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The concept of hypoallergenicity for atopy prevention
1Research Institute for the Prevention of Allergies and Respiratory Diseases, Children's Department, Marien-Hospital Wesel, Pastor-Janssen-Strasse 8-38, DE-46483 Wesel, Germany. vonberg@marien-hospital-wesel.de
Insights
Hydrolyzed infant formulas can help prevent allergies in high-risk infants. These formulas reduce cow
Area of Science:
- Pediatrics
- Immunology
- Allergy Research
Background:
- Infancy is a critical period for sensitization, with 2.5% of neonates experiencing hypersensitivity to cow's milk protein.
- Early cow's milk exposure is strongly linked to hypersensitivity reactions in infants.
- Preventing allergic diseases involves strategies like reduced allergenicity diets and oral tolerance induction.
Purpose of the Study:
- To evaluate the efficacy of hydrolyzed infant formulas in preventing allergic diseases.
- To explore the role of reduced allergenicity and oral tolerance in infant allergy prevention.
Main Methods:
- Review of clinical studies on partially and extensively hydrolyzed infant formulas.
- Analysis of in vitro allergenicity characterization versus in vivo immunogenic effects.
- Investigation of the manufacturing process's impact on formula efficacy.
Main Results:
- Hydrolyzed infant formulas are recommended for high-risk infants during the first 4-6 months.
- Both partially and extensively hydrolyzed formulas show potential in preventing atopic eczema and food allergy.
- Preventive effects may depend more on the hydrolyzation process than the degree of hydrolysis.
Conclusions:
- Hydrolyzed infant formulas are effective in reducing the risk of allergic diseases in infants.
- The manufacturing process may influence the induction of tolerogenic epitopes, enhancing preventive effects.
- Further research into specific processing methods is warranted.
Abstract:
Infancy represents the period in which an individual may be at the highest risk of sensitization. During the first year of life around 2.5% of neonates experience hypersensitivity reactions to cow's milk protein, which is highly associated with early exposure to cow's milk. Attempts to avoid sensitization in this very early period of life and to prevent allergic diseases focus on diets with reduced allergenicity and possibly on the induction of oral tolerance. Hydrolyzed infant formulas are characterized by a reduced allergenicity and thus recommended as substitute or supplementary to breastfeeding during the first 4-6 months of life for infants at high risk of developing atopic diseases. This concept of hypoallergenicity has been shown effective in clinical studies. Both partially and extensively hydrolyzed formulas have demonstrated a potential in protecting from allergic diseases, mainly atopic eczema and food allergy. The in vitro characterization of allergenicity by the degree of hydrolyzation and peptide size, however, does not necessarily predict the immunogenic effect in humans, as it could be shown that the preventive effect seems to be dependent on the process rather than on the degree of hydrolyzation, which could be best explained by a possible production of tolerogenic epitopes.
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