Cow's milk allergy: a new understanding from immunology

Area of Science:

• Pediatric Allergy and Immunology
• Gastroenterology
• Food Hypersensitivity

Background:

• Cow's milk allergy is a frequent food allergy in infants and young children.
• Distinguishing allergy from food intolerance is crucial for accurate diagnosis.
• Advances in immunology offer improved understanding and management of cow's milk allergy.

Purpose of the Study:

• To review recent immunological developments.
• To enhance understanding of cow's milk allergy's clinical spectrum in infants and children.

Main Methods:

• Literature review of English-language articles from PubMed.
• Focus on studies with immediate clinical implications.
• Emphasis on gastroenterological aspects, specifically the esophagus and small intestine.

Main Results:

• Cow's milk-sensitive esophagitis shows eosinophil infiltrate and T cell activation.
• Cow's milk-sensitive enteropathy involves T cell activation, often post-gastroenteritis.
• Sensitization may occur via breast milk, with reduced Th1 response and IgA deficiency noted.

Conclusions:

• Clinical manifestations of cow's milk allergy are diverse and vary geographically.
• Understanding immunological mechanisms is vital for explaining this diversity.