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A hydrolysed rice-based formula is tolerated by children with cow's milk allergy: a multi-centre study.
Clin Exp Allergy 2006; 36(3):311-6CE

Abstract

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, alpha-lactalbumin (ALA), beta-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 alpha-casein (n=54), beta-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.

Authors+Show Affiliations

Melloni Paediatria, Milan, Italy. allerg@tin.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Studies
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16499641

Citation

Fiocchi, A, et al. "A Hydrolysed Rice-based Formula Is Tolerated By Children With Cow's Milk Allergy: a Multi-centre Study." Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, vol. 36, no. 3, 2006, pp. 311-6.
Fiocchi A, Restani P, Bernardini R, et al. A hydrolysed rice-based formula is tolerated by children with cow's milk allergy: a multi-centre study. Clin Exp Allergy. 2006;36(3):311-6.
Fiocchi, A., Restani, P., Bernardini, R., Lucarelli, S., Lombardi, G., Magazzù, G., ... Ranzini, C. (2006). A hydrolysed rice-based formula is tolerated by children with cow's milk allergy: a multi-centre study. Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, 36(3), pp. 311-6.
Fiocchi A, et al. A Hydrolysed Rice-based Formula Is Tolerated By Children With Cow's Milk Allergy: a Multi-centre Study. Clin Exp Allergy. 2006;36(3):311-6. PubMed PMID: 16499641.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A hydrolysed rice-based formula is tolerated by children with cow's milk allergy: a multi-centre study. AU - Fiocchi,A, AU - Restani,P, AU - Bernardini,R, AU - Lucarelli,S, AU - Lombardi,G, AU - Magazzù,G, AU - Marseglia,G L, AU - Pittschieler,K, AU - Tripodi,S, AU - Troncone,R, AU - Ranzini,C, PY - 2006/2/28/pubmed PY - 2006/8/22/medline PY - 2006/2/28/entrez SP - 311 EP - 6 JF - Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology JO - Clin. Exp. Allergy VL - 36 IS - 3 N2 - 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, alpha-lactalbumin (ALA), beta-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 alpha-casein (n=54), beta-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. SN - 0954-7894 UR - https://www.unboundmedicine.com/medline/citation/16499641/A_hydrolysed_rice_based_formula_is_tolerated_by_children_with_cow's_milk_allergy:_a_multi_centre_study_ L2 - https://doi.org/10.1111/j.1365-2222.2006.02428.x DB - PRIME DP - Unbound Medicine ER -