Biomarkers of Tolerance to Baked Milk in Cow’s Milk–Allergic Children at High Risk of Anaphylaxis
Abstract
BACKGROUND AND OBJECTIVES: Consuming baked milk (BM) may accelerate tolerance in cow's milk-allergic (CMA) children. In high-risk patients, controlled BM-based oral food challenge (BM-OFC) is recommended, as the benefits can outweigh the risks of a prolonged exclusion diet. Objectives: To identify predictive biomarkers for BM-OFC outcomes in a cohort at high risk of anaphylaxis and compare the OFC thresholds for baked and pasteurized cow´s milk protein (CMP). METHODS: We performed a prospective study of children (≥12 months to 3 years, elevated CM-sIgE and casein-sIgE, and a positive BAT result. The cut-offs were as follows: >5 mm for skin prick testing with casein, ≥8.5 kUA/L for CM-sIgE, and ≥5.7 kUA/L for casein-sIgE. These made it possible to distinguish BM-allergic patients from CMA patients who tolerated BM. Among BM-tolerant patients, the CM-OFC threshold was 270 mg, with 43.8% reacting to
Fields of Study & Subjects
Food Allergy and Anaphylaxis Research
Eosinophilic Esophagitis
Probiotics and Fermented Foods
Publication details
- Journal / source
- Journal of Investigational Allergology and Clinical Immunology
- Publisher
- Esmon Publicidad, SA
- Volume
- 36
- Issue
- 1
- Pages
- 36–46
- Publication date
- 5 February 2026
- Language
- EN