Tehran University Medical Journal

Background: Cow's milk protein allergy (CMPA) is the most common food allergy during the first year of life. Strict avoidance of specific foods is the only accepted treatment for food-induced allergic reactions. This is often an unrealistic therapeutic option, since cow's milk is a basic food that is extensively used in infant formula. The recent preliminary experience of oral desensitization to cow's milk by Meglio & Patriarca seems promising. The object of this study was to investigate the desensitization of children with CMPA to cow's milk.

Methods: All the patients referred to the Allergology Department of the Children's Medical Center Hospital, Tehran from March 2004 to November 2005 suspected to have CMPA were evaluated. The patients were included in the intervention or control groups of the study. For the intervention group, Meglio's protocol was performed. We observed and examined the control group for at least 6 months. Eventually both groups were reevaluated for the symptoms and persistence of positive specific IgE for cow milk proteins.

Results: We enrolled 20 patients for oral desensitization and 13 patients were enrolled in the control group. Both groups were similar with regard to the mean age, sex and clinical symptoms. In 18 (90%) of the intervention subjects, oral desensitization with cow's milk was successfully performed. The entire protocol was completed by 14 (70%) of the intervention subjects. At the end of the six-month observation period, all the patients in the control group were still symptomatic after ingestion of cow's milk. The levels of specific IgE for cow's milk in the intervention group decreased significantly, which was not observed in the control group.

Conclusion: We successfully desensitized 90% of our CMPA patients. Considering that all the patients in the control group remained symptomatic after the period of observation and our promising results in oral desensitization with cow's milk, we can safely propose this protocol as a hopeful alternative in the treatment of CMPA. We speculate that oral desensitization to cow's milk does not alter the natural outcome of CMPA, but substantially increases the threshold dose necessary to elicit allergic symptoms.

Background: In the treatment of bronchial asthma, the identification, isolation, and elimination of causative allergens is the most effective part of treatment. With the recent diversification within the pet industry, pet owner exposure to many unknown antigens is on the rise. The results of population studies have been contradictory and some epidemiological studies have failed to confirm this, some indicating that keeping pets might actually reduce the risk of sensitization and asthma. The purpose of this study was to determine the association between pet ownership and asthma.

Methods: This case-control study included 300 asthmatic participants referred to the Children's Medical Center over a two-year period. Participants were asked to fill out a questionnaire regarding pet ownership, pet gender and puberty, the place it was kept, how long the pet was kept and the reason for keeping the pet. The same questions were asked from 300 age- and gender-matched nonasthmatic individuals as the control group. Statistical analysis was performed to calculate odds ratios (OR) of asthma morbidity in individuals who kept pets.

Results: The OR for asthma morbidity in patients who kept pets was 2.59 (CI=1.60-4.21 and p>0.001). Financial aim was the most common reason for keeping a pet and most pets were mature and kept outdoors. No significant correlations for pet genders were observed.

Conclusion: This survey provides evidence that pet ownership is an important risk factor for asthma, therefore we suggest that individuals at risk for asthma (atopic individuals) must avoid contact with pets. However, more research in this field in Iran is necessary.