Tolerance Induction in Cow’s Milk Allergic Children by Heated Cow’s Milk Protein: The iAGE Follow-Up Study

Author:

van Boven Frank E.1,Arends Nicolette J. T.2,Sprikkelman Aline B.34,Emons Joyce A. M.2,Hendriks Astrid I.2,van Splunter Marloes5,Schreurs Marco W. J.6,Terlouw Severina1ORCID,Gerth van Wijk Roy1,Wichers Harry J.7ORCID,Savelkoul Huub F. J.5ORCID,van Neerven R. J. Joost58ORCID,Hettinga Kasper A.9ORCID,de Jong Nicolette W.12ORCID

Affiliation:

1. Department of Internal Medicine, Section of Allergology & Clinical Immunology, Erasmus MC, University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands

2. Depertment of Peadiatric Allergology, Sophia Children Hospital, Erasmus MC, University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands

3. Department of Peadiatric Pulmonology & Allergology, University Medical Center Groningen, 9713 GZ Groningen, The Netherlands

4. University Medical Center Groningen, GRIAC Research Institute, University of Groningen, 9713 GZ Groningen, The Netherlands

5. Cell Biology & Immunology, Wageningen University & Research, 6708 PB Wageningen, The Netherlands

6. Department of Immunology, Erasmus MC, University Medical Centre Rotterdam, 3015 GD Rotterdam, The Netherlands

7. Food & Biobased Research, Wageningen University & Research, 6700 AA Wageningen, The Netherlands

8. FrieslandCampina, 3811 LP Amersfoort, The Netherlands

9. Dairy Science and Technology, Food Quality and Design Group, Wageningen University and Research, P.O. Box 17, 6700 AA Wageningen, The Netherlands

Abstract

Accelerating the induction of tolerance to cow’s milk (CM) reduces the burden of cow’s milk allergy (CMA). In this randomised controlled intervention study, we aimed to investigate the tolerance induction of a novel heated cow milk protein, the iAGE product, in 18 children with CMA (diagnosed by a paedriatric allergist). Children who tolerated the iAGE product were included. The treatment group (TG: n = 11; mean age 12.8 months, SD = 4.7) consumed the iAGE product daily with their own diet, and the control group (CG: n = 7; mean age 17.6 months, SD = 3.2) used an eHF without any milk consumption. In each group, 2 children had multiple food allergies. The follow-up procedures consisted of a double-blind placebo-controlled food challenge (DBPCFC) with CM t = 0, t = 1 (8 months), t = 2 (16 months), and t = 3 (24 months). At t = 1, eight (73%) of 11 children in the TG had a negative DBPCFC, versus four out of seven (57%) in the CG (BayesFactor = 0.61). At t = 3, nine of the 11 (82%) children in the TG and five of seven (71%) in the CG were tolerant (BayesFactor = 0.51). SIgE for CM reduced from a mean of 3.41 kU/L (SD = 5.63) in the TG to 1.24 kU/L (SD = 2.08) at the end of intervention, respectively a mean of 2.58 (SD = 3.32) in the CG to 0.63 kU/L (SD = 1.06). Product-related AEs were not reported. CM was successfully introduced in all children with negative DBPCFC. We found a standardised, well-defined heated CM protein powder that is safe for daily OIT treatment in a selected group of children with CMA. However, the benefits of inducing tolerance were not observed.

Funder

Netherlands Organisation for Scientific Research

Publisher

MDPI AG

Subject

Food Science,Nutrition and Dietetics

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