[Elimination Diets] [Medication]
[Oral Desensitization]
| Elimination Diets | Outcome | References |
| Elimination Diet
173 mainly adults with food allergy |
Strict elimination diet: some 2/3 reported after 3-5 years that a strict elimination diet had to be followed, otherwise prompt relapse of allergic symptoms was noted. About 1/3 of patients, mainly with milk, cheese or egg allergy, show spontaneous desensitization by appropriate diet (case history, RAST) | Wüthrich & Hofer 1986 |
| Elimination Diet
148 children with CMA (age of <1 year) |
All cases improved on a milk free diet, in 18% a further modification of the diet was required after the first prescription | Ventura & Greco 1988 |
| Elimination Diet
70 children with cow's milk protein intolerance (mean age 30 days) |
Remission of symptoms (severe colic) in 71% after elimination of cow's milk protein from the diet; successive challenges caused the return of symptoms in all infants | Iacono et al. 1991 |
| Elimination Diet, Nutritional Status
19 children with CMA (age of 0.6 to 4.1 years) |
Nutritional status of children was followed during an
elimination diet (2 children soy- based formula, other children other foodstuffs
and supplementary calcium):
significant reduction in serum prealbumin values; low serum zinc values in 12 children; low serum iron in 2 children; 2 had high serum alkaline phosphatase values; dietary intake of energy below recommendation in some children; protein intake high; low intakes of riboflavin in some children |
Paganus et al. 1992 |
| Elimination Diet, Calcium
a 4 year old boy with CMA |
Calcium deficiency rickets caused by prolonged elimination diet of cow's milk; adequate intake of calcium resulted in rapid improvement | Davidovits et al. 1993 |
| Elimination Diet
infants with CMA |
Clinical disappearance of symptoms after removal of milk
from the mother's diet and/or elimination from the child's diet,
significant correlation between alterations of intestinal permeability and ingestion of reputedly hypoallergenic foods, breast milk, and hydrolyzed protein formulas |
Barau & Dupont 1994 |
| Elimination Diet, Growth
100 children (mean age 7 months) with atopic dermatitis and challenge- proven CMA |
Mean length SD score and weight-for-length index of patients decreased compared with healthy controls; low serum albumin in 6% of patients, 24% had an abnormal urea concentration, and low serum phospholipid docosahexaenoic acid in 8%; delay in growth more pronounced in subgroup of patients with early onset of symptoms | Isolauri et al. 1998 |
| Proposed Diet
in case of CMA |
Avoidance of all products containing milk, milk protein, lactoprotein, lactoserum protein, CAS, caseinate, lactalbumin, lactose, margarine, cream (contains a list of "allowed" and "prohibited" foods) | Moneret-Vautrin 1999 |
| Medication* | Outcome | References |
| Terfenadine / TNF-alpha
children with CMA |
In vitro stimulation of PBMC with milk proteins (beta-LG, alpha-LA and CAS) with or without terfenadine: dose- dependent decrease in TNF-alpha secretion in the presence of terfenadine | Benlounes et al. 1997 |
| Treatment with DSCG
8 children with CMA |
Food challenge before and after a seven- day pre- treatment period with oral sodium chromoglycate: Full protection in 6 children (asthmatic symptoms persisted in 2 patients) | Businco et al. 1983a |
| Treatment with DSCG
