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Allergy to goat and sheep milk without allergy to cows’ milk

by IDBiotech, 19 August 2015

Allergy to goat and sheep milk without allergy to cows’ milk


Cows’ milk allergy occurs in 2% to 6% of the infant population, being the most frequent cause of food allergy. Many of these infants cannot tolerate goats’ or sheeps’ milk either (Bellioni-Businjco et al, 1999). Conversely, the goat’s or sheep’s milk allergies that are not associated with allergic cross-reactivity to cow’s milk are rare.

Until 2000 a dozen observations of caprine and ovine milk without allergy to bovine milk have been described (Wüthrich and Johansson,1995; Calvani and Allessandri, 1998; Umpiérrez et al, 1999). Since 2000 more frequent observations have been reported (Orlando and Breton-Bouveyron, 2000; Lamblin et al, 2001; Munoz-Martin et al, 2004; Restany, 2004; Martins, 2005; Attou et al, 2005; Tavarez et al, 2007; Boissieu et Dupont, 2008) and significative series have been described: 18 observations by Paty et al (2003), 31 by Bidat et al (2003) and 28 by Ah-Leung et al (2006). Recently Vitte and Bongrand (2008) reported a fatal ewe’s milk-induced anaphylaxis on a 8 years old boy.

Generally chidren had severe allergic reactions, including anaphylaxis, a few minutes after consumption of goats’ or sheeps’ milk products but tolerated cows’ milk products. Clinical observations, skin prick testing and immunoglobulin IgE-binding studies confirmed the diagnosis of goat’s or sheeps’ milk allergy without associated cows’ milk allergy.

The characteristics of goat’s or sheep’s milk allergy differ from those of cow’s milk allergy because it affects older children and appears later (around 6 years). However, Umpiérrez et al (1999) reported on a two years old girl who experienced allergic reactions after eating goat cheese and after touching goat and sheep cheese, but not after consuming cow milk. In the series of Bidat (2003) 19% of the children regularly consumed goats’ milk while previously allergic to cows’ milk.

The major allergenic proteins in cow’s milk are ß-lactoglobulin, a-lactalbumin, serum albumin and caseins (Räsänen et al, 1992). However, it has been suggested that caseins may be the main allergen both in children (Kohno et al, 1994) and adults (Stöger et al, 1993). In their series of infants with goat’s or sheep’s milk allergy, Ah-Leung et al (2006) demonstrated by enzyme allergosorbent tests that the casein fractions and not the whey proteins were involved. Cow’s milk caseins were not at all or poorly recognized by the patient’s IgE, while aS1-, aS2- and ß-caseins from goat’s or sheep’s milk were recognized with high specificity and affinity. Unlike what is observed in cow’s milk allergy, k-casein was not recognized by the IgE antibodies. A similar predominant role of caseins has been observed by Umpiérrez et al (1999). However, Tavares et al (2007) reported that a non-casein 14 kDa protein (probably a-lactalbunin) was involved for a 27 years old female patient exhibiting goats’ milk allergy not associated to cows’ milk allergy.

Due to severity of the anaphylactic reaction of patients with allergy to caprine and ovine milk, Boissieu and Dupont (2008) recommend to avoid eating cheese made from caprine or ovine milk (Feta, Roquefort, Ossau Iraty, Etorky etc.) and cheese not stored at home (restaurant, buffet, friends etc.). Care must be taken to present cheese made from bovine milk and cheese made from caprine or ovine cheese in separate plates to avoid the frequently observed cross-contaminations. Moreover, allergic patients must be circunspect with many foods which can contain goat’s or sheep’s dairy proteins such as pizza, toasted cheese, Moussaka etc.

