Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) Guidelines update - III - Cow's milk allergens and mechanisms triggering immune activation
Background: The immunopathogenesis of cow's milk protein allergy (CMPA) is based on different mechanisms related to immune recognition of protein epitopes, which are affected by industrial processing. Purpose: The purpose of this WAO DRACMA paper is to: (i) give a comprehensive overview of milk...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-09-01
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| Series: | World Allergy Organization Journal |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1939455122000448 |
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| author | Sebastian A. Jensen, MD Alessandro Fiocchi, MD Ton Baars, PhD Galateja Jordakieva, PhD Anna Nowak-Wegrzyn, MD, PhD Isabella Pali-Schöll, MD, PhD Stefano Passanisi, MD Christina L. Pranger, MSc Franziska Roth-Walter, PhD Kristiina Takkinen, PhD Amal H. Assa'ad, MD Carina Venter, PhD, RD Erika Jensen-Jarolim, MD |
| author_facet | Sebastian A. Jensen, MD Alessandro Fiocchi, MD Ton Baars, PhD Galateja Jordakieva, PhD Anna Nowak-Wegrzyn, MD, PhD Isabella Pali-Schöll, MD, PhD Stefano Passanisi, MD Christina L. Pranger, MSc Franziska Roth-Walter, PhD Kristiina Takkinen, PhD Amal H. Assa'ad, MD Carina Venter, PhD, RD Erika Jensen-Jarolim, MD |
| author_sort | Sebastian A. Jensen, MD |
| collection | DOAJ |
| description | Background: The immunopathogenesis of cow's milk protein allergy (CMPA) is based on different mechanisms related to immune recognition of protein epitopes, which are affected by industrial processing. Purpose: The purpose of this WAO DRACMA paper is to: (i) give a comprehensive overview of milk protein allergens, (ii) to review their immunogenicity and allergenicity in the context of industrial processing, and (iii) to review the milk-related immune mechanisms triggering IgE-mediated immediate type hypersensitivity reactions, mixed reactions and non-IgE mediated hypersensitivities. Results: The main cow’s milk allergens – α-lactalbumin, β-lactoglobulin, serum albumin, caseins, bovine serum albumins, and others – may determine allergic reactions through a range of mechanisms. All marketed milk and milk products have undergone industrial processing that involves heating, filtration, and defatting. Milk processing results in structural changes of immunomodulatory proteins, leads to a loss of lipophilic compounds in the matrix, and hence to a higher allergenicity of industrially processed milk products. Thereby, the tolerogenic capacity of raw farm milk, associated with the whey proteins α-lactalbumin and β-lactoglobulin and their lipophilic ligands, is lost. Conclusion: The spectrum of immunopathogenic mechanisms underlying cow's milk allergy (CMA) is wide. Unprocessed, fresh cow's milk, like human breast milk, contains various tolerogenic factors that are impaired by industrial processing. Further studies focusing on the immunological consequences of milk processing are warranted to understand on a molecular basis to what extent processing procedures make single milk compounds into allergens. |
| first_indexed | 2024-04-12T18:09:10Z |
| format | Article |
| id | doaj.art-5d0da67220014bedb11b944487f08be8 |
| institution | Directory Open Access Journal |
| issn | 1939-4551 |
| language | English |
| last_indexed | 2024-04-12T18:09:10Z |
| publishDate | 2022-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | World Allergy Organization Journal |
| spelling | doaj.art-5d0da67220014bedb11b944487f08be82022-12-22T03:21:54ZengElsevierWorld Allergy Organization Journal1939-45512022-09-01159100668Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) Guidelines update - III - Cow's milk allergens and mechanisms triggering immune activationSebastian A. Jensen, MD0Alessandro Fiocchi, MD1Ton Baars, PhD2Galateja Jordakieva, PhD3Anna Nowak-Wegrzyn, MD, PhD4Isabella Pali-Schöll, MD, PhD5Stefano Passanisi, MD6Christina L. Pranger, MSc7Franziska Roth-Walter, PhD8Kristiina Takkinen, PhD9Amal H. Assa'ad, MD10Carina Venter, PhD, RD11Erika Jensen-Jarolim, MD12Institute of Pathophysiology and Allergy Research, Centre of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria; University Clinics for Ear Nose and Throat, Medical University Vienna, Austria; The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, Vienna, AustriaAllergy Unit – Area of Translational Research in Pediatric Specialities, Bambino Gesù Children's Hospital, Rome, ItalyDivision of Pharmacology, Department of Pharmaceutical Sciences, Utrecht University, Utrecht, the NetherlandsDepartment of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, AustriaDepartment of Pediatrics, NYU Grossman School of Medicine, Hassenfeld Childrens' Hospital, New York, NY, USA; Department of Pediatrics, Gastroenterology and Nutrition, Collegium Medicum, University of Warmia and