Molecular diagnosis of cow's milk allergy.

Purpose Of Review: To identify and discuss studies on the molecular diagnosis of cow's milk allergy (CMA) with a view to update allergists since a general review of the methodology in 2006.

Recent Findings: Seven basic research studies reporting the use of component-resolved diagnostics in CMA were found. All studies were on children positively reacting to a formal challenge with cow's milk.

Avoidance or exposure to foods in prevention and treatment of food allergy?

Purpose Of Review: To caution against premature proposals advocating change before epidemiological and clinical evidence warrants such a paradigm shift.

Recent Findings: Until 2007, all allergy societies advocated allergen avoidance for prevention and therapy in food allergy. Since then, new evidence has prompted careful re-evaluation of the literature.

Incremental prognostic factors associated with cow's milk allergy outcomes in infant and child referrals: the Milan Cow's Milk Allergy Cohort study.

Background: The prognosis for many children with cow's milk allergy (CMA) is remission within 3 years, and the clinical parameters that predict duration of disease have not been measured incrementally.

Objective: To prospectively determine prognostic predictors of tolerance in a random cohort of referrals using CMA workup outcomes as covariates and tolerance as the status variable in a duration model of CMA.

Methods: The 2001-2006 Milan Cow's Milk Allergy Cohort (MiCMAC) enrolled children referrals using double-blind, placebo-controlled food challenges (DBPCFCs) as study end points (confirmation of CMA; onset of tolerance).

Ruling out food allergy in pediatrics and preventing the "march" of the allergic child.

When a child presents with an allergic symptom, the general pediatrician needs to discriminate which patient has to be sent to the specialist for an allergologic evaluation. If referred, the child will undergo not only skin-prick test, but also more complex specialistic evaluations that we define here as "the march of allergic children." The objective of this article is to overview the clinical evidence about possible diagnostic interventions to avoid unuseful referrals of children reported with allergy from the general to the specialist level.

Clinical tolerance of processed foods.

Objective: To review the effects of technological processing on selected foods of relevance to childhood allergy from the viewpoints of reduced allergenicity, contamination of processed foods by allergens introduced during processing, and ad hoc technologies to produce reduced hypoallergenic products.

Data Sources: We searched the literature (PubMed/MEDLINE) for articles published between January 1994 and April 2004 using the following keywords: food allergy AND process* OR heat* OR cooking OR toleran*.

Study Selection: We drew on our collective clinical and biological experience to restrict retrieved studies to those of more frequent relevance to a hospital allergy practice.

Clinical tolerance to lactose in children with cow's milk allergy.

Objective: Adverse reactions following the ingestion of lactose have been reported in children with cow's milk (CM) allergy. Whether this is attributable to the contamination of lactose with CM proteins is unknown. In this paper, we assessed clinical tolerance of lactose derived from CM whey in children hypersensitive to CM from 2 university hospital pediatric departments.

Inner-city asthma and the hygiene hypothesis.

Objective: Our goals were to analyze some of the similarities and differences in the increase in asthma, hay fever, and atopic sensitization between Europe and the United States and attempt to explain "inner-city asthma" within the framework of the hygiene hypothesis.

Data Sources: We reviewed historical descriptions of hay fever and asthma as well as the currently available related literature.

Study Selection: The authors' judgment was used in the selection of historical and epidemiologic evidence.

Accuracy of skin prick tests in IgE-mediated adverse reactions to bovine proteins.

Objectives: To review the recent literature on the diagnostic accuracy of skin prick tests (SPTs) in pediatric food allergy, focusing on adverse reactions to milk and beef. To present data about the test performance characteristics of beef extracts used in SPTs among children with atopic dermatitis (AD) reporting immediate hypersensitivity to beef.

Data Sources: MEDLINE search using the following algorithm ["skin prick test" AND "food allergy" OR allergen; 1997-2002; English; all children].