7-year-old child experienced acute, severe anaphylaxis after ingestion of cow's milk |
After 3 months of oral cromolyn therapy, the patient was able to tolerate small amounts of milk and moderate amounts of foods containing milk | Jones 1985 |
| Treatment with DSCG
16 children with CMA |
Pretreatment with sodium cromoglycate diminished the effect of milk challenge on gastrointestinal permeability, and usually decreased the severity of elicited symptoms | Falth-Magnusson et al. 1986 |
| Treatment with DSCG
30 children with suspected CMA, a) with clinically positive challenge, b) with negative challenge |
Oral disodiumcromoglycate (DSCG) pretreatment did not
alter the number of clinically positive challenges; significant increase
in urinary lactose/mannitol ratio (intestinal
permeability test) with placebo pretreatment as compared b); no significant differences after DSCG pretreatment |
Van Elburg et al. 1993 |
| Treatment with Ketotifen
1 patient with CMA |
White blood cells were pretreated with Ketotifen: inhibition of eosinophils degranulation | Podleski et al. 1984 |
| Oral Desensitization* | Outcome | References |
| Oral Desensitization
2 cow's milk and cheese allergic adults |
Effective oral desensitization with milk or CAS extracts (desensitization protocol) | Wüthrich & Hofer 1986 |
| Oral Desensitization
6 children with CMA (age 4-11 years) |
Diluted milk followed by increased pure milk was administered following a standardized protocol, at the beginning pretreatment with oral sodium cromoglycate, length of therapy 5 months, after therapy milk was tolerated (maintenance dose: 100 mL 2-3 times / week); 4 patients finished oral desentization successfully, 2 dropped | Patriarca et al. 1998 |
| Oral Desensitization
12-year-old girl with persistent IgE-CMA |
Effective oral desensitization starting with diluted milk (under clinical conditions, 4-6 doses per day) for 5 days, maintenance with daily intake of fresh milk | Bauer et al. 1999 |
| Oral Tolerization
a) 10 infants fed cow's milk- based formula b) 10 infants fed a CAS hydrolysate formula until the age of 9 months |
Exposure to cow's milk proteins after the age of 9 months resulted in depressed cellular and humoral responsiveness (beta-LG, BSA, CAS specific IgG and PBMC proliferation) | Vaarala et al. 1995 |
| Proteins / Glycoproteins | Allergen Nomenclature | References |
| alpha-Lactalbumin [14.2 kDa] | Bos d 4 | Goldman et al. 1963a, Gjesing et al. 1986 |
| beta-Lactoglobulin [18.3 kDa] | Bos d 5 | Goldman et al. 1963a, Gjesing et al. 1986 |
| Serum Albumin [67 kDa] | Bos d 6 | Goldman et al. 1963a, Gjesing et al. 1986 |
| Immunoglobulin [160 kDa] | Bos d 7 | Gjesing et al. 1986, Bernhisel-Broadbent et al. 1991 |
| Caseins [20-30 kDa] | Bos d 8 | Goldman et al. 1963a, Gjesing et al. 1986, Docena et al. 1996 |
| Lactoferrin [80 kDa] | Wal et al. 1995a |
7.1 Sensitization to Cow's Milk Allergens
| Country / Subjects | Sensitivity to | References | ||||||||||||||||||||||||||||||
| Argentina, La Plata
80 patients with CMA (3 months to 25 years, mean 6 years) |
|
Docena et al. 1996 | ||||||||||||||||||||||||||||||
| Australia, North Ryde, NSW
children with immediate-type CMA |
|
Adams et al. 1991 | ||||||||||||||||||||||||||||||
| Denmark, Odense
a) 21 infants with IgE-CMA b) 18 infants with non-IgE-CMA |
(specific serum IgE in CRIE after milk challenge) |
Host et al. 1992 | ||||||||||||||||||||||||||||||
| Finland, Turku
