COW-MILK ALLERGY

Hereditary predisposition is the major denominator of allergy, and hyp ersensitivity reactions contribute to the expression of the genetic pr edisposition. The route of sensitization varies with age so that dieta ry antigens predominate in infancy. The immaturity of the immune syste m and the gastrointestinal barrier may explain the peak prevalence of food allergies at an early age. The treatment of choice for cow-milk a llergy is complete avoidance of cow-milk antigens. The approach to con trol allergic inflammation by antigen elimination, however, has not be en satisfactory. New approaches are urgently needed for the management of patients with cow-milk allergy. These may include: (i) immunothera py to counteract the immunological dysfunction, and (ii) stabilisation of the gut mucosal barrier to strengthen endogenous defence mechanism s. (C) 1997 Elsevier Science B.V.