In this new context, the agroalimentary industry must now implement analytical methods to detect goat’s or sheep’s milk in bovine dairy products and in agro-alimentary products with added milk proteins. Most of the published analytical methods have been developed for the detection of bovine milk in the more expensive caprine or ovine milks. The detection limits are around 1% contamination since a lower percentage is not of economical interest. Now, the detection of potentially allergenic goat’s milk or sheep’s milk in cow’s milk must be more sensitive, down to 10-100 ppm, in order to guarantee the allergenic safety of the cow milk dairy products.


References

Ah-Leung S, Bernard H, Bidat E et al, 2006. Allergy to goat and sheep milk without allergy to cow’s milk. Allergy 61: 1358–65

Attou D, Caherec A, Bensakhria S et al, 2005. Allergie aux laits de chèvre et de brebis sans allergie associée au lait de vache. Rev Fr Allergol Immunol Clin 5: 601–607

Bellioni-Businco B, Paganelli R, Lucenti P, Giampietro PG, Perborn H, Businco L, 1999. Allergenicity of goat’s milk in children with cow’s milk allergy. J Allergy Clin Immunol, 103: 1191-1194

Bidat E, Rancé F, Baranes T et al, 2003. L’allergie au lait de chèvre ou de brebis chez l’enfant, sans allergie associée au lait de vache. Rev Fr Allergol 43: 273-277

Boissieu D, Dupont C, 2008. Allergy to goat and sheep milk without allergy to cow’s milk. Arch Pediatr 15: 349-351

Calvani Jr M, Alessandri C, 1998. Anaphylaxis to sheep’s milk cheese in a child unaffected by cow’s milk protein allergy. Eur J Pediatr 157: 17–19

Kohno Y, Honna K, Saito K et al, 1994. Preferential recognition of primary protein structures of casein by IgG and IgE antibodies of patients with milk allergy. Ann Allergy 7: 419-422

Lamblin C, Bourrier T, Orlando JP et al, 2001. Allergie aux laits de chêvre et de brebis sans allergie associée au lait de vache. Rev Fr Allergol Immunol Clin 41: 165–168

Martins P, Borrego LM, Pires G, Pinto PL, Afonso AR, Rosado-Pinto J, 2005. Sheep and goat’s milk allergy—a case study. Allergy 60: 129-130

Muñoz-Martín T, de la Hoz Caballer B, Marañón Lizana F, González Mendiola R, Prieto Montaño P, Sánchez Cano M, 2004. Selective allergy to sheep’s and goat’s milk proteins. Allergol Immunopathol 32: 39-42

Orlando JP, Breton-Bouveyron A, 2000. Anaphylactoid reaction to goat’s milk. Allerg Immunol 32: 231-232

Paty E, Chedevergne F, Scheinmann P et al, 2003. Allergie au lait de chèvre et de brebis sans allergie associée au lait de vache. Rev Fr Allergol 43: 455-462

Räsänen L, Lehto M, Reumala T, 1992. Diagnostic value of skin and laboratory tests in cow’s milk allergy/intolerance. Clin Exp Allergy 22: 385-390

Stöger P, Wüthrich B, 1993. Type I allergy to cow milk proteins in adults. A retrospective study of 34 adult milk- and cheese-allergic patients. Int Arch Allergy Immunol 102: 399-407

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Tavares B, Pereira C, Rodrigues F, Loureiro G, Chieira C, 2007. Goat’s milk allergy. Allergol Immunopathol 35: 113-116

Umpiérrez A, Quirce S, Marañón F, Cuesta J, García-Villamuza Y, Lahoz C, Sastre J, 1999. Allergy to goat and sheep cheese with good tolerance to cow cheese. Clin Exp Allergy 29: 1064-1068

Vitte J, Bongrand P, 2008. Fatal ewe’s milk-induced anaphylaxis: laboratory work-up. Arch Pédiatr 15: 1300-1303

Wüthrich B, Johansson SG, 1995. Allergy to cheese produced from sheep’s and goat’s milk but not to cheese produced from cow’s milk. J Allergy Clin Immunol 96: 270–273

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