challenge proven patients with CMA (age of <17 years) (n=11 in SPT, n=12 in RAST) |
|
Vanto et al. 1987 | ||||||||||||||||||||||||||||||
| France, Lille, Gif sur Yvette
92 patients with CMA |
Association of sensitivities (1): CAS in 87% of alpha-LA sensitive patients beta-LG in 78% of alpha-LA sensitive patients BSA sensitivity seemed independent Lactoferrin negative correlation to CAS |
(1) Wal et al. 1995a
(2) Lefranc-Millot et al. 1996 (3) Bernard et al. 1998 |
||||||||||||||||||||||||||||||
| Germany, Kiel
13 children with strongly suspected CMA (age of 8 months to 8 years) |
|
Kaiser et al. 1990 | ||||||||||||||||||||||||||||||
| Italy, Milan
6 children with CMA |
|
Restani et al. 1999 | ||||||||||||||||||||||||||||||
| Switzerland, Zurich
(1) 34 adults with CMA (2) 8 adults with CMA |
|
(1) Stoger &
Wüthrich 1993
(2) Wüthrich & Johansson 1995 |
||||||||||||||||||||||||||||||
| Taiwan, Taipei
30 children with suspected CMA (1 to 9 years of age) |
multiple sensitization to alpha-LA and beta-LG in 13% CAS and alpha-LA in 27% CAS, alpha-LA and beta-LG in 37% |
Lin et al 1998 | ||||||||||||||||||||||||||||||
| USA, Baltimore, MD
22 cow's milk- sensitive patients |
bovine Immunoglobulins in 73% (RAST) | Bernhisel-Broadbent et al. 1991 | ||||||||||||||||||||||||||||||
| USA, Galveston, TX
45 children with CMA (96% < 6 months of age) |
|
(1) Goldman
et al. 1963a
(2) Goldman et al. 1963b |
||||||||||||||||||||||||||||||
| USA, Rochester, NY
(1) 29 children with CMA (age of onset 1 day to 10 months) (2) 21 children with CMA |
|
(1) Schwartz
et al. 1987
(2) Amonette et al. 1993 |
7.2 alpha-Lactalbumin
7.3 beta-Lactoglobulin
7.4 Bovine Serum Albumin
7.5 Caseins
| Extract / Purified Allergens | Methods | References |
| CAS and whey proteins | Review of purification and analytical methods by chromatography and electrophoresis methods | Strange et al. 1993 |
| alpha CAS | Purification of commercial CAS by IEC (DEAE Sepharose) | Spuergin et
al. 1996
Spuergin et al. 1997 |
| alpha S1-, alpha S2-, beta-, and kappa- CAS | Isoelectric precipitation of whole CAS from skimmed raw milk at pH 4.6; isolation of CAS fractions by successive, selective precipitations, followed by dissolving, dialysis and freeze drying steps; further purification by IEC (purity assessed by RP-HPLC) | Bernard et al. 1998 |
| glycosylated and non-glycosylated alpha-LA fractions | Isolation from whey protein fraction by IEC (DEAE Sepharose) followed by SEC (Sephadex G-75) | Slangen & Visser 1999 |
| beta-LG | Preparation from milk (1); purification by affinity chromatography (antibovine IgG column) followed by IEC (Q Sepharose), purity assessed by RP-HPLC and SDS-PAGE (2) | (1) Wal et al. 1995b
(2) Selo et al. 1999 |
| bovine IgG | Acid precipitation of colostral whey and concentration of supernatant, isolation of IgG by affinity chromatography (Avid Gel AL) and further purification by IEC, dialysis, lyophylization | Lefranc-Millot et al. 1996 |
| Cross-Reacting Allergens | Subjects / Methods | References |
| Cow's Milk Allergens
cow's dander allergens |
6 patients with cow's milk and 5 with cow's dander allergy:
4/6 patients with CMA showed serum IgE binding to dander allergens of 20, 22, 36, 50 and >200 kDa, dander cross- reactive cow's milk allergens were CAS (2 cases) and beta-LG (1 case); 1/5 cow's dander allergic patients showed serum IgE binding to milk allergens of 69, 92 and >200 kDa (immunoblot inhibition) |
Szepfalusi et al. 1993 |
