Cow’s milk allergic children can present sensitisation to probiotics
Study with the aim to evaluate sensitivity to probiotic products in children with cow’s milk allergy. Eighty-five children with atopic dermatitis were screened for possible cow’s milk allergy by skin prick test (SPT).
36/85 had a positive SPT (mean wheal diameter ≥ 3 mm) to cow’s milk and were further skin prick tested with preparations of three probiotic products, in Italy sold under the brands of Fiorilac® (L. paracasei I 1688 and L. salivarius I 1794, sachet product), Dicoflor® (L. GG, sachet product) and Reuterin® (Lactobacillus reuteri, oil suspension).
Positive SPT was found in 26/36 subjects for Fiorilac, in two patients for Dicoflor, and in one child to Reuterin. In four children, the mean diameter of the SPT wheal with Fiorilac was greater than the predictive cut-off index of positive response to oral challenge (> 6 mm for children less than 2 years old and > 8mm for older patients). No child that was SPT- positive for Dicoflor or Reuterin had a mean wheal diameter > 6 mm. However, oral challenge with the probiotic products was not performed.
When considering the use of probiotic products with limited information on content of allergens, it is advisable to do a screening SPT in high risk, cow’s milk allergic children to evaluate contamination with allergens.