Research

Residual allergenicity of amino acid-based and extensively hydrolysed cow’s milk formulas

M E Levin, D M Blackhurst, F Kirstein, D Kok, G F van der Watt, A D Marais

Abstract


Background. Criteria for labelling infant feeds as suitable for the dietary management of cow’s milk protein allergy (CMPA) rely on proving the hypoallergenicity of such feeds or clinical studies showing that the feeds are tolerated by 90% of children with proven CMPA. South African (SA) labelling legislation does not indicate what testing is necessary to prove hypoallergenicity.

Objectives. To evaluate all extensively hydrolysed cow’s milk formulas and amino acid-based formulas available in SA for residual allergen content, protein size and amino-acid content.

Results. All amino-acid and extensively hydrolysed formulas were found to be similar in composition, with no residual cow’s milk allergens detectable by enzyme-linked immunosorbent assay. Furthermore, proteins were absent and only small molecules in the size range of amino acids and possibly of very small oligopeptides were detected.

Conclusions. These findings indicate that the formulas are extremely likely to be compliant with the definition of hypoallergenicity as tolerance in 90% of proven sufferers from cow’s milk allergy. The formulas may therefore be labelled as suitable for the dietary management of infants with CMPA.


Authors' affiliations

M E Levin, Division of Allergology, Department of Paediatrics, Faculty of Health Sciences, University of Cape Town, South Africa

D M Blackhurst, Division of Chemical Pathology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, South Africa

F Kirstein, Institute of Infectious Disease and Molecular Medicine, Division of Immunology, Faculty of Health Sciences, University of Cape Town, South Africa; International Centre for Biotechnology and Genetic Engineering, Cape Town Component, South Africa

D Kok, Division of Organic Chemistry, Faculty of Applied Sciences, Cape Peninsula University of Technology, Cape Town, South Africa

G F van der Watt, Division of Chemical Pathology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, South Africa

A D Marais, Division of Chemical Pathology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, South Africa; National Health Laboratory Service, Cape Town, South Africa

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Keywords

Allergy; Cow's milk; Infant feeds

Cite this article

South African Medical Journal 2017;107(9):763-767. DOI:10.7196/SAMJ.2017.v107i9.12137

Article History

Date submitted: 2017-08-25
Date published: 2017-08-25

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