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Review
. 2022 Jun;120(3):200-206.
doi: 10.5546/aap.2022.eng.200.

Cow's milk protein allergy; new knowledge from a multidisciplinary perspective

[Article in English, Spanish]
Romina Mehaudy  1   2 , María B Jáuregui  2   3 , Gabriel Vinderola  4 , Luciana Guzmán  5 , Jorge Martínez  6 , Marina Orsi  1 , Claudio Parisi  7   8   9
Affiliations
Free article
Review

Cow's milk protein allergy; new knowledge from a multidisciplinary perspective

[Article in English, Spanish]
Romina Mehaudy et al. Arch Argent Pediatr. 2022 Jun.
Free article

Abstract
in English, Spanish

In recent decades, a higher prevalence, persistence, and severity of cow's milk protein allergy (CMPA) have been observed. Different hypotheses have been proposed in relation to potential responsible mechanisms, with emphasis on the role of the microbiota in the induction and maintenance of immune tolerance as well as the importance of establishing a healthy microbiota in an early manner through the promotion of breastfeeding, vaginal delivery, rational use of antibiotics and proton pump inhibitors, along with an early introduction of varied foods. The use of probiotics and allergenspecific immunotherapy (AIT) come up as the treatment strategies with the greatest evidence in favor of tolerance acquisition. The objective of this review was to describe the information currently available about the immune mechanisms involved in CMPA, the role of microbiota, and future treatment perspectives.

En las últimas décadas, se ha observado una mayor prevalencia, persistencia y gravedad de la alergia a la proteína de leche de vaca (APLV). Se han postulado diversas hipótesis respecto a posibles mecanismos responsables, con énfasis en el papel de la microbiota en la inducción y el mantenimiento de la tolerancia inmunitaria, así como la importancia del establecimiento temprano de una microbiota saludable a través de la promoción de la lactancia materna, el parto por vía vaginal, el uso racional de antibióticos e inhibidores de la bomba de protones, junto con la introducción temprana y variada de alimentos. La utilización de probióticos y la inmunoterapia específica para alérgenos (ITA) emergen como las estrategias terapéuticas con más evidencia a favor para la adquisición de tolerancia. El objetivo de esta revisión ha sido describir la información actual respecto a los mecanismos inmunitarios involucrados en la APLV, el papel de la microbiota y las perspectivas futuras en el tratamiento.

Keywords: food; hypersensitivity; microbiota; tolerance; treatment.

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Conflict of interest statement

Mead Johnson Nutrition Argentina facilitated the meetings and technical details of this study. The manuscript was written with the colaboration of all authors in an autonomous manner; the company did not interfere with the editorial management or the final article. The authors state that their only relationship with Mead Johnson Nutrition was their participation in conferences and symposiums organized by the company, as in others carried out by other companies.

References

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    1. Schrander JJ, van den Bogart JP, Forget PP, Schrander- Stumpel CT, et al. Cow’s milk protein intolerance in infants under 1 year of age: a prospective epidemiological study. Eur J Pediatr. 1993;152(8):640-4.

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