| Cow's Milk
goat's, sheep, and modified cow's milk formulas |
16 children with CMA: high inhibition of IgE- binding to cow's milk by goats', sheep, modified cows' milk formula and CAS formula (RAST inhibition) | Dean et al. 1993 |
| Cow's Milk
goat's milk |
9 milk allergic patients: IgE- binding to cow's and goat's milk proteins corresponding in Mr to beta-LG and CAS (immunoblot) | Sabbah et al. 1996 |
| Cow's Milk
beef* |
8/11 beef allergic children presented concomitant reactivity to cow's milk (DBPCFC)* | Werfel et al. 1997a |
| Cow's Milk
goat's milk |
26 children with CMA (DBPCFC positive);
Sensitivity to goat's milk in 92% (DBPCFC); cow's milk completely extinguished IgE- binding to goat's milk allergens, goat's milk partially inhibited IgE- binding to cow's milk allergens (SDS-PAGE inhibition) |
Bellioni-Businco et al. 1999 |
| Cow's Milk
ewe, goat, buffalo milk |
6 children with CMA:
IgE- binding to milk allergens from cow, ewe, goat, and buffalo, but not from camel (SDS-PAGE immunoblot, inhibition) |
Restani et al. 1999 |
| alpha-LA
lysozyme (hen's egg white) |
6/9 egg allergic patients: 12-49% Inhibition of IgE- binding to lysozyme by alpha-LA (RAST inhibition) | Walsh et al. 1987 |
| Caseins
goat's, sheep's, and cow's milk |
Inhibition of IgE- binding to goat's and sheep's CAS by cow's milk CAS in 1 adult (RAST inhibition) | Wüthrich & Johansson 1995 |
| alpha Caseins
goat's, sheep's, and cow's milk |
17 children with CMA (immediate type): Inhibition of IgE binding to bovine alpha-CAS by alpha-CAS from cow, goat, and sheep (RAST inhibition), lower specific IgE levels to goat- and sheep alpha-CAS (RAST) | Spuergin et al. 1997 |
| Unique Allergens | Subjects / Methods | References |
| Caseins
goat's and sheep's vs cow's milk CAS |
No inhibition of IgE- binding to goat's and sheep's CAS by cow's milk CAS in 1 adult (RAST inhibition) | Wüthrich & Johansson 1995 |
| Caseins
goat's and sheep's vs cow's milk CAS |
1 cow's milk tolerant child with goat's and sheep's milk allergy: Decreased inhibition of IgE- binding to goat's milk and CAS by cow's milk and CAS, but not by goat's and sheep's milk and CAS (RAST inhibition); IgE binding to allergens in goat's milk at 22, 27, and 31 kDa, in sheep's milk at 31 kDa and cow's milk at 34 kDa (SDS-PAGE immunoblot) | Umpierrez et al. 1999 |
| Mare's Milk / Cow's Milk
16 and 18 kDa allergens (most likely representing alpha-LA and beta-LG) from mare's milk did not cross-react with corresponding cow's milk allergens |
1 mare's milk allergic adult (cow's milk tolerant)
(SPT, intracutaneous test, RAST, SDS-PAGE immunoblot) |
Gall et al. 1996 |
10 Stability of Cow's Milk Allergens
| Treatment | Effects | References | ||||||||||||||||||||
| Heat
boiling of skimmed milk, 10 min |
Reduction of IgE binding to alpha-LA about 50%, to CAS fractions >66% and to beta-LG, BSA and bovine Ig binding abolished (CRIE score) | Gjesing et al. 1986 | ||||||||||||||||||||
| Pasteurization, Homogenization, Hydrolysis
1) raw untreated, 2) pasteurized or, 3) homogenized and pasteurized cow's milk, and 4) a commercial hypoallergenic hydrolysed CAS infant formula |
Similar positive reactions in SPT and DBPCFC to 1), 2) and 3), no reactions to 4) in 5 cow's milk allergic children (immediate- type); tendency of lower thresholds of processed milk | Host & Samuelsson 1988 | ||||||||||||||||||||
| Heat
boiling of milk, 2 and 10 min |
