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  • Open Access

PD28 - Is other bovid mammals milk tolerated by children who have been submitted to cow’s milk oral immunotherapy?

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Clinical and Translational Allergy20144 (Suppl 1) :P28

  • Published:


  • Adverse Event
  • Milk Protein
  • Inhibition Assay
  • Skin Prick Test
  • Maintenance Phase


Caseins cross-reactivity rises up to 90% between cow’s milk (CM) and other bovid milks. There are few studies on tolerance to other mammals milk in patients submitted to cow’s milk oral immunotherapy (CMOIT). AIMS: To determine the percentage of patients whom after CMOIT tolerate water buffalo (WB), goat and sheep’s milk proteins (MP). To describe immunologic features which can predict allergy.


Inclusion criteria: children submitted to CMOIT tolerating >150cc CM daily, more than 1 year in maintenance phase. We evaluated: total IgE, skin prick test (SPT) to CMP, WB, goat and sheep’s MP; specific IgE (sIgE) and IgG4 to CMP, goat and sheep’s MP. Patients underwent oral food challenge (OFC) to WB, goat and sheep’s MP.


51 children, 28 males, mean age at CMOIT 6.6 years (2.2-14.2) and 9.2 at OFC with WB, goat and sheep’s MP. At OFC to WB, goat and sheep’s MP: 47, 30 and 32 patients tolerated; 3, 7 and 4 non-anaphylactic reaction; 1, 12 and 11 anaphylaxis; 0, 2 and 4 didn’t undergo OFC, respectively. Significant differences between tolerant and non-tolerant in SPT to casein, goat and sheep’s MP, and sIgE to CM, casein, goat and sheep’s MP were observed. The area under the ROC curve for goat’s sIgE relating tolerance was 0.92, p<0.05, cut-off point 5.66 KUI/L (89.5% sensibility-96.3% specificity); for sheep’s sIgE 0.87, p<0.05, cut-off point 7.69 KUI/L (80% sensibility-86.7% specificity). CAP inhibition assays (solid phase goat and sheep, tolerant vs non-tolerant sera pools, CM as inhibitor) without significant differences although in the tolerant pool a greater inhibition is observed.


58.8% of the patients who have undergone CMOIT tolerate other bovid MP. 92.15% tolerate WBMP. In OFC to goat and sheep’s MP 23.95% have experienced anaphylaxis and only 1.96% in WBMP OFC. Our cut-off points can predict adverse events.

Authors’ Affiliations

Hospital Sant Joan de Déu, Barcelona, Spain


© Piquer et al; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.