TY - JOUR
TI - Strategies and Future Opportunities for the Prevention, Diagnosis, and
Management of Cow Milk Allergy
AU - Zepeda-Ortega, Benjamin
AU - Goh, Anne
AU - Xepapadaki, Paraskevi and
AU - Sprikkelman, Aline
AU - Nicolaou, Nicolaos
AU - Hernandez, Rosa Elena
AU - Huerta
AU - Latiff, Amir Hamzah Abdul
AU - Yat, Miu Ting
AU - Diab, Mohamed
AU - and Al Hussaini, Bakr
AU - Setiabudiawan, Budi
AU - Kudla, Urszula
AU - van
AU - Neerven, R. J. Joost
AU - Muhardi, Leilani
AU - Warner, John O.
JO - Frontiers in Immunology
PY - 2021
VL - 12
TODO - null
SP - null
PB - Frontiers Media SA
SN - null
TODO - 10.3389/fimmu.2021.608372
TODO - partially hydrolysate; intermediate extensive hydrolysate; extensive
hydrolysate; prevention; management; cow milk allergy; hydrolysate
step-wise approach; early oral tolerance development milk ladder
TODO - The prevalence of food allergy has increased over the last 20-30 years,
including cow milk allergy (CMA) which is one of the most common causes
of infant food allergy. International allergy experts met in 2019 to
discuss broad topics in allergy prevention and management of CMA
including current challenges and future opportunities. The highlights of
the meeting combined with recently published developments are presented
here. Primary prevention of CMA should start from pre-pregnancy with a
focus on a healthy lifestyle and food diversity to ensure adequate
transfer of inhibitory IgG- allergen immune complexes across the
placenta especially in mothers with a history of allergic diseases and
planned c-section delivery. For non-breastfed infants, there is
controversy about the preventive role of partially hydrolyzed formulae
(pHF) despite some evidence of health economic benefits among those with
a family history of allergy. Clinical management of CMA consists of
secondary prevention with a focus on the development of early oral
tolerance. The use of extensive Hydrolysate Formulae (eHF) is the
nutrition of choice for the majority of non-breastfed infants with CMA;
potentially with pre-, probiotics and LCPUFA to support early oral
tolerance induction. Future opportunities are, among others, pre- and
probiotics supplementation for mothers and high-risk infants for the
primary prevention of CMA. A controlled prospective study implementing a
step-down milk formulae ladder with various degrees of hydrolysate is
proposed for food challenges and early development of oral tolerance.
This provides a more precise gradation of milk protein exposure than
those currently recommended.
ER -