Prevalence of soy protein hypersensitivity in cow's milk protein-sensitive children in Korea

Area of Science:

• Pediatric Allergy and Immunology
• Clinical Nutrition
• Dermatology

Background:

• Cow's milk allergy (CMA) is common in infants.
• Soy protein is often used as an alternative formula.
• Cross-reactivity between cow's milk and soy protein is a concern.

Purpose of the Study:

• To determine the prevalence of soy protein hypersensitivity in Korean children with cow's milk protein sensitivity.
• To assess the risk of soy allergy in infants diagnosed with CMA.

Main Methods:

• Recruited 1,363 children with allergic conditions (atopic dermatitis, urticaria, etc.).
• Measured specific IgE levels to soy using CAP assay (>0.7 kU/L considered positive).
• Conducted open challenge tests with soy in 21 CMA patients with negative soy-specific IgE.

Main Results:

• 18.3% of children sensitized to cow's milk protein showed positive soy-specific IgE.
• Soy sensitization prevalence decreased with age: 36.8% (1st year), 16.4% (2nd year), 13.7% (3rd year).
• Soy allergy was confirmed in 42.9% of 21 CMA patients via challenge tests.

Conclusions:

• A significant proportion of cow's milk-sensitive children are also sensitized to soy.
• Soy protein formula requires careful consideration as a cow's milk substitute, especially for infants under one year old.
• Further research into cross-reactivity and management strategies is warranted.