Boiling of milk for 10 but not for 2 min eliminated SPT reactivity to BSA and beta-LG, whereas CAS was heat stabile (8 DBPCFC positive adults with CMA) | Norgaard et al. 1996 | ||||||||||||||||||||
| Heat
boiling of milk, 5 min |
No difference in IgE- binding to raw and cooked milk from sera of 2 patients with CMA (immuno-dot-blotting) | Werfel et al. 1997a | ||||||||||||||||||||
| Heat, Reduction, Hydrolysis
a) heat 96°C, pH 8.0 b) carboxymethylation c) limited proteolysis |
Thermoaggregated (a) and reduced forms (b) exhibited
similar
anaphylactic effect on sensitized guinea pigs; allergenic properties of beta-LG appeared unaltered in food hydrolyzates after thermal treatment and limited proteolysis |
Gmoshinskii et al. 1990 | ||||||||||||||||||||
| Pepsin Hydrolysis, Pancreatic Enzymes,
Whey Proteins
hydrolysis with pepsin (pH 2, 3, and 4, for 90 min) followed by hydrolysis with a mixture of pancreatic enzymes (pH 7.5 for 150 min) of beta-LG, alpha-LA, BSA, and bovine IgG |
Percent inhibition of IgE-binding from sera of patients
with IgE- mediated CMA to native proteins by respective hydrolysates of
homologue protein:
* beta-LG is barely hydrolysed by pepsin, but susceptible to pancreatic enzymes |
Schmidt et al. 1995 | ||||||||||||||||||||
| Duodenal Digestion
in vitro digestion of cow's milk proteins by duodenal fluid (1) and human trypsins and elastases (2) |
Rate of hydrolysis:
purified proteins > crude cow's milk or formula; rates of alpha-LA, beta-LG, and CAS digestion were 0.03, 0.12, and 16.1 mg/mL duodenal juice/min (same capacity to hydrolyze the milk proteins in infants with CMPI, celiac disease, or unclassified gastrointestinal disorder) |
(1) Jakobsson
et al. 1982
(2) Jakobsson et al. 1983 |
||||||||||||||||||||
| Intestinal Digestion
intestinal digestion of beta-LG, alpha-LA and CAS (intestinal cells, 48h) |
Lower TNF-alpha production by stimulation of PBMC from cow's milk allergic patients with intestinal digested cow's milk proteins as compared to intact proteins | Benlounes et al. 1996 | ||||||||||||||||||||
| Cell-Envelop Proteinase
specific hydrolysis of CAS and ultrafiltration |
Elimination of IgE-binding epitopes by degradation of CAS and removal of whey proteins by ultrafiltration | Alting et al. 1998 | ||||||||||||||||||||
| Pepsin Hydrolysis, beta-LG
pepsin hydrolysis of beta-LG |
222 cow's milk intolerant / allergic patients:
Higher degree of IgG binding to native beta-LG than to pepsin digested LG as compared to controls; almost complete discrimination between patient groups by cross- reactive experiments (ELISA) |
Duchateau et al. 1998 | ||||||||||||||||||||
| Lactic Acid Fermentation
lactic acid fermentation of sterilized cow's milk with a mixed culture of meso- and thermophilic bacteria strains |
About 99% reduced antigenicity of whey proteins as compared to raw milk (rabbit pAb, ELISA); allergenicity of alpha-LA and beta-LG only slightly attenuated (Skin Tests) | Jedrychowski & Wroblewska 1999 |
| Reported Adverse Reactions | References |
| Human Milk
Cow's milk taken by the mother precipitated allergic symptoms in 61 breast fed infants (elimination/challenge in mother's diet) (1) |
(1) Gerrard & Shenassa 1983a, 1983b |
| "Non-dairy" Foods
Allergic reactions in 6 patients with CMA after ingestion of "non-dairy" products: tofu frozen dessert (2 cases), beef hot dog (2 cases), bologna (2 cases), rice frozen dessert, tuna packed in aqueous solution; contents of milk proteins due to contamination by manufacturing facilities (37-2202 µg/mL) or to unlabeled adding of caseinate (136 µg/mL) (1) |
