Ouerdani Yasmina, Zamali Imen, Galai Yousr, Ben Hmid Ahlem, Nasri Yosra, Ben Sghaier Ines, Kebaier Hayet, Louzir Hechmi, Bouguila Jihene, Ben Alaya Bouafif Nissaf, Ben Ahmed Mélika, Samoud Samar
Laboratory of Clinical Immunology, Institut Pasteur de Tunis, Tunis, Tunisia.
Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia.
Front Allergy. 2025 Apr 17;6:1564564. doi: 10.3389/falgy.2025.1564564. eCollection 2025.
Cow's milk protein allergy (CMPA) represents a major health concern in Tunisia, with diagnostic challenges influencing disease prognosis. Molecular allergen testing has emerged as a valuable tool to enhance diagnostic accuracy and predict disease persistence.
This study aims to characterize the clinical and epidemiological features of CMPA in a Tunisian population, with a particular focus on the role of molecular allergens in assessing disease chronicity.
A retrospective analysis was conducted on 262 cases of IgE-mediated CMPA diagnosed at the Pasteur Institute of Tunis between 2020 and 2023. Sensitization to molecular allergens was assessed using ImmunoCAP (Phadia 100).
CMPA symptoms predominantly manifested in infancy (94%, 246/262), with a male predominance (sex ratio: 1.6). Acute reactions were the most frequent presentation (69.9%, 79/113), and polysensitization was common (81%, 212/262), particularly to β-lactoglobulin. Spontaneous resolution occurred in approximately 33% of cases (29/87), with a mean age of 3 years and 8 months. Persistent CMPA was significantly associated with elevated IgE levels to whole milk, β-lactoglobulin, and casein ( < 0.05). ROC curve analysis identified predictive thresholds for disease persistence, including 4.2 kU/L for whole milk-specific IgE and 0.37 kU/L for casein-specific IgE ( = 0.006).
Molecular allergen testing improves CMPA diagnosis and offers critical prognostic insights. The identification of IgE thresholds may facilitate early risk stratification and guide personalized management strategies.
牛奶蛋白过敏（CMPA）是突尼斯的一个主要健康问题，诊断挑战影响疾病预后。分子过敏原检测已成为提高诊断准确性和预测疾病持续性的重要工具。
本研究旨在描述突尼斯人群中CMPA的临床和流行病学特征，特别关注分子过敏原在评估疾病慢性化中的作用。
对2020年至2023年在突尼斯巴斯德研究所诊断的262例IgE介导的CMPA病例进行回顾性分析。使用免疫捕获法（Phadia 100）评估对分子过敏原的致敏情况。
CMPA症状主要在婴儿期出现（94%，246/262），男性居多（性别比：1.6）。急性反应是最常见的表现（69.9%，79/113），多致敏现象常见（81%，212/262），尤其是对β-乳球蛋白。约33%的病例（29/87）出现自发缓解，平均年龄为3岁8个月。持续性CMPA与全脂牛奶、β-乳球蛋白和酪蛋白的IgE水平升高显著相关（<0.05）。ROC曲线分析确定了疾病持续性的预测阈值，包括全脂牛奶特异性IgE为4.2 kU/L，酪蛋白特异性IgE为0.37 kU/L（=0.006）。
分子过敏原检测改善了CMPA的诊断，并提供了关键的预后见解。IgE阈值的确定可能有助于早期风险分层并指导个性化管理策略。
