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Cow's Milk Desensitization in Anaphylactic Patients: A New Personalized-dose Method
Delara Babaie1, Mohammad Nabavi2, Saba Arshi2
1Department of Allergy and Clinical Immunology, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Iranian Journal of Allergy, Asthma, and Immunology
|April 19, 2017
Summary
An individualized oral immunotherapy (OIT) protocol successfully desensitized 88.8% of children with cow's milk allergy (CMA), including those with asthma. This approach offers a safer, more efficient treatment for IgE-mediated CMA.
Area of Science:
- Allergy and Immunology
- Pediatrics
- Immunotherapy
Background:
- Cow's milk allergy (CMA) is the most prevalent food allergy in children.
- Oral immunotherapy (OIT) shows promise for CMA treatment, but safe protocols are needed, especially for high-risk patients with coexisting asthma.
- Individualized OIT protocols may enhance safety and efficiency in desensitization.
Purpose of the Study:
- To evaluate the efficacy and safety of an individualized OIT protocol for children with IgE-mediated CMA, particularly those with asthma.
- To determine if personalized OIT can lead to successful desensitization and reduced allergic reactions.
Main Methods:
- 18 children (age >3 years) with confirmed IgE-mediated CMA were enrolled.
- An individualized starting OIT dilution was determined by skin prick tests (SPT) and serial milk dilutions.
- Desensitization involved gradually increasing milk intake, starting with one drop of the determined dilution.
Main Results:
- 16 out of 18 children (88.8%) achieved a daily intake of 120 mL of milk.
- Four children completed the protocol without adverse reactions; 12 experienced mild to severe reactions.
- Significant decreases in SPT wheal/erythema and serum IgE levels were observed post-desensitization.
Conclusions:
- An individualized OIT protocol was successful in desensitizing the majority of children with IgE-mediated CMA.
- Personalized OIT may improve treatment efficiency and reduce allergic symptoms in cow's milk-allergic children.
- This approach is particularly relevant for managing CMA in high-risk pediatric populations, including those with asthma.