publications

(17 citation statements)

References 33 publications

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“…Among these it has been demonstrated that the consumption of baked milk as such or as an ingredient included into the food matrix might induce milk tolerance in 50–70% of CM allergic children enrolled in the study [16,17]. This is also confirmed by other more recent works reporting that the consumption of baked goods containing egg or cow’s milk may hasten the development of tolerance to these foods in an unheated form [18,19,20]. This paves the way for setting up oral food challenge studies using milk-including baked goods to be administered to milk allergic patients.…”

Section: Introductionsupporting

confidence: 71%

Modulation of Milk Allergenicity by Baking Milk in Foods: A Proteomic Investigation

et al. 2019

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Cow’s milk is considered the best wholesome supplement for children since it is highly enriched with micro and macro nutrients. Although the protein fraction is composed of more than 25 proteins, only a few of them are capable of triggering allergic reactions in sensitive consumers. The balance in protein composition plays an important role in the sensitization capacity of cow’s milk, and its modification can increase the immunological response in allergic patients. In particular, the heating treatments in the presence of a food matrix have demonstrated a decrease in the milk allergenicity and this has also proved to play a pivotal role in developing tolerance towards milk. In this paper we investigated the effect of thermal treatment like baking of cow’s milk proteins that were employed as ingredients in the preparation of muffins. A proteomic workflow was applied to the analysis of the protein bands highlighted along the SDS gel followed by western blot analyses with sera of milk allergic children in order to have deeper information on the impact of the heating on the epitopes and consequent IgE recognition. Our results show that incorporating milk in muffins might promote the formation of complex milk–food components and induce a modulation of the immunoreactivity towards milk allergens compared to milk baked in the oven at 180 °C for ten minutes. The interactions between milk proteins and food components during heating proved to play a role in the potential reduction of allergenicity as assessed by in vitro tests. This would help, in perspective, in designing strategies for improving milk tolerance in young patients affected from severe milk allergies.

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Section: Introductionsupporting

confidence: 71%

Modulation of Milk Allergenicity by Baking Milk in Foods: A Proteomic Investigation

et al. 2019

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“…Search for new hypoallergenic variants of food allergens is in focus, due to the high risk of severe adverse side effects during food allergy IT with native allergens. Denaturation of proteins, whether it is by heat‐treatment or chemically, is an approach that potentially reduces the allergenicity 12‐14,30‐33 . In the present study, we investigated the allergenicity of two denatured cow's milk proteins in comparison with their native form.…”

Section: Discussionmentioning

confidence: 99%

“…However, for cow's milk allergic infants an alternative approach to strict avoidance is the use of hypoallergenic infant formulas 11 . In addition, incorporation of heat‐denatured milk into the diet has recently been suggested as an alternative to strict avoidance, 12,13 as studies have shown that milk‐containing baked products can be tolerated by the majority of milk allergic children 12‐14 . In children who were able to add milk‐containing baked products into their diet, immunologic changes similar to the ones induced by oral immunotherapy (IT) were observed 14 and suggested to speed up recovery from CMA 15‐17 .…”

Section: Introductionmentioning

confidence: 99%

The use of aluminium hydroxide as adjuvant modulates the specific antibody response—A Brown Norway rat study with native and denatured cow's milk allergens

2020

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There is a need for efficient methods to treat food allergy; however, no immunotherapeutic method has yet been satisfactory due to the high rate of unpredictable severe reactions and the limited efficacy. Therefore, modified versions of food allergens have been suggested as alternatives to the parent proteins for immunotherapy. The aim of the study was to compare the inherent allergenicity of the native and denatured version of the cow's milk proteins β‐lactoglobulin and α‐lactalbumin, and to study the impact of the use of Al(OH)3 as an adjuvant. Brown Norway rats were immunized intraperitoneally with either native or denatured β‐lactoglobulin or α‐lactalbumin, with or without the use of Al(OH)3 as adjuvant. Antibody responses were analysed in various ways by means of different ELISAs. Both the immunogenicity and the sensitizing capacity of the cow's milk allergens were influenced by their globular folding, with the native version being more allergenic than the denatured counterpart. The native folded proteins mainly raised antibodies against conformational epitope, whereas the denatured versions predominantly raised antibodies against linear epitopes. Most interestingly, the study showed that the use of Al(OH)3, besides increasing immunogenicity and sensitizing capacity of the cow's milk allergens, caused a modification of the specificity of the antibodies raised against the native version of the proteins. Adsorption of the native forms of the allergens to Al(OH)3 caused a significant greater proportion of antibodies raised against linear epitopes, stressing that the adsorption induced a partly unfolding of the proteins. This may have implications for IT safety and efficacy.

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“…The addition of baked-milk to the diet appears to accelerate the development of unheated-milk tolerance compared to strict avoidance, along with a significant increase in casein IgG4 values in the baked-milk-tolerant group, similar to those spontaneously outgrowing milk allergy and treated with milk oral immunotherapy (OIT) (83, 88–92). Recent studies on the regular consumption of baked milk and related immunologic changes reinforce baked milk as a proactive treatment for food allergy (85, 86, 93–95). A randomized controlled trial assessed the effect of baked milk on accelerating tolerance in 84 children with CMPA who tolerated baked milk in oral food challenge (OFC) (96).…”

Section: Intervention Strategies For Tolerance Induction In Cmpamentioning

confidence: 99%

Current Trends in Tolerance Induction in Cow's Milk Allergy: From Passive to Proactive Strategies

et al. 2019

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This review addresses the current strategies of inducing tolerance development in infant and childhood cow's milk protein allergy (CMPA). The change in prevention strategies for CMPA has been emphasized based on the lack of evidence to support the efficacy of food allergen avoidance in infancy and the concept of the dual-allergen-exposure hypothesis, which suggests that allergen exposure through the skin leads to sensitization, whereas early oral consumption of allergenic food protein induces oral tolerance. The new approach is based on the likelihood of early introduction of allergenic foods to the infant's diet to reduce the development of food allergies through oral tolerance induction. The latest treatment guidelines recommend the continuation of breast feeding and the elimination of cow's milk and products from the maternal diet in exclusively breast-fed infants with CMPA, the use of an extensively hydrolyzed infant formula (eHF) with proven efficacy in CMPA as the first elimination diet in formula-fed infants with CMPA and the use of amino acid-based formula (AAF) in severe cases, such as anaphylaxis, enteropathy, eosinophilic esophagitis, and food protein-induced enterocolitis syndrome (FPIES), as well as cases of multiple system involvement, multiple food allergies, and intolerance to extensively hydrolyzed formula (eHF). In conclusion, this paper presents the current knowledge on tolerance development in infants and children with CMPA to increase the awareness of the clinicians concerning the new approaches in CMPA treatment Tolerance development is considered a relatively new concept in CMPA, inducing a shift in interventions in CMPA from a passive (avoidance of responsible allergen) toward a proactive (tolerance induction) strategy.

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The Role of Baked Egg and Milk in the Diets of Allergic Children

Cited by 20 publications

References 33 publications

Modulation of Milk Allergenicity by Baking Milk in Foods: A Proteomic Investigation

Modulation of Milk Allergenicity by Baking Milk in Foods: A Proteomic Investigation

The use of aluminium hydroxide as adjuvant modulates the specific antibody response—A Brown Norway rat study with native and denatured cow's milk allergens

Current Trends in Tolerance Induction in Cow's Milk Allergy: From Passive to Proactive Strategies

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