(1) Gern et al. 1991 |
| Cake, Cookie, Pastry
Near-fatal anaphylactic reactions in 2 children with CMA (age of 9 and 12 years) after ingestion of a cookie, a cake or pastry containing the allergen (1) |
(1) Sampson et al. 1992 |
| Chocolate, Candy
Occupational asthma and rhinoconjunctivitis in a chocolate candy worker (positive conjunctival and bronchial challenge tests with lactalbumin) (1) |
(1) Bernaola et al. 1994 |
| Several Food Products
9 Adverse reactions to unexpected cow's milk allergens in a) Meatballs containing 1.1% CAS (undeclared) b) Hot dog containing 0.04% CAS (contaminated) c) Recombined ham containing 2.6% (undeclared) d) Sausage containing 1.0% CAS (undeclared) e) Sausage containing 0.06% CAS (contaminated) f) Dark chocolate containing 0.8% CAS (contaminated) g) Ice cream (soy based) containing 0.2% CAS (contaminated) h) Lollipop, strawberry / cream containing 0.2% CAS (undeclared) i) Meringue containing 1.1% CAS (undeclared) |
Malmheden Yman et al. 1994 |
| Sorbets
Frozen desserts manufactured using the same equipment used for producing ice cream may contain milk allergens: Anaphylaxis in a 2-year-old boy after ingestion of a "pareve"- labeled raspberry sorbet (kosher labeling to select dairy-free foods) (1) Anaphylaxis in a 3-year-old boy within 20 min after ingestion of a lemon sorbet (ca. 113 to 170 g) containing trace amounts of milk allergens (whey proteins: 9 µg/mL) (2) |
(1) Jones et al.
1992
(2) Laoprasert et al. 1998 |
| Sausage
Severe reactions after ingestion of sausage containing CAS (texturing agent) (1) |
(1) Foucard et al. 1997 |
| Cheese
Anaphylaxis after ingestion of cheese in a 23-year old woman (1) |
(1) Wüthrich & Hofer 1986 |
| Goat's and Sheep's Cheese
Several allergic reactions after ingestion of feta (cheese made from sheep's milk) in a 15-year-old boy, after ingestion of sheep's or goat's cheese in a 25-year old patient, both tolerated ingestion of diary procucts from cow's milk (1) Allergic reactions after eating goat's cheese and after touching of goat's and sheep's cheese in a 2-year-old girl with tolerance to dairy products from cow's milk (2) |
(1) Wüthrich
& Johansson 1995
(2) Umpierrez et al. 1999 |
| Sheep's Cheese
Several anaphylactic reactions after ingestion of food containing "pecorino" cheese made from sheep's milk in a 5-year-old atopic boy unaffected by cow's milk protein allergy (1) |
(1) Calvani & Alessandri 1998 |
| Mozarella / Ricotta / Parmesan Cheese
Asthma, urticaria and rhinitis in a boy with atopic dermatitis after ingestion of mozarella cheese made from ewe's and cow's milk; several allergic reactions after ingestion of ricotta cheese containing ewe's milk and parmesan cheese made from cow's milk, respectively (1) |
(1) Fiocchi et al. 1999 |
| Baby Food
A baby food, cereal flour P, containing alpha- lactalbumin (although labeled guaranteed free of cow's milk), caused failure to thrive and diarrhea, vomiting, and coughing fits in a 22- month- old child with cow's milk allergy (1) |
(1) Fremont et al. 1996 |
| Human Milk
16/17 of cow's milk allergic children showed allergic symptoms during cow's milk challenge through human milk from asymptomatic mothers (age of children 1.8 to 9.4 months) |
(1) Jarvinen et al. 1999b |
| Infant Formulas | see 12.2 Allergenicity / Safety of Infant Formulas |
