Premium
A hydrolysed rice‐based formula is tolerated by children with cow's milk allergy: a multi‐centre study
Author(s) -
Fiocchi A.,
Restani P.,
Bernardini R.,
Lucarelli S.,
Lombardi G.,
Magazzù G.,
Marseglia G. L.,
Pittschieler K.,
Tripodi S.,
Troncone R.,
Ranzini C.
Publication year - 2006
Publication title -
clinical and experimental allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.462
H-Index - 154
eISSN - 1365-2222
pISSN - 0954-7894
DOI - 10.1111/j.1365-2222.2006.02428.x
Subject(s) - milk allergy , medicine , casein , allergy , oral food challenge , food allergy , immunoglobulin e , cow milk , food science , hydrolyzed protein , sensitization , infant formula , milk protein , hydrolysis , immunology , biology , biochemistry , pediatrics , antibody
Summary Background Children allergic to cow's milk are fed a soy‐ or a hydrolysed cow's milk‐based substitute. Neither can rule out a sensitization risk. Previous studies have shown that hydrolysed rice is tolerated by animals and children with multiple food hypersensitivities. Objective A prospective clinical assessment of tolerance to a rice‐based hydrolysed formula was carried out in children allergic to cow's milk. Patients and methods One hundred children (42 girls and 58 boys, mean age 3.17±2.93 years, median 2.20, range 0.18–14.6 years) with a history of immediate reactions to cow's milk and confirmed at double‐blind, placebo‐controlled food challenge (DBPCFC) when not contraindicated were assessed for clinical tolerance to cow's milk proteins. Their allergy work‐up included skin prick tests with whole milk, α‐lactalbumin (ALA), β‐lactoglobulin (BLG) and total caseins, and specific IgE determinations using CAP technology were performed against whole milk, ALA, BLG and casein. Sensitization to rice and rice‐based hydrolysed formula was similarly investigated. Patients' sera were evaluated at immunoblotting for specific IgE to cow's milk proteins, rice and rice‐based hydrolysed formula. DBPCFC was carried out with increasing doses of a rice‐based hydrolysed formula. Results All patients were sensitized to cow's milk and/or at least one cow's milk protein fraction. Eighty‐seven out of 99 were positive to cow's milk and/or a cow's milk protein fraction at skin prick test. Positive (>0.35 kUA/L) specific IgE determinations were found for cow's milk and/or milk fractions (92/95), rice (21/91) and hydrolysed rice infant formula (4/91). At immunoblotting, sera from 96 children were positive to α‐casein ( n =54), β‐casein ( n =38), ALA ( n =57), BLG ( n =37) and bovine serum albumin ( n =61). Similarly, although patients' sera often contained specific IgE against rice proteins at CAP (21/91) and immunoblotting (70/96), only six very weakly positive responses were observed against rice‐based hydrolysed formula. All DBPCFC with rice‐based hydrolysed formula were negative. Conclusions Rice‐based hydrolysed formula is a possible alternative not only for children with multiple allergies, but also for children with cow's milk allergy.