Mazury, Olsztyn, PolandCincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; AllergyCare - Allergy Diagnosis Center Vienna, Private Clinics Döbling, Vienna, AustriaDepartment of Human Pathology of Adult and Developmental Age, University of Messina, ItalyInstitute of Pathophysiology and Allergy Research, Centre of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria; The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, Vienna, AustriaUniversity Clinics for Ear Nose and Throat, Medical University Vienna, Austria; The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, Vienna, AustriaVTT Technical Research Centre of Finland Ltd, Espoo, FinlandCincinnati Children's Hospital Medical Center, Cincinnati, OH, USAChildrenás Hospital Colorado, University of Colorado, Denver, CO, USAInstitute of Pathophysiology and Allergy Research, Centre of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria; The Interuniversity Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University Vienna and University Vienna, Vienna, Austria; AllergyCare - Allergy Diagnosis Center Vienna, Private Clinics Döbling, Vienna, Austria; Corresponding author. Institute of Pathophysiology and Allergy Research, Centre for Pathophysiology, Infectiology and Immunology, Medical University Vienna, Währinger Gürtel 18 – 20, 1090 Vienna, Austria.Background: The immunopathogenesis of cow's milk protein allergy (CMPA) is based on different mechanisms related to immune recognition of protein epitopes, which are affected by industrial processing. Purpose: The purpose of this WAO DRACMA paper is to: (i) give a comprehensive overview of milk protein allergens, (ii) to review their immunogenicity and allergenicity in the context of industrial processing, and (iii) to review the milk-related immune mechanisms triggering IgE-mediated immediate type hypersensitivity reactions, mixed reactions and non-IgE mediated hypersensitivities. Results: The main cow’s milk allergens – α-lactalbumin, β-lactoglobulin, serum albumin, caseins, bovine serum albumins, and others – may determine allergic reactions through a range of mechanisms. All marketed milk and milk products have undergone industrial processing that involves heating, filtration, and defatting. Milk processing results in structural changes of immunomodulatory proteins, leads to a loss of lipophilic compounds in the matrix, and hence to a higher allergenicity of industrially processed milk products. Thereby, the tolerogenic capacity of raw farm milk, associated with the whey proteins α-lactalbumin and β-lactoglobulin and their lipophilic ligands, is lost. Conclusion: The spectrum of immunopathogenic mechanisms underlying cow's milk allergy (CMA) is wide. Unprocessed, fresh cow's milk, like human breast milk, contains various tolerogenic factors that are impaired by industrial processing. Further studies focusing on the immunological consequences of milk processing are warranted to understand on a molecular basis to what extent processing procedures make single milk compounds into allergens.http://www.sciencedirect.com/science/article/pii/S1939455122000448AllergyCow's milkBeta-lactoglobulinFood allergyPasteurization |
| spellingShingle | Sebastian A. Jensen, MD Alessandro Fiocchi, MD Ton Baars, PhD Galateja Jordakieva, PhD Anna Nowak-Wegrzyn, MD, PhD Isabella Pali-Schöll, MD, PhD Stefano Passanisi, MD Christina L. Pranger, MSc Franziska Roth-Walter, PhD Kristiina Takkinen, PhD Amal H. Assa'ad, MD Carina Venter, PhD, RD Erika Jensen-Jarolim, MD Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) Guidelines update - III - Cow's milk allergens and mechanisms triggering immune activation World Allergy Organization Journal Allergy Cow's milk Beta-lactoglobulin Food allergy Pasteurization |
| title | Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) Guidelines update - III - Cow's milk allergens and mechanisms triggering immune activation |
| title_full | Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) Guidelines update - III - Cow's milk allergens and mechanisms triggering immune activation |
| title_fullStr | Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) Guidelines update - III - Cow's milk allergens and mechanisms triggering immune activation |
| title_full_unstemmed | Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) Guidelines update - III - Cow's milk allergens and mechanisms triggering immune activation |
| title_short | Diagnosis and Rationale for Action against Cow's Milk Allergy (DRACMA) Guidelines update - III - Cow's milk allergens and mechanisms triggering immune activation |
| title_sort | diagnosis and rationale for action against cow s milk allergy dracma guidelines update iii cow s milk allergens and mechanisms triggering immune activation |
| topic | Allergy Cow's milk Beta-lactoglobulin Food allergy Pasteurization |
| url | http://www.sciencedirect.com/science/article/pii/S1939455122000448 |
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