Berni Canani R

Carucci L.

Coppola S.

Cosenza L.

Lettieri M.

Nocerino R.

Paparo L.

Voto L.

English

Archivio della ricerca - Università degli studi di Napoli Federico II

The evaluation of tolerance rate and the immune tolerance acquisition in children with cow’s milk allergy switching from amino acid-based formula to extensively hydrolyzed casein formula: the SDACMA project  R. Nocerino1, L. Cosenza1, M. Lettieri1, L. Carucci1, S. Coppola1, L. Voto1, L. Paparo1, V. Giglio1, R. Berni Canani1  1University of Naples Federico II, Department of Translational Medical Science, Naples, Italy  Objectives and Study: The Step down approach for cow’s milk allergy (SDACMA) project was designed to evaluate the tolerance rate and the effect of immune tolerance acquisition in CMA children who started dietary treatment with amino acid-based formula (AAF) and switched to extensively hydrolyzed casein formula with the probiotic L.rhamnosus GG (EHCF+LGG).  Methods: Double blind randomized trial involving children with IgE-mediated CMA receiving AAF from at least 4 weeks with full and stable symptoms remission. The EHCF+LGG tolerance was evaluated by the results of double blind placebo controlled food challenge (DBPCFC). Then, subjects who tolerated EHCF+LGG were randomly allocated to two groups of 12-m dietary intervention: group 1, continuing AAF, and group 2 receiving EHCF+LGG. Immune tolerance acquisition was evaluated after 12 months of dietary treatment by the result of DBPCFC.  Results: 60 IgE-mediated CMA children were enrolled [55% male, mean age (±SD) at CMA diagnosis 4 (±1.3) months]. 59 out of 60 patients were able to tolerate EHCF+LGG. These patients were randomly allocated into the two groups of dietary intervention. At the enrollment demographic and anamnestic features were similar into the two groups [Group 1: 53.3% male, mean age (±SD) at CMA diagnosis 3.9 (±1.3) months; symptoms at CMA diagnosis: 66.7% gastrointestinal, 80% cutaneous, 13.3% respiratory. Group 2: 58.6 % male, mean age (±SD) at CMA diagnosis 4.2 (±1.2) months; symptoms at CMA diagnosis: 75.9% gastrointestinal, 65.5% cutaneous, 10.3% respiratory]. After 12-m of dietary treatment, the rate of immune tolerance acquisition was higher in the EHCF+LGG group if compared to the AAF group (48.3% vs 3.3%, p<0.001).  Conclusions: The results of the SDACMA project suggest that EHCF+LGG could be tolerated by the vast majority of the IgE-mediated CMA children and that, when possible, the step down from AAF to EHCF+LGG could result in a higher rate of immune tolerance acquisition after 12-m of dietary treatment.  Disclosure of interests This work was supported in part by an unrestricted grant from Mead Johnson Nutritionals, Evansville, IN, US.  Contact e-mail adress: berni@unina.it  

The evaluation of tolerance rate and the immune tolerance acquisition in children with cow's milk allergy switching from amino acid-based formula to extensively hydrolyzed casein formula: the SDACMA project.

https://www.iris.unina.it/bitstream/11588/893850/1/The%20evaluation%20of%20tolerance%20rate%20and%20the%20immune%20tolerance%20acquisition%20in%20children%20with%20cow.pdf

The evaluation of tolerance rate and the immune tolerance acquisition in children with cow's milk allergy switching from amino acid-based formula to extensively hydrolyzed casein formula: the SDACMA project.

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Archivio della ricerca - Università degli studi di Napoli Federico II