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Certain infants and children have relatively high risk of the onset of anaphylaxis when exposed to the foods containing cow milk protein. This pathogenic immunological process is mainly mediated by IgE. Currently, the chief methods eliminating the sensitization of milk protein include heat treatment, high pressure treatment, enzymatic hydrolysis, and glycosylation modification, etc. Based on different mechanisms, each technique has specific advantages, nevertheless, also accompanied with ineluctable shortcomings, such as reducing the nutritional value or generating odd flavors. As a type of secondary metabolites with wide botanical resources, polyphenols exhibit pleiotropic bioactivities involving anti-aging, antibiosis, anti-inflammation and antioxidation. It is well known that polyphenols have strong affinity to proteins via covalent or non-covalent binding, which is so-called 'polyphenol-protein interaction (PPI)'. Accumulating reports showed that phenolic compounds could reduce the immunoreactivity of diverse food allergens through PPI. This review summarizes and discusses the role of PPI on the desensitization of lactoproteins, and proposed some promising conceptions in the light of up-to-date researches, hoping to provide new ideas and theoretical foundations for the development of safe dairy products of low-sensitization.

Well-recognized tactic for the management of formula-fed children with cow’s milk protein allergy (CMPA) is exclusion of whole cow milk protein and its replacement with extensively hydrolyzed or amino acid formula. One of the most topical issue is the choice of therapeutic formula for a child with CMPA. This article presents information about the clinical manifestations of CMPA and describes the principles of nutrition therapy. All the stages of preparation of adapted therapeutic formula are discussed in detail. It has been shown that the choice of therapeutic formula for a child with CMPA depends on the disease clinical manifestations, their severity, and the presence of comorbid conditions. Current requirements for extensively hydrolyzed formula are reduced to limitations in the size of peptides with immunoreactive properties and indicate the need for evidence of the clinical efficacy of such formula in double-blind placebo-controlled studies.

The article presents modern data on the epidemiology, etiology and clinical manifestations of food allergies in children. Evidence-based approaches to diagnosis, including differential, treatment, and prevention of food allergies in children are shown. Patient management tactics and algorithms are presented in detail. The guidelines are based on all available up-to-date data on food allergies. The material is based on the methodological guideline for the management of patients with food allergies previously developed by expert specialists of the Union of Pediatricians of Russia in 2021.

The continued increase in the number of allergic diseases and the high prevalence of digestive disturbances in infants explain the interest of pediatricians, allergists and gastroenterologists in the development and improvement of nutritional methods for the prevention and correction of these pathologies. This article discusses current ideas on the role of partially hydrolysed protein formulas in infants’ nutrition for recovery of most common functional gastrointestinal disorders, allergy primary prevention. Also, the article discusses formulas place in sequential nutrition therapy of food allergy. Descriptions of cow milk proteins molecular characteristics and its allergens properties are presented. Features of creation and production of partially hydrolysed protein formulas are described as well.

(1) Background: Preterm birth exposes the infant to the known risk factors for atopic diseases. We aimed to study the neonatal risk factors and to describe the clinical manifestations of atopy, including the march of symptoms, in a cohort of preschool children born preterm. (2) Methods: We enrolled neonates with gestational age < 32 weeks or birth weight < 1500 g. We classified patients in cases and controls according to the presence of at least one atopic manifestation. (3) Results: We observed 72 cases and 93 controls. Multivariate models showed that the administration of more than one cycle of antibiotics (B 0.902, p = 0.026) and gestational diabetes (B 1.207, p = 0.035) influence the risk of atopy in babies born preterm. In addition, risk of atopic dermatitis was influenced by gestational age < 29 weeks (B −1.710, p = 0.025) and gestational diabetes (B 1.275, p = 0.027). The risk of wheeze was associated with familiarity for asthma (B 1.392, p = 0.022) and the administration of more than one cycle of antibiotics (B 0.969, p = 0.025). We observed a significant reduction in the rate of atopic manifestation after 2 years of life (33.9% vs. 23.8%, p < 0.05). (4) Conclusions: Modifiable (gestational diabetes, antibiotics use) and unmodifiable (familiarity for asthma) conditions influence the risk of atopy in babies born preterm. Extreme prematurity reduces the risk of atopic dermatitis. Preterm babies showed a peculiar atopic march. [ABSTRACT FROM AUTHOR]

Given that the prevalence of pediatric IgE-mediated food allergies (FA) has followed a substantive increase in recent decades, nowadays, a research challenge is to establish whether the weaning strategy can have a role in FA prevention. In recent decades, several studies have demonstrated that delayed exposure to allergenic foods did not reduce the risk of FA, leading to the publication of recent guidelines which recommend against delaying the introduction of solid foods after 4–6 months of age, both in high- and low-risk infants, in order to prevent food allergy. In the present review, focusing on cow’s milk protein, hen’s eggs, peanuts, soy, wheat and fish, we describe the current scientific evidence on the relationship between timing of these foods’ introduction in infants’ diet and allergy development. [ABSTRACT FROM AUTHOR]

