Amirhossein Hosseini - Assistant Prof. of Gastroenterology (Peds.)

Allergy risk has become a significant public health issue with increasing prevalence. Exclusive breastfeeding is recommended for the first six months of life, but this recommendation is poorly adhered to in many parts of the world; putting infants at risk of developing allergic sensitization and disorders. Cow’s milk is one of the most important and basic nutrients introduced early in life in our diet but can induce IgE-associated allergy. IgE-associated allergy to cow’s milk can cause severe allergic manifestations in the gut, skin and even in the respiratory tract and may lead to lifethreatening anaphylactic shock due to the stability of certain cow’s milk allergens. Two types of preventions are available for cow’ milk protein allergy. Primary prevention strategies aim preventing the IgE sensitization to cow’s milk allergens very early in life and secondary prevention intends to stop the transition from clinically silent IgE sensitization to symptoms of allergy and/ or the progression of mild to severe symptoms. Several factors, like allergen-specific IgE levels, the number of recognized allergens from an allergen source and cross-reactive allergens detected early in lifeseem to be predictive for the onset of allergic symptoms. Most importantly, children from mothers with specific plasma IgG levels > 30 ISU against an allergen did not develop IgE sensitization against that allergen at 5 years of age, suggesting a highly protective effect of maternal IgG on allergic sensitization. Accordingly, primary prevention of sensitization to cow’s milk allergens in children might be initiated either by milk consumption of the mother to keep allergen-specific IgG levels high or by vaccinating the mother with hypoallergenic derivatives of cow’s milk allergens.

cow’s milk allergy; cow’s milk allergens; prevention of cow’s milk allergy