Modern possibilities for assessing IgE-mediated sensitization and predicting the formation of desensitization to cow’s milk proteins

Introduction. Cow’s milk proteins (CMP) often cause severe anaphylactic reactions in IgE-mediated food allergies. To establish the atopic nature of symptoms, it is necessary to collect clinical and anamnestic data and conduct an allergological study. Determining spectrum and levels of IgE sensitization can provide information in predicting timing of desensitization and risks of repeated systemic reactions.

Aim. Еstablish molecular spectrum and level of IgE sensitization to milk proteins and their peptides on Milk Allergen MicroArray (MAMA) ImmunoCAP ISAC microchip in children suffering from allergy to CMP; to monitor indicators after a long-term elimination diet.

Materials and methods. Prospective cohort open study included children (n = 41, 31 boys and 10 girls): group 1 – with persistent CMP allergy, who had a history of anaphylaxis to CMP (n = 20); group 2 – children with CMP allergy (n = 21) without systemic reactions. Average age – 4.17 ± 2.14 years. Anamnesis collection, clinical examination and on MAMA panel examination were performed. Repeated measurement of sIgE in twelve people was carried out after 18 months of a dairy-free elimination diet.

Results. Spectrum and level of sIgE to CMP were determined on MAMA panel (n = 41): sIgE values in children with anaphylaxis were significantly higher (from 2.0 to 346.0 ISU-E) than in children without systemic reactions (from 0.3 to 11.4 ISU-E) (p = 0.000). High sensitization to at least one major protein was recorded in children with anaphylaxis. A repeat study identified patients with desensitization who can be administered milk proteins.

Conclusions. Milk Allergen Micro-Array (MAMA) ImmunoCAP ISAC multiplex panel can be useful in diagnosing and monitoring of spectrum and level of sensitization in IgE-dependent forms of CMP allergy from moment of diagnosis until formation of desensitization and signs of clinical tolerance.

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