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Evaluation of a Standardized Bakery Product (SUTMEK) as a Potential Tool for Baked-Milk Tolerance and Immunotherapy Research Studies

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dc.contributor.authorÖZEN, AHMET OĞUZHAN
dc.contributor.authorsKiykim, Ayca; Karakoc-Aydiner, Elif; Gunes, Esra; Nain, Ercan; Ogulur, Ismail; Yazici, Duygu; Aktac, Sule; Bicer, Ayse Humeyra; Sackesen, Cansin; Baris, Safa; Ozen, Ahmet
dc.date.accessioned2022-03-12T22:30:18Z
dc.date.available2022-03-12T22:30:18Z
dc.date.issued2019
dc.description.abstractBackground and Objectives: About 65-80% of children with IgE-mediated cow's milk allergy (CMA) can tolerate extensively heated milk. We have invested in the mass fabrication of a test product containing milk protein baked at 180 degrees C for 30 min (SUTMEK-milk) and a milk-free placebo (SUTMEK-placebo) to carry out a standardised double-blind placebo-controlled food challenge (DBPCFC) test in patients with CMA. Methods: We studied children with IgE-mediated CMA between 13 and 48 months of age. Specific IgEs (spIgE) to milk proteins were quantified. A DBPCFC with our bakery products was performed, and factors determining reactivity to extensively heated milk were evaluated. We also tested the applicability of SUTMEK products in baked-milk oral immunotherapy in a pilot assessment. Results: We studied 15 children (8 girls, 7 boys) with a median age of 26 months (range: 13-48 months). Nine (60%) patients tolerated a challenge with extensively heated milk, while 6 (40%) were found reactive (anaphylaxis: 2, wheezing: 2, urticaria: 2). spIgE to milk, alpha-lactalbumin, and casein, and the wheal diameter on skin prick testing were higher in the reactive group than the tolerant groups (p = 0.001, p = 0.001, p = 0.002, and p = 0.048, respectively). Receiver-operating characteristic curve analyses yielded the following cut-off values for spIgEs that would predict a reactivity to extensively heated milk; milk: 25 kU/L (area under curve, AUC: 0.981), casein: 32 kU/L (AUC: 0.983), and alpha-lactalbumin: 17 kU/L (AUC: 0.981). Nine patients have tolerated well a continued daily consumption of SUTMEK-milk or -placebo for 6 months at the desired doses. Conclusions: Our bakery products were successfully used in DBPCFC studies and qualified as an acceptable tool for use in the research of interventional tolerance induction. Although spIgE appears useful in determining children at high risk of reacting to extensively heated milk, the predictive cut-off values are still far from being perfect. (c) 2018 S. Karger AG, Basel
dc.identifier.doi10.1159/000492824
dc.identifier.eissn1423-0097
dc.identifier.issn1018-2438
dc.identifier.pubmed30404088
dc.identifier.urihttps://hdl.handle.net/11424/235465
dc.identifier.wosWOS:000456652500001
dc.language.isoeng
dc.publisherKARGER
dc.relation.ispartofINTERNATIONAL ARCHIVES OF ALLERGY AND IMMUNOLOGY
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectCow's milk allergy
dc.subjectBaked-milk product
dc.subjectFood challenge
dc.subjectChildren
dc.subjectFOOD ALLERGY
dc.subjectCHALLENGE
dc.subjectIGE
dc.subjectDIAGNOSIS
dc.titleEvaluation of a Standardized Bakery Product (SUTMEK) as a Potential Tool for Baked-Milk Tolerance and Immunotherapy Research Studies
dc.typearticle
dspace.entity.typePublication
local.avesis.idc7cff550-69e3-4954-bbde-6ad66c17714a
local.import.packageSS17
local.indexed.atWOS
local.indexed.atSCOPUS
local.indexed.atPUBMED
local.journal.numberofpages9
local.journal.quartileQ3
oaire.citation.endPage9
oaire.citation.issue1
oaire.citation.startPage1
oaire.citation.titleINTERNATIONAL ARCHIVES OF ALLERGY AND IMMUNOLOGY
oaire.citation.volume178
relation.isAuthorOfPublication3e9c297b-e636-4836-8f61-dc9c8b7c29cf
relation.isAuthorOfPublication.latestForDiscovery3e9c297b-e636-4836-8f61-dc9c8b7c29cf

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