Cow's milk allergy: therapeutic options and immunological aspects

Adverse reaction to cow's milk and infant formulas are common during infancy. Cow's milk has more than 20 constituent proteins and in principle many are capable of giving rise to an IgE mediated response. The prevalence of cow's milk allergy is between 0.5-10% of the paediatric population (Frier & Kletter, 1970, Gerrard et al., 1973, Foucard, 1985). The clinical diagnosis of cow's milk allergy is difficult because of the great diversity and varying severity of symptoms and is often based on criteria which is then confirmed by challenge with cow's milk (Bock et al., 1988, Wershil & Walker, 1988). There is no doubt that various immunological mechanisms are involved in cow's milk allergy and in recent years a number of researchers have investigated the role of humoral and cell-mediated immunity in the pathogenesis of cow's milk allergy.