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

Frank E. van Boven, Nicolette J.T. Arends, Aline B. Sprikkelman, Joyce A.M. Emons, Astrid I. Hendriks, Marloes van Splunter, Marco W.J. Schreurs, Severina Terlouw, Roy Gerth van Wijk, Harry J. Wichers, Huub F.J. Savelkoul, R. J.Joost van Neerven, Kasper A. Hettinga, Nicolette W. de Jong*

*Corresponding author for this work

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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.

Original languageEnglish
Article number1181
JournalNutrients
Volume15
Issue number5
DOIs
Publication statusPublished - Mar 2023

Bibliographical note

Funding Information:
This work is part of the research programme iAGE/TTW with project number 14536, which is (partly) financed by The Netherlands Organisation for Scientific Research (NWO).

Publisher Copyright:
© 2023 by the authors.

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