Comparison of Oral Desensitization with Heated Cow's Milk Products with Conventional Desensitization Method in Children with Cow's Milk Allergy

Masoud  Movahedi; Emad  Bahraminia; Aliakbar  Amirzargar

doi:10.18502/ijaai.v24i6.20152

Masoud Movahedi Division of Allergy and Clinical Immunology, Pediatrics Center of Excellence, Children’s Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran
Emad Bahraminia Division of Allergy and Clinical Immunology, Pediatrics Center of Excellence, Children’s Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran
Aliakbar Amirzargar Department of Immunology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/ijaai.v24i6.20152

Keywords: Allergy; Cow's milk allergy; Food allergy; Oral desensitization; Regulatory T cell

Abstract

Cow’s milk allergy (CMA) is one of the most prevalent Immunoglobulin E (IgE)-dependent food allergies in children. Currently, the only accepted treatment for food allergy is avoiding the relevant allergen. The purpose of this study is to investigate the immunological changes following the consumption of heated cow's milk products compared to the usual method of oral desensitization in children aged over two years old with cow's milk allergy.

In a prospective double-blind clinical trial study, 25 children aged two years and older
with a definite diagnosis of IgE-dependent cow's milk allergy referred to the allergy clinic of the Children's Medical Center from 2016 to 2017 were enrolled. The eligible patients were randomly divided into two groups: the first group was desensitized with raw milk (normal desensitization: n=13), and the second group was desensitized with heated cow's milk products (intervention group, n=12).

The mean ages in the raw milk group and heated milk group were 3.92±1.44 and 4.50±1.73 years, respectively. The rate of anaphylaxis in the heated milk group was higher than in the raw milk group (50% vs. 15.4%), although the incidence of urticaria and angioedema was not significantly different between the two groups. The mean concentration of serum IgE in the two groups decreased after desensitization compared to before, although there was no significant difference between the two groups. The increase in the number of CD4+Foxp3+ and CD4+ CD25+ cells was less in the heated milk group than the raw milk group, but this difference was not statistically significant. Additionally, the number of eosinophil cells was higher in the heated milk group than in the raw milk group, but this difference was not statistically significant difference.

We concluded that the changes in the level of eosinophil, IgE, and regulatory T cells in the conventional desensitization group were not significantly different compared to desensitization with heated milk. Further multicenter studies with a higher sample size are recommended to confirm these results.