Methods: We performed an interim analysis for the first 9 subjects who completed the escalation phase. SPT to milk extract, fresh milk-1:10, and fresh milk were evaluated at baseline and at 200 ml. Milk protein component (casein, β-lactoglobulin, α-lactalbumin) specific serum IgE, IgG4, and IgA were evaluated at baseline and at 200 ml.
Results: There was a statistically significant decrease in SPT from baseline to 200 ml for milk extract (mean difference 4.44mm, 95% CI 0.01-8.88mm), fresh milk-1:10 (mean difference 6.22mm, 95% CI 1.41- 11.03mm), and fresh milk (mean difference 7.56mm, 95% CI 1.91-13.22mm). In parallel, serum IgG4 and IgA to casein, β-lactoglobulin, and α-lactalbumin significantly increased at 200 ml compared to baseline. Specific IgE to all three milk proteins increased slightly but not significantly.
Conclusions: Successful escalation phase of milk OIT in IgE-mediated CMA in children is associated with a decrease in milk-specific SPT and an increase in milk protein-components serum IgG4 and IgA.