Cow-milk allergy

Hereditary predisposition is the major denominator of allergy, and hypersensitivity reactions contribute to the expression of the genetic predisposition. The route of sensitization varies with age so that dietary antigens predominate in infancy. The immaturity of the immune system and the gastrointestinal barrier may explain the peak prevalence of food allergies at an early age. The treatment of choice for cow-milk allergy is complete avoidance of cow-milk antigens. The approach to control allergic inflammation by antigen elimination, however, has not been satisfactory. New approaches are urgently needed for the management of patients with cow-milk allergy. These may include: (i) immunotherapy to counteract the immunological dysfunction, and (ii) stabilisation of the gut mucosal barrier to strengthen endogenous defence mechanisms. (C) 1997 Elsevier Science B.V.