1.1 Subjects with Atopic or Other Diseases
| Country / Subjects | Sensitivity / Allergy to | References |
| Denmark, Copenhagen
Germany, Bochum 21 selected milk-allergic patients |
goat's milk (CRIE) | Gjesing et al. 1986 |
| France, Gif Sur Yvette / Paris
58 patients with CMA and specific IgE to bovine CAS (0.3 to >100 IU/mL) |
sheep's milk: ovine CAS 98% (RAST)
goat's milk: caprine CAS 93% (RAST) rat's milk CAS 59% (RAST) rabbit's milk CAS 57% (RAST) |
Bernard et al. 1999 |
| France, Nancy and Toulouse
544 food allergic children |
goat's milk 0.55% (food challenge)
cow's milk 13% (food challenge) |
Rance et al. 1999b |
| Italy, Florence
54 episodes of food-dependent anaphylaxis in 44 children (age of 1 month to 16 years) (from 1994-1996) |
goat's milk 4%
cow's milk 22% |
Novembre et al. 1998 |
| Italy, Palermo
21 hydrolysed protein formula intolerant infants with CMA (median age at diagnosis 2 months) treated with an ass' milk-based diet |
goat's milk in 5/6 (DBPCFC)
sheep's milk in 4/7 (DBPCFC) |
Carroccio et al. 2000 |
| Italy, Rome
26 children with CMA (DBPCFC) |
goat's milk in 92% (DBPCFC) | Bellioni-Businco et al. 1999 |
| Symptoms & Case Reports | References |
| systemic reactions
anaphylaxis (2), anaphylactoid reaction (5) cutaneous symptoms
gastrointestinal symptoms
respiratory symptoms
|
(1) Wüthrich
& Johansson 1995
(2) Novembre et al. 1998 (3) Bellioni-Businco et al. 1999 (4) Umpierrez et al. 1999 (5) Orlando et al. 2000 |
| Percentage of Reactions
Urticaria in 50%, respiratory symptoms (rhinitis and/or wheezing) in 21%, angioedema in 13%, and vomiting and rush in 17% of patients (24 goat's milk allergic children, DBPCFC) (1) |
(1) Bellioni-Businco et al. 1999 |
| Threshold for Elicitation of Symptoms
Doses between 3 and 100 mL (mean 38 mL) of goat's milk allergic symptoms in 24 goat's milk allergic patients (DBPCFC) (1) |
(1) Bellioni-Businco et al. 1999 |
3 Diagnostic Features of Goat's Milk
Allergy
| Parameters / Subjects | Outcome | References |
| SPT, RAST, Clinical Reactivity without
Sensitization to Cow's Milk
2 patients with allergy to goat's and sheep's cheese |
Positive SPT to:
goat's milk in both patients Positive skin scratch test to: goat's and sheep's cheese in both patients Negative SPT cow's milk in both patients Positive RAST to: goat's and sheep's cheese and caseins in both patients, Negative RAST to: cow's milk, alpha-lactalbumin, beta-lactoglobulin, and casein Clinical reactivity to goat's cheese and sheep's cheese with tolerance of cow's milk and cheese |
Wüthrich & Johansson 1995 |
| SPT, RAST, Clinical Reactivity without
Sensitization to Cow's Milk
2-year old girl with allergy to goat's and sheep's cheese |
Positive SPT to:
goat casein, sheep's milk, and sheep casein Positive prick-to-prick test to: goat's milk and cheese, sheep's milk and cheese Negative SPT and prick-to-prick test to cow's milk Positive RAST to: goat's milk and casein, and sheep's milk and casein Negative RAST to: cow's milk and casein Clinical reactivity to goat's cheese and sheep's cheese with tolerance of cow's milk and cheese |
Umpierrez et al. 1999 |
| Proteins / Glycoproteins | aa Sequence | Allergen Nomenclature | References |
| alpha-Lactalbumin [15 kDa] | Swiss-Prot: P00712 | Bellioni-Businco et al. 1999, Docena et al. 2002 | |
| beta-Lactoglobulin [18 kDa] | Swiss-Prot: P02756 | Bellioni-Businco et al. 1999, Docena et al. 2002 | |
| Serum Albumin [69 kDa] | Bellioni-Businco et al. 1999, Docena et al. 2002 | ||
| Caseins [33-40 kDa] | Swiss-Prot:
P18626 (alpha-S1) P33049 (alpha-S2) P33048 (beta) P02670 (kappa) |
Bellioni-Businco et al. 1999, Umpierrez et al. 1999, Docena et al. 2002 | |
| Allergens: 22 and 28 kDa | Bellioni-Businco et al. 1999 |
| Cross-Reacting Allergens | Subjects / Methods | References |
| Goat's Milk
