Cow’s Milk Allergy: Immunomodulation by Dietary Intervention
Open accessAbstract
Cow’s milk proteins cause allergic symptoms in 2% to 3% of all infants. In these individuals, the physiological mechanism of tolerance is broken with subsequent possible sensitization to antigens, which can lead eventually to allergic responses. The present review aims to provide an overview of different aspects of immune modulation by dietary intervention in cow’s milk allergy (CMA). It focuses on pathogenetic mechanisms of different CMA related disorders, e.g., gastroesophageal reflux and eosinophilic esophagitis, highlighting the role of dietary management on innate and adaptive immune systems. The traditional dietary management of CMA has greatly changed in the last years, moving from a passive approach, consisting of an elimination diet to relieve symptoms, to a “proactive” one, meaning the possibility to actively modulate the immune system. Thus, new insights into the role of hydrolysates and baked milk in immunomodulation are addressed here. Additionally, nutritional components, such as pre- and probiotics, may target the immune system via microbiota, offering a possible road map for new CMA prevention and treatment strategies.
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Studies of probiotic use in cow's milk allergy remain inconclusive due to heterogeneity in host health status and genetic background.
“Disrupted microbial colonization in early childhood is associated with an increased risk of food allergy [96], but studies of the use of probiotics in cow’s milk allergy remain inconclusive due to heterogeneity in host health status and genetic background [97].”
From Current Concepts in Probiotic Safety and Efficacy (2026) · cites this paper as [97]
The Conclusions (section 9; page unavailable) say that the paucity and heterogeneity of studies limit conclusions and recommendations about probiotics for cow’s milk allergy. The paper does not identify differences in host health status or genetic background as the reason; section 8 instead discusses uncertainty about effective probiotic strains, doses, and treatment duration. (LLM, conf=0.87)
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References 156 · Cited by 70
- Authors
- D’Auria, E., Salvatore, S., Pozzi, E., Mantegazza, C., Sartorio, M. U. A., Pensabene, L., Baldassarre, M. E., Agosti, M., Vandenplas, Y., & Zuccotti, G.
- Affiliations
- University of Milan (IT)
- University of Insubria (IT)
- Magna Graecia University (IT)
- University of Bari Aldo Moro (IT)
- Vrije Universiteit Brussel (BE)
- Corresponding author
- D’Auria, Enza
- ORCID
- Venue
- Nutrients
- Publisher
- MDPI AG
- Published
- 2019-06-21
- Volume
- 11
- Issue
- 6
- Pages
- 1399
- ISSN
- 2072-6643 (ISSN-L)
- PMC
- PMC6627562
- OpenAlex
- W2952334507
- Cited by
- 70
- References
- 156
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 10 · 2023: 13 · 2022: 9 · 2021: 15 · 2020: 11 · 2019: 4 · 2018: 1
- FWCI
- 1.27
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- Nutrients (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- IrInSubria (University of Insubria) (submittedVersion)
- CINECA IRIS Institutional Research Information System (University of Bari Aldo Moro) (submittedVersion, other-oa)
- CINECA IRIS Institutional Research Information System (University of Bari Aldo Moro) (submittedVersion)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Topics
- Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
- Health Sciences › Medicine › Surgery › Eosinophilic Esophagitis
- Health Sciences › Nursing › Nutrition and Dietetics › Infant Nutrition and Health
- Keywords
- cow's milk allergy, dietary intervention, immunomodulation, hydrolysate, baked milk, elimination diet, gastroesophageal reflux, eosinophilic esophagitis, prebiotics, probiotics, gut microbiota, innate and adaptive immunity, infant allergy, allergy prevention
- MeSH terms
- Animals, Epitopes, Humans, Immunity, Innate, Milk Proteins, Risk Factors, Milk Hypersensitivity, Treatment Outcome, Dietary Supplements, Adaptive Immunity
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