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A hydrolysed rice-based formula is tolerated by children with cow's milk allergy: a multi-centre study.

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.

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  • Authors+Show Affiliations

    ,

    Melloni Paediatria, Milan, Italy. allerg@tin.it

    , , , , , , , , ,

    Source

    MeSH

    Adolescent
    Animals
    Caseins
    Child
    Child, Preschool
    Double-Blind Method
    Electrophoresis, Polyacrylamide Gel
    Female
    Food, Formulated
    Humans
    Hydrolysis
    Immune Tolerance
    Immunoglobulin E
    Infant
    Infant Formula
    Male
    Milk
    Milk Hypersensitivity
    Milk Substitutes
    Oryza
    Prospective Studies
    Skin Tests

    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 -