Section of Allergy and Clinical Immunology, Department of Pediatrics, University of Manitoba, Winnipeg, Canada; Division of Allergy and Immunology, Department of Pediatrics, University of British Columbia, Vancouver, Canada.
Division of Allergy and Immunology, Department of Pediatrics, Elliot and Roslyn Jaffe Food Allergy Institute, Mount Sinai Kravis Children's Hospital, New York, New York; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York.
Ann Allergy Asthma Immunol. 2021 Jul;127(1):36-41. doi: 10.1016/j.anai.2021.01.007. Epub 2021 Jan 13.
Scoping review on IgE-mediated cow's milk allergy prevention.
Literature search of PubMed database and gray literature.
Peer-reviewed relevant observational and randomized controlled studies in the pediatric population in the English language were selected and reviewed.
There is increasing literature supporting the role of early and ongoing cow's milk ingestion in the prevention of cow's milk allergy. The studies supporting a preventive role with early cow's milk ingestion suggest cow's milk introduction at a very early age (most within the first month of life), suggesting the possibility of a different mechanism of sensitization than other common allergens. It is possible that gut colonization and the diversity and intensity of microbial exposure may play a role in inducing cow's milk tolerance. It is also possible that vitamin D may have a role in modulating those immune functions.
Further research regarding the role that early cow's milk ingestion plays in the prevention of cow's milk allergy is required, and questions remain. The absolute amount required for tolerance is unclear. Studies in higher risk populations are required. However, there is an intriguing and increasingly more pervasive association between early ongoing cow's milk ingestion and cow's milk allergy prevention.
IgE 介导的牛奶过敏预防的范围综述。
对 PubMed 数据库和灰色文献进行文献检索。
选择并回顾了在儿科人群中以英文发表的具有相关性的观察性和随机对照研究。
越来越多的文献支持早期和持续摄入牛奶在预防牛奶过敏中的作用。支持早期摄入牛奶具有预防作用的研究表明，牛奶的引入时间非常早（大多数在出生后的第一个月内），这表明致敏的机制可能与其他常见过敏原不同。肠道定植和微生物暴露的多样性和强度可能在诱导牛奶耐受中发挥作用。维生素 D 也可能在调节这些免疫功能方面发挥作用。
需要进一步研究早期摄入牛奶在预防牛奶过敏中的作用，目前仍存在疑问。耐受所需的绝对量尚不清楚。需要在高危人群中开展研究。然而，早期持续摄入牛奶与预防牛奶过敏之间存在着有趣且日益普遍的关联。
