PMID- 18221476
OWN - NLM
STAT- MEDLINE
DCOM- 20081112
LR  - 20220318
IS  - 1399-3038 (Electronic)
IS  - 0905-6157 (Linking)
VI  - 19
IP  - 5
DP  - 2008 Aug
TI  - Oral desensitization in children with immunoglobulin E-mediated cow's milk 
      allergy--follow-up at 4 yr and 8 months.
PG  - 412-9
LID - 10.1111/j.1399-3038.2007.00670.x [doi]
AB  - Until now, the basic treatment for food allergy has been to avoid the offending 
      item. This approach is difficult in the case of common foods and in the case 
      where there is a risk of severe reaction after consuming the offending food, even 
      inadvertently. This is the follow-up of a previous study aimed at desensitizing 
      21 children with immunoglobulin E (IgE)-mediated cow's milk (CM) allergy. This 
      protocol was totally or partially successful in 85% of cases, but failed in the 
      remaining 15%. Our aims were to study the long-term effectiveness and safety of 
      oral CM desensitization, and the prognostic value of Skin Prick Test (SPT) and 
      specific serum CM IgE. The 21 children were called back (one dropped out). The 
      allergic history and other information on CM intake over the last 4-5 yr were 
      recorded. Children underwent SPT, and end-point SPT, with casein and 
      alpha-lactoalbumin. Specific CM IgE was also measured. At follow-up, 14/20 
      children totally (n = 13, 65%) or partially (n = 1, 5%) tolerated CM. None of the 
      recalled children reported use of emergency care. SPT positivity to casein and/or 
      alpha-lactoalbumin decreased significantly (p < 0.01), and all the negative SPT 
      referred to the tolerant children. Cutaneous sensitivity to both casein and 
      alpha-lactoalbumin (end-point SPT) significantly decreased after the 6-month 
      desensitization period of the previous study (p < 0.001), but did not decrease 
      significantly at follow-up. A significant reduction of serum-specific CM IgE was 
      also observed (p < 0.05). Clinical tolerance induced by oral CM desensitization 
      persists in time. Negativization of SPT and reduction of specific CM IgE could be 
      considered prognostic indicators of CM tolerance. Oral CM desensitization seems 
      to be a promising method to treat CM food allergy. This protocol is 
      time-consuming but offers the advantage that it can be performed at home. This 
      methodology must only be used by trained staff.
FAU - Meglio, Paolo
AU  - Meglio P
AD  - Research Center, San Pietro Hospital, Fatebenefratelli, AFaR, Rome, Italy. 
      paolo.meglio@tiscali.it
FAU - Giampietro, Paolo G
AU  - Giampietro PG
FAU - Gianni, Simona
AU  - Gianni S
FAU - Galli, Elena
AU  - Galli E
LA  - eng
PT  - Journal Article
DEP - 20080122
PL  - England
TA  - Pediatr Allergy Immunol
JT  - Pediatric allergy and immunology : official publication of the European Society 
      of Pediatric Allergy and Immunology
JID - 9106718
RN  - 0 (Allergens)
RN  - 0 (Epitopes)
RN  - 37341-29-0 (Immunoglobulin E)
SB  - IM
MH  - Allergens/adverse effects/*immunology
MH  - Animals
MH  - Child
MH  - Child, Preschool
MH  - *Desensitization, Immunologic/adverse effects
MH  - Epitopes/blood
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Immune Tolerance/*immunology
MH  - Immunoglobulin E/blood
MH  - Male
MH  - Milk/adverse effects/*immunology
MH  - Milk Hypersensitivity/*immunology/physiopathology/therapy
MH  - Prognosis
MH  - Skin Test End-Point Titration
MH  - Time Factors
EDAT- 2008/01/29 09:00
MHDA- 2008/11/13 09:00
CRDT- 2008/01/29 09:00
PHST- 2008/01/29 09:00 [pubmed]
PHST- 2008/11/13 09:00 [medline]
PHST- 2008/01/29 09:00 [entrez]
AID - PAI670 [pii]
AID - 10.1111/j.1399-3038.2007.00670.x [doi]
PST - ppublish
SO  - Pediatr Allergy Immunol. 2008 Aug;19(5):412-9. doi: 
      10.1111/j.1399-3038.2007.00670.x. Epub 2008 Jan 22.