As soon as possible in IgE-cow’s milk allergy immunotherapy

• Published in: European journal of pediatrics Vol. 180; no. 1; pp. 291 - 294
• Main Authors: Boné Calvo, Javier, Clavero Adell, Marcos, Guallar Abadía, Isabel, Laliena Aznar, Sara, Sancho Rodríguez, María Luisa, Claver Monzón, Angela, Aliaga Mazas, Yolanda
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 2021; Springer Nature B.V
• Subjects: Allergies; Children; Cow's milk; Food allergies; Immunoglobulin E; Immunotherapy; Infants; Medicine; Medicine & Public Health; Milk; Patients; Pediatrics; Prophylaxis; Short Communication; Skin tests; Oral food challenge; Children; Oral immunotherapy; Cow’s milk allergy
• ISSN: 0340-6199; 1432-1076
• DOI: 10.1007/s00431-020-03731-3

Oral immunotherapy is a common treatment in cow’s milk protein allergy. The Department of Pediatric Allergology at the Children’s Hospital of Zaragoza performed a retrospective analysis of 335 infants under 1 year of age diagnosed with IgE-mediated cow’s milk and early treated. Clinical evaluation, skin prick test, and serum-specific IgE level control were performed before starting and after finishing treatment. Upon completion of treatment, more than 98% of patients became tolerant to milk and no one presented serious adverse reactions. Nowadays, the remaining non-tolerant patients (1.8%) can take milk or derivatives daily—as prophylaxis—to a certain maximum dose and still remain asymptomatic. After immunotherapy, both positive skin prick tests and a progressive decrease in specific IgE levels were found, as desensitization to milk increased.
Conclusion
: Oral immunotherapy is a safe and effective treatment against allergy to cow’s milk proteins in infants. Such treatment should be offered to the children’s families from the first moment of diagnosis.
What is known:
• Cow’s milk proteins are responsible for the earliest IgE-mediated allergic reactions in children.
• Oral immunotherapy (OIT) is commonly used as cow’s milk allergy treatment and it is proposed at different ages.
What is new:
• OIT it is an effective and safe method with no severe reactions at early ages.
• The number of reaching successful treatments is awesome so we believe that immunity response can be molded at the first months of life, so the probability of success with infants is greater than in older children.