Alérgenos de leche de vaca: características moleculares y relevancia clínica
DOI:
https://doi.org/10.22529/me.2025.10(4)02Palabras clave:
proteínas, alergia alimentaria, pronósticoResumen
La leche de vaca es un alimento de alto valor nutricional y ampliamente consumido por personas de todas las edades. Así como se conocen sus propiedades beneficiosas también se sabe que puede desencadenar enfermedades inmuno-mediadas, siendo la alergia a la proteína de leche de vaca (APLV) una de las alergias alimentarias más frecuente. Los alérgenos de la leche de vaca son las caseínas y las proteínas del suero, entre las que se encuentran β-lactoglobulina (β-LG), α-lactoalbúmina (α-LA), albúmina sérica bovina (BSA), lactoferrina (LF) e inmunoglobulinas (Igs). Se ha demostrado que la persistencia de esta enfermedad está estrechamente vinculada al perfil de sensibilización predominante del paciente, dado las diferentes características moleculares de los alérgenos.Descargas
Referencias
Boyce JA, Assa'ad A, Burks AW, Jones SM, Sampson HA, Wood RA, et al. Guidelines for the diagnosis and management of food allergy in the United States. J Allergy Clin Immunol 2010;126(6 0): S1-58.
Purser SEM, Jones CJ, Protudjer JLP, Herbert LJ, Screti C, Roleston C, et al. Associations with food allergy‐related psychological distress in a global sample of adults, children and caregivers. Clin Transl Allergy 2025;15(6): e70071. https://doi.org/10.1002/clt2.70071 DOI: https://doi.org/10.1002/clt2.70071
Warren C, Nimmagadda SR, Gupta R, Levin M. The epidemiology of food allergy in adults. Ann Allergy Asthma Immunol 2023;130(3):276-87. https://doi.org/10.1016/j.anai.2022.11.026 DOI: https://doi.org/10.1016/j.anai.2022.11.026
Arasi S, Cafarotti A, Fiocchi A. Cow's milk allergy. Curr Opin Allergy Clin Immunol 2022;22(3):181-7. ttps://doi.org/10.1097/ACI.0000000000000823 DOI: https://doi.org/10.1097/ACI.0000000000000823
Santos AF, Riggioni C, Agache I, Akdis CA, Akdis M, Alvarez-Perea A, et al. EAACI guidelines on the management of IgE-mediated food allergy. Allergy. 2025;80(1):14-36. https://doi.org/10.1111/all.16345 DOI: https://doi.org/10.1111/all.16345
Allen KJ, Koplin JJ. The epidemiology of IgE-mediated food allergy and anaphylaxis. Immunol Allergy Clin North Am 2012;32(1):35-50.
https://doi.org/10.1016/j.iac.2011.11.008 DOI: https://doi.org/10.1016/j.iac.2011.11.008
Program HF. The FASTER Act: Sesame Is the Ninth Major Food Allergen. FDA [Internet]. 25 de febrero de 2025 [citado 24 de septiembre de 2025]; Disponible en: https://www.fda.gov/food/food-allergies/faster-act-sesame-ninth-major-food-allergen
Sicherer SH, Sampson HA. Food allergy: A review and update on epidemiology, pathogenesis, diagnosis, prevention, and management. J Allergy Clin Immunol 2018;141(1):41-58. https://doi.org/10.1016/j.jaci.2017.11.003 DOI: https://doi.org/10.1016/j.jaci.2017.11.003
Johansson SGO, Hourihane J o'b, Bousquet J, Bruijnzeel-Koomen C, Dreborg S, Haahtela T, et al. A revised nomenclature for allergy: An EAACI position statement from the EAACI nomenclature task force. Allergy 2001;56(9):813-24. https://doi.org/10.1034/j.1398-9995.2001.t01-1-00001.x DOI: https://doi.org/10.1034/j.1398-9995.2001.t01-1-00001.x
Lucas JSA, Atkinson RG. What is a food allergen? Clin Exp Allergy J Br Soc Allergy Clin Immunol 2008;38(7):1095-9. https://doi.org/10.1111/j.1365-2222.2008.02988.x DOI: https://doi.org/10.1111/j.1365-2222.2008.02988.x
Wal JM. Cow's milk proteins/allergens. Ann Allergy Asthma Immunol 2002;89(6 Suppl 1):3-10. https://doi.org/10.1016/S1081-1206(10)62115-1 DOI: https://doi.org/10.1016/S1081-1206(10)62115-1
Pomés A, Davies JM, Gadermaier G, Hilger C, Holzhauser T, Lidholm J, et al. WHO/IUIS Allergen Nomenclature: Providing a common language. Mol Immunol 2018; 100:3-13. https://doi.org/10.1016/j.molimm.2018.03.003 DOI: https://doi.org/10.1016/j.molimm.2018.03.003
Argentina.gob.ar [Internet]. 2018 [citado 23 de septiembre de 2025]. Código Alimentario Argentino. Disponible en: https://www.argentina.gob.ar/anmat/codigoalimentario
Geiselhart S, Podzhilkova A, Hoffmann-Sommergruber K. Cow's milk processing-friend or foe in food allergy? Foods Basel Switz 2021;10(3):572. https://doi.org/10.3390/foods10030572 DOI: https://doi.org/10.3390/foods10030572
Dramburg S, Hilger C, Santos AF, de las Vecillas L, Aalberse RC, Acevedo N, et al. EAACI Molecular Allergology User's Guide 2.0. Pediatr Allergy Immunol 2023;34(S28): e13854.
Muraro A, Werfel T, Hoffmann-Sommergruber K, Roberts G, Beyer K, Bindslev-Jensen C, et al. EAACI food allergy and anaphylaxis guidelines: diagnosis and management of food allergy. Allergy 2014;69(8):1008-25. https://doi.org/10.1111/all.12429 DOI: https://doi.org/10.1111/all.12429
Fiocchi A, Bouygue GR, Albarini M, Restani P. Molecular diagnosis of cow's milk allergy. Curr Opin Allergy Clin Immunol 2011;11(3):216-21. https://doi.org/10.1097/ACI.0b013e32834694ef DOI: https://doi.org/10.1097/ACI.0b013e32834694ef
Cuomo B, Indirli GC, Bianchi A, Arasi S, Caimmi D, Dondi A, et al. Specific IgE and skin prick tests to diagnose allergy to fresh and baked cow's milk according to age: a systematic review. Ital J Pediatr 2017; 43:93. https://doi.org/10.1186/s13052-017-0410-8 DOI: https://doi.org/10.1186/s13052-017-0410-8
Tosca MA, Schiavetti I, Olcese R, Trincianti C, Ciprandi G. Molecular allergy diagnostics in children with cow's milk allergy: Prediction of oral food challenge response in clinical practice. J Immunol Res 2023; 2023:1129449. https://doi.org/10.1155/2023/1129449 DOI: https://doi.org/10.1155/2023/1129449
Foong RX, Dantzer JA, Wood RA, Santos AF. Improving diagnostic accuracy in food allergy. J Allergy Clin Immunol Pract 2021;9(1):71-80. https://doi.org/10.1016/j.jaip.2020.09.037 DOI: https://doi.org/10.1016/j.jaip.2020.09.037
