Modified proteins in allergy prevention

Area of Science:

• Allergy and Immunology
• Pediatric Nutrition
• Gastroenterology

Background:

• Cow's milk protein hypersensitivity affects approximately 2.5% of neonates, often linked to early milk exposure.
• Hydrolyzed infant formulas (pHF, eHF) are developed to mitigate allergy risk in high-risk infants needing supplementation.
• The efficacy of hydrolyzed formulas may depend on both the degree and process of protein hydrolysis.

Purpose of the Study:

• To evaluate the allergy-preventive potential of partially and extensively hydrolyzed cow's milk formulas.
• To differentiate the indications for pHF and eHF in primary and secondary allergy prevention.
• To assess the trend of atopy reduction in children using hydrolyzed formulas.

Main Methods:

• Review of clinical trials investigating hydrolyzed cow's milk formulas (pHF, eHF).
• Analysis of outcomes related to atopy, specifically atopic eczema and food allergy.
• Comparison of hydrolyzed formulas' efficacy based on hydrolysis degree and process.

Main Results:

• Certain pHFs and eHFs demonstrated a trend toward reducing atopy, primarily atopic eczema and food allergy, in children up to age 6.
• Partially hydrolyzed formulas (pHF) and extensively hydrolyzed formulas (eHF) show promise for primary allergy prevention in high-risk infants.
• Extensively hydrolyzed formulas (eHF) are indicated for secondary prevention in infants with diagnosed cow's milk allergy.

Conclusions:

• Hydrolyzed cow's milk formulas can be considered for primary allergy prevention in infants requiring supplementation, even without a family history of atopy.
• The choice between pHF and eHF depends on whether it's for primary or secondary prevention of allergies.
• Further consideration of hydrolysates for all supplemented infants may be warranted given the high prevalence of allergy in children without a family history.