1.1 Subjects with Atopic or Other Diseases
| Country / Subjects | Sensitivity / Allergy to | References |
| France, Gif Sur Yvette / Paris
58 patients with CMA and specific IgE to bovine CAS |
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, Pierre Benite
a) 580 patients with adverse reactions to food b) 60 cases of anaphylaxis (study period 1984-92) |
a) cow's milk 18%
b) ewe's milk (sheep's milk) 1.7%, cow's milk 3.3% |
Andre et al. 1994 |
| 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 |
| Symptoms & Case Reports | References |
| systemic reactions
anaphylaxis (1, 3), anaphylactoid reaction (6) cutaneous symptoms
gastrointestinal symptoms
respiratory symptoms
|
(1) Andre et al. 1994
(2) Wüthrich & Johansson 1995 (3) Calvani & Alessandri 1998 (4) Fiocchi et al. 1999 (5) Umpierrez et al. 1999 (6) Orlando et al. 2000 |
3 Diagnostic Features of Sheep's Milk
Allergy
| Parameters / Subjects | Outcome | References |
| 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 [14 kDa] | Swiss-Prot: P09462 | Docena et al. 2002 | |
| beta-Lactoglobulin [18 kDa] | Swiss-Prot: P02757 | Docena et al. 2002 | |
| Serum Albumin [67 kDa] | Swiss-Prot: P14639 | Fiocchi et al. 1995, Docena et al. 2002 | |
| Caseins [22-31 kDa] | Swiss-Prot:
P04653 (alpha-S1) P04654 (alpha-S2) P11839 (beta) P02669 (kappa) |
Umpierrez et al. 1999, Docena et al. 2002 |
| Cross-Reacting Allergens | Subjects / Methods | References |
| Sheep's Milk
cow's and goat'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 |
| Sheep's Milk
cow's, goat'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 |
| Sheep'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 |
| Sheep'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 |
| Sheep'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 |
| Sheep'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 |
| Sheep'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 |
| Sheep'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 |
| Inhalation of Proteins
A young man with IgE-mediated allergy to milk, caseins, and beta-lactoglobulin experienced respiratory crisis every time he milked his sheep (1) |
(1) Vargiu et al. 1994 |
| 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 |
| Sheep's Cheese
Several anaphylactic reactions after ingestion of food containing "pecorino" cheese made from sheep's milk in a 5-year-old atopic boy unaffected by cow's milk protein allergy (1) |
(1) Calvani & Alessandri 1998 |
| Mozarella / Ricotta / Parmesan Cheese
Asthma, urticaria and rhinitis in a boy with atopic dermatitis after ingestion of mozarella cheese made from ewe's and cow's milk; several allergic reactions after ingestion of ricotta cheese containing ewe's milk and parmesan cheese made from cow's milk, respectively (1) |
(1) Fiocchi et al. 1999 |
| Food Allergen | Labelling / Regulation Status | References |
| International Regulations
Sheep's milk and products of these |
labelling not recommended (1) | (1) Codex Alimentarius Commission 1999 |
| European Regulations
Sheep's milk and products of these |
labelling not recommended (1) | (1) Bousquet et al. 1998 |