Analysis of alpha-lactalbumin-, beta-lactoglobulin-, and casein-specific IgE among children with atopic diseases in a tertiary medical center in northern Taiwan

Background: Cow's milk allergy is the first manifestation of the allergic march, because cow's milk proteins are the first foreign proteins consumed in large quantities by infants. The aim of this study was to determine which of these proteins causes the greatest sensitization in Taiwanese individuals, and its correlation with atopic patients. ;Methods: We retrospectively reviewed the medical records of atopic patients who were treated at the National Taiwan University Hospital from January 2009 to March 2011. A total of 190 patients were enrolled and tested for isolated cow's milk protein (a-lactalbumin, beta-lactoglobulin, and casein) sensitization. These patients were further divided into atopic dermatitis and non-atopic dermatitis subgroups, and also grouped by age. Differences in sensitization to cow's milk proteins between groups were analyzed using the non-parametric Mann Whitney U-test. ;Results: The sensitization rate to a-lactalbumin-specific IgE was 60%, followed by beta-lactoglobulin (46.84%) and casein (40.53%). The levels of specific IgE antibodies against a-lactalbumin, beta-lactoglobulin, and casein were higher in patients with atopic dermatitis (1.8, 1.19, 0.95 vs. 0.77, 0.55, 0.40 kUA/L). The younger age group had higher mean specific IgE antibodies against cow's milk proteins than the older age groups. ;Conclusion: There was a different distribution of cow's milk protein sensitization in Taiwanese patients in our study, with alpha-lactalbumin being most common as compared to casein in Western countries. Among the patients with cow's milk sensitization, the atopic dermatitis group had significantly higher cow's milk protein-specific IgE antibodies as compared to the non-atopic dermatitis group. Copyright (C) 2012, Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC. All rights reserved