Cow's milk, boiled

Further Reading

Cow's milk f2

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Code: f231
Latin name: Bos spp.
Source material: Boiled skimmed cow's milk
Boiling is known to reduce the allergenicity of the whey proteins but not of casein.
 
Boiled milk or casein could be used to test whether a cow´s milk-sensitive patient is likely to tolerate cooked or baked milk products.

Allergen Exposure

Among the many proteins in milk, six are of major interest. These include: bovine serum albumin (BSA), gamma globulin, a-lactalabumin, b-lactoglobulin, lactoferrin and casein. The casein fraction represents 80% of the total bovine milk proteins. The major allergens of whey are a-lactalabumin, b-lactoglobulin and BSA. Boiling is known to reduce the allergenicity of the whey proteins, but not of casein. Whey is commonly included as an ingredient in baked goods, bread, ice cream, frozen desserts, dry mixes, processed cheese, confections, sauces and gravies. Boiled milk or casein could be used to test whether a cow's milk sensitive patient is likely to tolerate cooked or baked milk products.

Potential Cross-Reactivity

Cross-reactivity between cow's milk and milk from related animals exists (2). The a -caseins from cow, goat and sheep share more than 85% identical amino acids. Sensitivity to cow's milk does not usually presume sensitivity to beef or inhalation of cow dander. However, the presence of common allergens in milk, meat and dander has been demonstrated (3, 4).

Clinical Experience

Cow's milk allergy (CMA) is a common disease of infancy and childhood. The prevalence of CMA is approximately 2.5% during the first 3 years of life (1).
 
Review
Cow's milk allergy (CMA) is a common disease of infancy and childhood. The prevalence of CMA is approximately 2.5% during the first 3 years of life (1). Among the many proteins in milk six are of major interest. These include: bovine serum albumin (BSA), gamma globulin, a-lactalabumin, b-lactoglobulin, lactoferrin and casein. The casein fraction represents 80% of the total bovine milk proteins. The major allergens of whey are a-lactalabumin, b-lactoglobulin and BSA. Boiling is known to reduce the allergenicity of the whey proteins but not casein. Whey is commonly included as an ingredient in baked goods, bread, ice cream, frozen desserts, dry mixes, processed cheese, confections, sauces and gravies. Boiled milk or casein could be used to test whether a cow's milksensitivity patient is likely to tolerate cooked or baked milk products. Cross-reactivity between cow's milk and milk from related animals exists (2). The a-caseins from cow, goat and sheep share more than 85% identical amino acids. Sensitivity to cow's milk does not usually presume sensitivity to beef or inhalation of cow dander. However, the presence of common allergens in milk, meat and dander has been demonstrated (3, 4).

References

  1. Bellioni-Businco B, Paganelli R, Lucenti P, Giampietro PG, Perborn H, Businco L. Allergenicity of goat's milk in children with cow's milk allergy. J All Clin Immunol 1999; 103(6):1191-4.
  2. Spuergin P, Walter M, Schiltz E, Deichmann K, Forster J, Mueller H. Allergenicity of a-caseins from cow, sheep, and goat. Allergy 1997;52:293-8.
  3. Werfel SJ, Cooke SK, Sampson HA. Clinical reactivity to beef in children allergic to cow's milk. J All Clin Immunol 1997;99:293-300.
  4. Szépfalusi Z, Ebner C, Urbanek R, Ebner H, Scheiner O, Boltz-Nitulescu G, Kraft D. Detection of IgE Antibodies Specific for Allergens in Cow Milk and Cow Dander. Int Arch Allergy Immunol 1993;102:288-294.

 

As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.