Predicting resolution of cow's milk allergy

Researchers at Mount Sinai School of Medicine, New York and Finland's University of Helsinki have collaborated on an investigation into why many children outgrow cow's milk allergy by school age, while others do not. The results of the study, which was funded by the Food Allergy Initiative, were published recently in the Journal of Allergy and Clinical Immunology.

Over several years, a research team led by Hugh Sampson tracked 23 patients who were diagnosed with cow's milk allergy as infants. Eleven still had the condition at age eight to nine, while 12 had outgrown their allergy by the time they were three years old. Using serum samples from these patients, the researchers examined the pattern of binding between five major cow's milk proteins and three antibodies, IgE, IgA, and IgG4.

Results showed that IgE epitope–binding patterns were stable over time in patients with persisting cow's milk allergy, whereas binding decreased in patients whose allergy resolved at a young age.

In those children whose allergy resolved early, IgG4 binding was found to gradually increase as IgE binding decreased.

Based on these results, the researchers believe it may be possible to predict whether or not a child is likely to outgrow cow's milk allergy early by profiling antibody binding to cow's milk protein epitopes. The findings could also lead to the development of new immunotherapies for cow's milk allergy.

Reference: Savilahti et al. Journal of Allergy and Clinical Immunology Vol 125(6) pp. 1315-1321.e9