Monaco S, Russo G, Romano A, Liotti L, Verga M C, Miceli Sopo S
Allergy Unit, Pediatrics Area, Department of Woman and Child Health, Policlinico Gemelli Universitary Foundation IRCCS, Catholic University of Sacre Hearth, Rome, Italy.
Allergy Unit, Pediatric Clinic, Civil Hospital, Senigallia, Italy.
Allergol Immunopathol (Madr). 2019 Jul-Aug;47(4):322-327. doi: 10.1016/j.aller.2018.10.005. Epub 2018 Dec 17.
Children with IgE-mediated cow's milk allergy (IgE-CMA) with gastrointestinal symptoms tolerate yogurt at 100%. Yogurt tolerance in children with IgE-CMA with urticaria and anaphylaxis was 7%.
We enrolled children with IgE-CMA with cutaneous, respiratory, gastrointestinal and anaphylactic symptoms. All performed prick by prick (PbP) and oral food challenge (OFC) with yogurt. Some children performed also an OFC with CM mixed with wheat flour and baked, baked liquid CM, parmesan.
34 children were enrolled, 31/34 (91%) with systemic adverse reaction after ingestion of CM (systemic CMA), 3/34 (9%) with isolated contact urticaria (ICU CMA). PbP with yogurt was negative only in one patient. OFC with yogurt was passed (that is, the OFC was negative) by 20/31 (64%) of the children with systemic CMA. 10/11 (91%) of the patients who failed OFC (that is, the OFC was positive) with yogurt were positive to SPT with casein vs. 8/20 (40%) of the patients who passed it (p=0.018). None of the 19 children who passed OFC with yogurt failed all OFC with processed CM forms other than yogurt that tested vs. 4/8 among those who failed OFC with yogurt (p=0.006). The rub test with yogurt was negative in 1/3 (33%) of the patients with ICU CMA.
The results of our study are placed alongside others already present in the literature and concerning other methods of processing CM proteins and help to reduce the dietary restrictions of the majority of children with systemic IgE-CMA.
有胃肠道症状的IgE介导的牛奶过敏（IgE-CMA）儿童对酸奶的耐受性为100%。有荨麻疹和过敏反应的IgE-CMA儿童对酸奶的耐受性为7%。
我们纳入了有皮肤、呼吸、胃肠道和过敏症状的IgE-CMA儿童。所有儿童均进行了酸奶点刺试验（PbP）和口服食物激发试验（OFC）。部分儿童还进行了牛奶与小麦粉混合烘焙物、烘焙液态牛奶、帕尔马干酪的OFC。
共纳入34名儿童，31/34（91%）在摄入牛奶后出现全身不良反应（全身性CMA），3/34（9%）有孤立性接触性荨麻疹（ICU CMA）。仅1例患者的酸奶PbP试验为阴性。全身性CMA儿童中，20/31（64%）通过了酸奶OFC（即OFC为阴性）。酸奶OFC未通过（即OFC为阳性）的患者中，10/11（91%）对酪蛋白皮肤点刺试验（SPT）呈阳性，而通过酸奶OFC的患者中这一比例为8/20（40%）（p=0.018）。19名通过酸奶OFC的儿童中，没有一人对除酸奶外的其他加工牛奶形式的所有OFC均未通过，而酸奶OFC未通过的儿童中有4/8是这种情况（p=0.006）。ICU CMA患者中，1/3（33%）的酸奶摩擦试验为阴性。
我们的研究结果与文献中已有的关于其他加工牛奶蛋白方法的研究结果相符，有助于减少大多数全身性IgE-CMA儿童的饮食限制。
