Tolerance to sterilised cow's milk in patients with eosinophilic oesophagitis triggered by milk

• Published in: Alimentary pharmacology & therapeutics 2022-09, Vol.56 (6), p.957-967
• Main Authors: González‐Cervera, Jesús, Arias, Ángel, Navarro, Pilar, Juárez‐Tosina, Rocío, Cobo‐Palacios, María, Olalla, José M., Angueira‐Lapeña, Teresa, Lucendo, Alfredo J.
• Format: Article
• Language: English
• Subjects: Allergens; Animals; Cattle; Cow's milk; desensitisation; Endoscopy; Enteritis; Eosinophil cationic protein; Eosinophilia; Eosinophilic Esophagitis - pathology; eosinophilic oesophagitis; Esophagitis; Female; Gastritis; Humans; immune tolerance; Immunoglobulin E; Leukocytes (eosinophilic); Male; Milk; Milk - adverse effects; Milk hypersensitivity; Milk Hypersensitivity - diagnosis; Milk/immunology; Patients; Quality of Life; Remission; Serum levels; Skin tests; Tryptase
• ISSN: 0269-2813; 1365-2036
• DOI: 10.1111/apt.17171

Summary Background Cow's milk protein is the main food trigger for eosinophilic oesophagitis (EoE) in children and adults and should be continuously avoided once identified as such. Aims To evaluate tolerance of sterilised cow's milk (boiled instead of UHT processing) with regard to maintenance of EoE remission, health‐related quality of life (HRQoL), nutritional intake and allergic sensitisation in patients of all ages with milk‐triggered EoE Methods We prospectively recruited patients in whom cow's milk was demonstrated to trigger EoE after an empirical food elimination diet‐based study. They were given 200 ml of sterilised cow's milk twice daily for 8 weeks. Endoscopic assessment, peak eosinophil counts, oesophageal‐related symptoms, HRQoL, blood eosinophils, eosinophil cationic protein (ECP), skin prick test and serum total and specific immunoglobulin E (IgE) to major milk proteins were monitored before and after sterilised milk intake. Results Eighteen patients (13 male) in EoE remission underwent a sterilised milk challenge. Twelve maintained EoE remission (