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Nutrients. 2019 Jun 14;11(6). pii: E1331. doi: 10.3390/nu11061331.

Individual Sensitization Pattern Recognition to Cow's Milk and Human Milk Differs for Various Clinical Manifestations of Milk Allergy.

Author information

1
Division of Clinical and Molecular Allergology, Research Center Borstel - Leibniz Lung Center, Priority Area Asthma and Allergy, Airway Research Center North (ARCN), German Center for Lung Research (DZL), 23845 Borstel, Germany. fschocker@fz-borstel.de.
2
Division of Clinical and Molecular Allergology, Research Center Borstel - Leibniz Lung Center, Priority Area Asthma and Allergy, Airway Research Center North (ARCN), German Center for Lung Research (DZL), 23845 Borstel, Germany. skull@fz-borstel.de.
3
Division of Clinical and Molecular Allergology, Research Center Borstel - Leibniz Lung Center, Priority Area Asthma and Allergy, Airway Research Center North (ARCN), German Center for Lung Research (DZL), 23845 Borstel, Germany. cschwager@fz-borstel.de.
4
Core Facility Fluorescence Cytometry, Research Center Borstel, 23845 Borstel, Germany. jbehrends@fz-borstel.de.
5
Division of Clinical and Molecular Allergology, Research Center Borstel - Leibniz Lung Center, Priority Area Asthma and Allergy, Airway Research Center North (ARCN), German Center for Lung Research (DZL), 23845 Borstel, Germany. ujappe@fz-borstel.de.
6
Interdisciplinary Allergy Outpatient Clinic, MK III, University of Lübeck, Airway Research Center North (ARCN), German Center for Lung Research (DZL), 23538 Lübeck, Germany. ujappe@fz-borstel.de.

Abstract

Cow's milk allergy (CMA) belongs to one of the most common food allergies in early childhood affecting 2-3% of children under 3 years of age. However, approximately 1% of adults remain allergic to cow's milk, often showing severe reactions even to traces of milk. In our study, we recruited patients with different clinical manifestations of CMA, including patients with anaphylaxis and less severe symptoms. We assessed the sensitization patterns and allergic responses of these subgroups through different immunological and cell-based methods. Sera of patients were investigated for IgE against whole cow's milk and its single allergens by CAP- FEIA. In a newly developed in-house multiplex dot assay and a basophil activation test (BAT), cow's milk allergens, in addition to human breast milk and single allergens from cow's and human milk were analyzed for IgE recognition and severity of CMA in the included patients. Both the CAP-FEIA routine diagnostic and the multiplex dot test could differentiate CMA with severe from milder allergic reactions by means of the patients' casein sensitization. The BAT, which mirrors the clinical response in vitro, confirmed that basophils from patients with severe reactions were more reactive to caseins in contrast to the basophils from more moderate CMA patients. By means of this improved component-resolved diagnosis of CMA, individual sensitization patterns could be assessed, also taking sensitization against human milk into consideration.

KEYWORDS:

CAP-FEIA (Fluorescence Enzyme Immunoassay); Cow’s milk allergy (CMA), anaphylaxis; basophil activation test (BAT), human breast milk; cow’s milk allergens; multiplex dot test; sensitization pattern

PMID:
31197093
DOI:
10.3390/nu11061331
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