Value Of Dairy Products And Milk Component SIgE In The Management Of Infant Milk Allergy

Objective: To explore the clinical value of different dairy products in diet management of infants with milk allergy and the clinical significance of milk component s Ig E in accurate diagnosis and treatment management of milk allergy.Methods:1.The subjects were divided into three groups: the first group(n = 288)with Ig E-mediated milk allergy,the milk s Ig E positive group(n = 60),the milk s Ig E negative group(n = 60)and the control group(n = 56).According to the clinical symptoms,the milk s Ig E positive group was divided into five groups: atopic dermatitis(AD)group,digestive tract allergy group,AD+ digestive tract allergy group,malnutrition group and urticaria group.2.Methods: the s Ig E levels of 8 kinds of dairy products and 4 kinds of milk components in serum of three groups(milk s Ig E positive group,milk s Ig E negative group and control group)were detected by protein chip method,and then the positive rates of s Ig E and s Ig E in children with different clinical symptoms were compared and analyzed.3.Statistical methods: nonparametric rank sum test,chi-square test and Fisher exact probability method were used for statistical analysis.Results:1.Analysis of clinical data of milk s Ig E positive group: according to clinical symptoms,milk s Ig E positive group was divided into AD group,digestive tract allergy group,AD+ digestive tract allergy group,malnutrition group and urticaria group.When comparing the clinical data of the five groups,it was found that there were significant differences in the distribution of age,course of disease,feeding mode,history of past allergies,symptoms and physical development during follow-up.2.The positive rate of s Ig E in different milk products and milk components of infants in milk s Ig E positive group: The positive rates of s Ig E in different dairy products were 1.4%(4/288)in boiled milk,2.1%(6/288)in mare’s milk,4.5%(13/288)in partially hydrolyzed milk powder,5.9%(17/288)in yoghurt,13.2%(38/288)in cheddar cheese,13.5%(39/288)in buttermilk,and 14/288 in buffalo milk 9%(43/288)and goat milk 25.4%(73/288);The positive rates of s Ig E in milk fractions were 13.5%(39/288)of α-whey protein,18.1%(52/288)of casein,20.8%(60/288)of bovis serum albumin and 21.1%(61/288)ofβ-lactoglobulin,respectively.3.The positive rate of s Ig E in different dairy products and milk components in milk s Ig E positive group was compared with that in milk s Ig E negative group and control group: compared with milk s Ig E negative group,the positive rate of buffalo milk,goat milk,cheddar cheese,casein,casein,α-whey protein,β-lactoglobulin and bovine serum albumin s Ig E in milk s Ig E positive group was higher than that in milk s Ig E negative group.Compared with the control group,the positive rates of s Ig E in goat milk,cheddar cheese,buttermilk,casein,β-lactoglobulin and bovine serum albumin s Ig E were higher in the milk s Ig E positive group.4.The s Ig E positive rates of different dairy products and milk components in each subgroup of milk s Ig E positive group were compared with those of milk s Ig E negative group and control group: the s Ig E positive rate of different dairy products was higher than that of milk s Ig E negative group,the s Ig E positive rate of buffalo milk,goat milk,cheddar cheese,buttermilk and yogurt was higher in AD group,and the s Ig E positive rate of buffalo milk,goat milk and cheddar cheese was higher in digestive tract allergy group.The positive rate of s Ig E in goat milk,partially hydrolyzed milk powder,cheddar cheese and buttermilk was higher in AD+ allergy group;the positive rate of s Ig E in goat milk and buttermilk in malnutrition group was higher;and the positive rate of s Ig E in buffalo milk and cheddar cheese in urticaria group was higher.Compared with the milk s Ig E negative group,the positive rate of s Ig E in milk components was higher in casein,β-lactoglobulin and bovine serum albumin in the other four groups,except that the s Ig E positive rates of the four milk components in AD group were higher than those in milk s Ig E negative group.Compared with the control group,the positive rate of s Ig E in buttermilk and yoghurt in AD group was higher,the positive rate of s Ig E in goat milk was higher in digestive tract allergy group,and the positive rate of s Ig E in goat milk and buttermilk in AD+ digestive tract allergy group and malnutrition group was higher than that in control group.Compared with the control group,the positive rate of s Ig E in milk components was higher in the AD group,except for casein,β-lactoglobulin and bovine serum albumin s Ig E.The positive rates ofβ-lactoglobulin and bovine serum albumin s Ig E were higher in the other four groups.5.The positive rate of s Ig E in different dairy products and milk components in the milk s Ig E negative group was compared with that in the control group,and there was no significant difference between the two groups.Conclusion:1.Milk components,casein,α-lactalbumin,β-lactoglobulin,and bovine serum albumin are the main allergen molecules of Ig E-mediated milk allergy infants and young children.2.Most infants with Ig E-mediated milk allergy may be able to tolerate boiled milk,mare’s milk,partially hydrolyzed milk powder,and yogurt.3.Children with milk allergy may also be allergic to buffalo milk,goat milk,cheddar cheese,and buttermilk.Buffalo milk and goat milk should not be used as milk substitutes for milk allergic children.4.The component diagnosis of milk allergy has clinical significance in accurate diagnosis,cross allergic reaction and diet management of milk allergy.