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Related Experiment Video

Updated: Oct 13, 2025

Basophil Activation Test for Allergy Diagnosis
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Elevated Cow's Milk-Specific IgE Levels Prior to Oral Immunotherapy Decrease the Likelihood of Reaching the

Casey G Cohen1, Wei W Zhao1, Danbing Ke2

  • 1Research Institute of the McGill University Health Centre, Division of Experimental Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.

The Journal of Allergy and Clinical Immunology. in Practice
|November 18, 2021
PubMed
Summary
This summary is machine-generated.

Higher cow's milk-specific IgE levels decrease the likelihood of reaching maintenance doses in oral immunotherapy (OIT). Increased milk tolerance at the start of OIT increases the chance of success.

Keywords:
CaseinCow’s milk allergyOral immunotherapySpecific IgEα-Lactalbuminβ-Lactoglobulin

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Area of Science:

  • Allergy and Immunology
  • Pediatric Gastroenterology
  • Clinical Therapeutics

Background:

  • Oral immunotherapy (OIT) is an emerging treatment for food allergies, including cow's milk (CM) allergy.
  • Adverse reactions during OIT can prolong treatment duration and lead to discontinuation.
  • Identifying factors predicting OIT success is crucial for patient management.

Purpose of the Study:

  • To determine factors associated with achieving maintenance dosage in pediatric patients undergoing CM OIT.
  • To evaluate the impact of baseline clinical characteristics and biomarkers on OIT success.

Main Methods:

  • A retrospective study involving patients undergoing CM OIT at three major children's hospitals.
  • Univariable and multivariable Cox regression analyses were used to assess predictors of reaching the maintenance dose.
  • Data analyzed included sociodemographic factors, comorbidities, clinical characteristics, and specific IgE antibody levels.

Main Results:

  • Higher baseline levels of IgE antibodies to α-lactalbumin, β-lactoglobulin, casein, and total CM were associated with a decreased probability of reaching maintenance.
  • Each 10-mL increase in CM tolerated at the entry challenge increased the probability of reaching maintenance by 10%.
  • The median duration to reach 200 mL of CM was 24.0 weeks.

Conclusions:

  • Elevated CM-specific IgE levels may predict a lower likelihood of successful OIT.
  • Greater CM tolerance at the initial challenge is a positive predictor for reaching maintenance dosage.
  • Pre-treatment assessment of these factors could aid in predicting CM OIT outcomes.