Five mixtures of milk and pea protein (0–40 g pea protein/100 g total protein) were fermented by ten starter cultures of lactic acid bacteria (LAB) 2 to select the cocktails that can lead to products similar to a conventional yoghurt. Generally speaking, an increase in pea concentration leads to products with higher acidity, higher syneresis and lower firmness. From the sensory perspective, up to 30 g pea protein/100 g total protein, starter cultures show either positive or negative effects. A principal component analysis (PCA) 3 and a hierarchical cluster analysis (HCA) 4 carried out on all variables revealed five groups of products. Two groups of products of 0 g or 10 g pea protein/100 g total protein seemed to be the most similar to conventional dairy products. The third group included products fermented with two starters with negative characteristics such as astringency and bitterness. The last two groups included members made of 10 g, 20 g, 30 g and 40 g pea protein/100 g total protein, among them one group showing a positive sensory profile. From this group, four starter cultures seem promising for the fermentation of milk and pea protein mixtures. [ABSTRACT FROM AUTHOR]

Introduction. The disorder of cow milk protein intolerance is characterized by a wide spectrum of clinical manifestations caused by hypersensitivity of type I, II, or IV, and occurs in 2-3% of children, mostly infants. Objective. The aim of this study was to present our experiences and observations of clinical signs and symptoms of cow milk protein intolerance in infants aged below 12 months. Method. The investigation was carried out on a sample of 55 infants, aged between 1.5-9 months (x=4.2l±1.25), who had cow milk protein intolerance. Diagnosis of illness was based on characteristic anamnestic, clinical, and laboratory parameters, as well as on an adequate patient's response to antigen elimination. Results. The clinical presentation of cow milk protein intolerance was dominated by cutaneous problems, found in 40/55 (72.73%) infants, followed by digestive disorders, found in 31 (56.36%), while respiratory tract disorders were observed least frequently (14.55%). None of the patients developed anaphylactic shock. Changes involving only one system were found in 35 (63.64%) patients; of these 20 (36.36%) were cutaneous and 15 (27.27%) digestive. Twenty (36.36%) infants displayed multisystemic changes; of these 12 were cutaneus with digestive, 4 were cutaneus with respiratory, while 4 infants had cutaneous, digestive, and respiratory disorders. Of the 55 infants with cow milk protein intolerance, 26 (47.27%) had urticaria, 22 (40.00%) perioral erythema, 21 (38.18%) diarrhoea (15 haemorrhagic, 6 non-haemorrhagic), 13 (23.64%) vomiting, 12 (21.82%) Quincke's oedema, 12 (21.82%) eczema, 5 (9.09%) obstructive bronchitis, while 3 (5.45%) infants had laryngitis. In 5 (9.09%) patients we found a significant body weight deficit and in 3 (5.45%), sideropenic anaemia, while longitudinal growth retardation was not registered in any of the patients. Conclusion. Our study showed that the disorder of cow milk protein intolerance predominantly involved cutaneous disorders as well as combinations of cutaneous and digestive disorders, while respiratory system disorders proved to be relatively rare.

Abstract: The most frequent symptoms among the manifestations of cow milk allergy (CMA) are gastrointestinal. CMA pathogenesis involves immunological mechanisms with participation of immunocompetent cells, production of immunoglobulin E (IgE) and immunoglobulin G (IgG). We aim to determine whether cow milk-specific IgE antibodies coexist with cow milk-specific IgG antibodies in CMA patients with diarrhea symptom, and if there is any relationship between both antibody types. 65 CMA patients (average age of 17years, ranging from 2 to 74years), all of who had diarrhea symptom of CMA, were enrolled in this study. The total cow IgE and IgG subclass in serum were measured by electrochemiluminescence immunoassay and rate immune scatter turbidimetry, respectively. And also the cow milk-specific IgE was determined by enzyme-linked immunosorbent assay. The number of eosinophils in serum was calculated by Sysmex XE-2100 Hematology Analyzer. Our data showed that both cow milk-specific IgG and IgE levels were significantly elevated in CMA patients compared to those of age-matched control subjects. Out of the 65 CMA patients, 40 showed elevated cow milk-specific IgE antibody level, among which, 28 cases presented highly sensitive reaction to cow milk-specific IgG, along with each six of moderate and mild sensitive reaction to cow milk-specific IgG; while 20 showed elevated total IgG levels. The IgG3 positive rate was 16.9%, which was the highest. A moderate correlation between cow milk-specific IgE and cow milk-specific IgG was found in the CMA patients (r =0.415, P =0.001). The results indicated that cow milk-specific IgE antibodies could coexist with cow milk-specific IgG antibodies in patients suffering from CMA. The aberrant changes in the concentration of cow milk-specific IgE antibodies were associated with cow milk-specific IgG antibodies. [Copyright &y& Elsevier]

The prevalence of allergy to proteins of the cow milk, at world-wide level is approximately 2% to 5%; in Mexico this number is not known. In a high percentage of the cases the suspicion from the part of the health personnel does not exist, and therefore the diagnosis and the treatment are delayed. The diagnosis, in most of the cases, is clinical; nevertheless, a great amount of tests, invasive and noninvasive with variable sensitivity and specificity, exist to diagnose it. The test of suppression of the allergen and favorable clinical answer is the better accepted diagnostic method. The objective of this publication is to present a known pathology (that is more frequent than it is often believed) and its clinical features, as well as the different diagnostic methods and its treatment. [ABSTRACT FROM AUTHOR]

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