| Pharmaceuticals
Anaphylaxis in a 12 months-old boy after cutaneous application of a CAS containing ointment to an inflamed diaper area (1) Severe anaphylactic reaction in a 33-year-old woman during artificial insemination due to sperm- processing medium containing BSA (SPT, RAST) (2) Generalized anaphylactic reaction a few hours after tooth extraction in a 54-year-old woman, hemofibrine (a hemostatic sponge made of bovine fibrin) elicited symptoms (Scratch test, RAST) (3) |
(1) Jarmoc &
Primack 1987
(2) Wüthrich et al. 1995 (3) Wüthrich et al. 1996 |
| "Neutralizing" of Food Allergies
68-year-old woman with systemic mastocytosis was given "neutralizing" injections of milk and wheat and experienced flushing, palpitations, and lightheadedness with syncope (unproven technique of provocation/neutralization) (1) |
(1) Teuber & Vogt 1999 |
| Allergens in Products | Content / Products | References |
| Human Milk
38 mothers |
Detectable amounts of immunoactive beta-LG (5-33 ng/mL) in 18/38 human milk samples | Jakobsson et al. 1985 |
| Human Milk
25 mothers |
Detectable amounts of beta-LG (5-800 ng/mL) in 40%of
human milk samples, presence of symptoms in the infant such as diarrhoea,
vomiting, colic,
exanthema significantly correlated to high levels of beta-LG in the milk |
Axelsson et al. 1986 |
| Human Milk
57 breastfeeding mothers |
Detectable amounts of bovine beta-LG (up to 6.4 ng/mL) in 45% of samples; persisted up to 3 days after maternal dietary elimination of cow's milk | Machtinger & Moss 1986 |
| Human Milk
9 breastfeeding mothers |
Detectable amounts of bovine beta-LG (0.5-45 ng/mL) in 30% of samples | Host et al.1988 |
| Human Milk
36 samples of human breast milk |
Detectable amounts of bovine IgG (mean 3.4 ng/ml) | Maeda et al. 1993 |
| Human Milk
55 breastfeeding mothers (cow's milk allergy in 46 infants, oral challenge) |
beta-LG in human milk before and after oral cow's milk load (given after 24 hour milk free diet): beta-LG levels >2 ng/mL in 75% of samples, increased levels in 50% after load | Sorva et al. 1994 |
| Fat Substitutes
13 (16) egg and/or cow's milk allergic patients |
Allergenicity of microparticulated egg and cow's milk proteins in fat substitues (Simplesse, Beta IL): No alteration of allergenic potencies in SDS-PAGE immunoblot | (1) Sampson
& Cooke 1990
(2) Sampson & Cooke 1992 |
| Flavourings / Seasonings
dill-pickle seasoning (containing lactose) |
Positive skin test reaction to lactose containing seasoning (1 patient with CMA); CAS and whey proteins identified in this seasoning, and whey proteins in pharmaceutical grade lactose | Watson et al. 1995 |
| Lactose
"food-quality" lactose |
alpha-LA content in "food quality" lactose 1-5 µg/g (RAST inhibition) | Fremont et al. 1996 |
| Natural Rubber Latex Gloves
cow's milk CAS |
15/30 commonly marketed natural rubber latex glove brands contained cow's milk CAS (rocket immunoelectrophoresis, ELISA inhibition) | Ylitalo et al. 1999 |
| Allergen Depleted Products | Method | References |
| Cow's Milk
depletion of beta-LG |
Specific affinity matrix: beta-LG coupled to Sepharose 4B used to remove beta-LG from milk, significant retardation in its elution because reversible polymerization with soluble beta-LG; beta-LG depleted milk proposed as hyposensitizing milk formula to be used by lactating mothers | Chiancone & Gattoni 1993 |
12 Infant Formulas
13 References