cow's and sheep's milk, and modified cow's milk formulas |
16 children with CMA: high inhibition of IgE- binding to cow's milk by goat's and sheep's milk, modified cows' milk formula and CAS formula (RAST inhibition) | Dean et al. 1993 |
| Goat's Milk
cow's milk |
9 milk allergic patients: IgE- binding to cow's and goat's milk proteins corresponding in Mr to beta-LG and CAS (immunoblot) | Sabbah et al. 1996 |
| Goat's Milk
cow's milk |
26 children with CMA (DBPCFC positive) and positive SPT and RAST to goat's milk; 92% reacted to goat's milk in DBPCFC; cow's milk completely extinguished IgE- binding to goat's milk allergens, goat's milk partially inhibited IgE- binding to cow's milk allergens (RAST- and SDS-PAGE inhibition) | Bellioni-Businco et al. 1999 |
| Goat's Milk
cow's, ewe's, and buffalo milk |
6 children with CMA:
IgE- binding to milk allergens from cow, ewe, goat, and buffalo, but not from camel (SDS-PAGE immunoblot, inhibition) |
Restani et al. 1999 |
| Goat's Caseins
goat's, sheep's, and cow's milk |
Inhibition of IgE- binding to goat's and sheep's CAS by cow's milk CAS in 1 adult (RAST inhibition) | Wüthrich & Johansson 1995 |
| Goat's Caseins
whole casein fractions from cow, goat, ewe, rabbit and rat milk * |
Sera from 58 patients with CMA
and specific IgE to bovine CAS:
specific IgE titers: bovine > ovine > caprine CAS; 79% and 66% of sera showed IgE-binding to rabbit-CAS and rat-CAS of <10% intensity as compared to bovine CAS (ELISA) |
Bernard et al. 1999 |
| Goat's Caseins
goat's and sheep's milk |
1 cow's milk tolerant child with goat's and sheep's milk allergy: high degree of cross-reactivity between goat's and sheep's milk CAS (RAST inhibition); IgE binding to allergens in goat's milk at 22, 27, and 31 kDa and sheep's milk at 31 kDa (SDS-PAGE immunoblot) | Umpierrez et al. 1999 |
| Goat's alpha Caseins
goat's, sheep's, and cow's milk |
17 children with CMA (immediate type): Inhibition of IgE binding to bovine alpha-CAS by alpha-CAS from cow, goat, and sheep (RAST inhibition), lower specific IgE levels to goat- and sheep alpha-CAS (RAST) | Spuergin et al. 1997 |
| Unique Allergens | Subjects / Methods | References |
| Goat's Caseins
goat's and sheep's vs cow's milk CAS |
No inhibition of IgE- binding to goat's and sheep's CAS by cow's milk CAS in 1 adult (RAST inhibition) | Wüthrich & Johansson 1995 |
| Goat's Caseins
goat's and sheep's vs cow's milk CAS |
1 cow's milk tolerant child with goat's and sheep's milk allergy: Decreased inhibition of IgE- binding to goat's milk and CAS by cow's milk and CAS, but not by goat's and sheep's milk and CAS (RAST inhibition); IgE binding to allergens in goat's milk at 22, 27, and 31 kDa, in sheep's milk at 31 kDa and cow's milk at 34 kDa (SDS-PAGE immunoblot) | Umpierrez et al. 1999 |
| Reported Adverse Reactions | References |
| Goat's and Sheep's Cheese
Several allergic reactions after ingestion of feta (cheese made from sheep's milk) in a 15-year-old boy, after ingestion of sheep's or goat's cheese in a 25-year old patient, both tolerated ingestion of diary procucts from cow's milk (1) Allergic reactions after eating goat's cheese and after touching of goat's and sheep's cheese in a 2-year-old girl with tolerance to dairy products from cow's milk (2) A young adult male had severe a anaphylactoid reaction after eating goat's cheese; goat's and sheep's milk elicited mainly oral pruritus while cow's milk and cheese was well tolerated (3) |
(1) Wüthrich
& Johansson 1995
(2) Umpierrez et al. 1999 (3) Orlando et al. 2000 |
| Food Allergen | Labelling / Regulation Status | References |
| International Regulations
Goat's milk and products of these |
labelling not recommended (1) | (1) Codex Alimentarius Commission 1999 |
| European Regulations
Goat's milk and products of these |
labelling not recommended (1) | (1) Bousquet et al. 1998 |