Increased Tolerance to Less Extensively Heat-Denatured (Baked) Milk Products in Milk-Allergic Children
| Autor: | Anna Nowak-Wegrzyn, Hugh A. Sampson, Madhan Masilamani, Kaitie Lawson, Jacob D. Kattan, Henry T. Bahnson |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
Hot Temperature Milk allergy Article 03 medical and health sciences fluids and secretions 0302 clinical medicine Animal science Food allergy Immune Tolerance Animals Humans Immunology and Allergy Medicine Cooking 030212 general & internal medicine Food science Child Increased tolerance Adverse effect Baked milk business.industry Oral food challenge Liquid milk food and beverages Allergens Immunoglobulin E Active Study medicine.disease Milk 030228 respiratory system Child Preschool Female Milk Hypersensitivity business |
| Zdroj: | The Journal of Allergy and Clinical Immunology: In Practice. 6:486-495.e5 |
| ISSN: | 2213-2198 |
| DOI: | 10.1016/j.jaip.2017.10.021 |
| Popis: | Background Most milk-allergic children tolerate baked milk. Objective To investigate the effect of more frequent versus less frequent introduction of higher doses of more allergenic (less heat-denatured) forms of milk (MAFM) on progression to tolerance. Methods Milk-allergic children were challenged with increasing doses of MAFM; baked foods were incorporated into the diet; challenges were repeated at 6- or 12-month intervals over 36 months. Results A total of 136 children (70% males) were enrolled in the active group (median age, 7 years). At baseline, 41 (30%) reacted to muffin, 31 (23%) to pizza, 11 (8%) to rice pudding, 43 (32%) to non–baked milk; and 10 (7%) tolerated non–baked milk. Children who tolerated baked milk but reacted to non–baked liquid milk were randomized to MAFM challenges every 6 months (n = 41) or 12 months (n = 44). At month 36, 61% children in the 6-month and 73% in the 12-month escalation groups tolerated MAFM. Overall, 41 (48%) children who ingested baked-milk diet became tolerant to non–baked milk; no difference was seen between 6- and 12- month escalations. Among children who reacted to muffin at baseline and continued avoidance, 20% developed tolerance to baked milk and 0% tolerated non–baked milk. None of the 34 children who qualified for inclusion but chose not to take part in the active study became tolerant to any form of milk by history. Conclusions Majority of children tolerated baked milk at baseline. Baked-milk diets were associated with progressive immunomodulation. Most children who incorporated baked milk into their diet progressed to tolerating MAFM, but there was no advantage to more frequent attempts to escalate to MAFM, per intention-to-treat analysis. |
| Databáze: | OpenAIRE |
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