Comparison of Skin Prick Test Results Performed With Raw, Pasteurized and Commercial Cow’s Milk

Yıl 2019, Cilt: 41 Sayı: 1, 1 - 5, 01.01.2019

Hülya Anıl , Koray Harmancı

https://doi.org/10.20515/otd.443472

Öz

Skin prick tests
are the most commonly used method of diagnosing IgE-mediated reactions because
of the high sensitivity and specificity of laboratory tests for allergic
diseases, low cost and rapid response. Although many allergens have an extract
to the commercial standard, skin prick tests made with standardized extracts
are negative in a group of patients who describe reactions with foods, while
positivity was determined by tests of the same foods with natural raw extracts.
In this study, the reactions of raw, pasteurized and commercial extracts were
compared in a skin prick test with children who applied with asthma, allergic
rhinitis, atopic dermatitis and urticaria. Skin prick test was performed with
raw, pasteurized and commercial extracts of the infected cow's cigarette with
allergic disease in our policlinic. The files were reviewed retrospectively.
Presenting symptoms, family history, and 
laboratory findings were obtained from regular medical record. 245 female
(49%) and 255 male (51%) children aged between 0 and 18 years were included in
the study. The mean age was 6.28 ±4.31 years. Of the 500 patients, 46 (9.2%)
had a positive skin prick test positive for raw milk. Skin prick test
positivity was detected in 31 children (6.2%) 
with  pasteurized milk and 20
children with commercial extracts.  There
was no statistically significant difference between the prick test induration
diameters of the children (p> 0.05). According to the pasteurized and
commercial milk extracts, the skin prick tests performed with raw milk extracts
showed more positivity and the positivity in the asthmatic patient group was
found to be higher than the other patient groups.

Anahtar Kelimeler

skin prick test; raw cow’s milk; pasteurized cow’s milk; commercial milk; allergic diseases

Çiğ, Pastörize ve Ticari İnek Sütü Deri Prik Testlerinin Karşılaştırılması

Öz

Birçok alerjenin ticari standardize
ekstresi bulunmasına karşın, besinlerle reaksiyon tarifleyen bir grup hastada,
standardize ekstrelerle yapılan deri prik testleri negatif iken, aynı
besinlerin doğal çiğ ekstreleriyle yapılan testlerinde pozitiflik saptanmıştır.
Bu çalışmada, astım, alerjik rinit, atopik dermatit ve ürtiker tanısı ile
başvuran çocuklara inek sütü ile yapılan deri prik testinde çiğ, pastörize ve
ticari ekstrelerin reaksiyonları karşılaştırılmıştır. Polikliniğimize alerjik
hastalık öyküsüyle başvuran  hastalara
inek sütünün çiğ, pastörize ve ticari ekstreleri ile deri prik testi yapıldı.
Hastaların başvuru şikayetleri, aile öyküleri ve laboratuvar bulguları
dosyalarından incelendi. Çalışmaya yaşları 0 ile 18 yaş arasında değişen 245
kız (%49), 255 erkek (%51) çocuk alındı. Ortalama yaş  6,284,31 yıl olarak saptandı. 500 hastanın,
46’sında   (%9,2) deri prik testinde çiğ
süte karşı pozitiflik saptandı. 31 çocukta 
(%6,2) pastörize süte,  20 çocukta
(%4) standart ekstre  süte karşı
pozitiflik saptandı.  Çocukların prik
test endurasyon çapları arasında istatistiksel fark saptanmadı (p>0,05).
Pastörize ve ticari süt ekstrelerine göre çiğ süt ekstreleriyle yapılan  deri prik testlerinde daha fazla pozitiflik
saptanmış olup,  astımlı hasta grubundaki
pozitiflik, diğer hasta gruplarına göre daha fazla bulunmuştur. 

Anahtar Kelimeler

Deri prik test; çiğ inek sütü; pastörize inek sütü; ticari süt;

Kaynakça

• Kaynaklar1.Dreborg S. Skin testing. The safety of skin tests and the information obtained from using different methods and concentrations of allergen. Allergy 1993;48:473-5.
• 2. Rosen JP, Selcow JE, Mendelson LM, Grodofsky MP, Factor JM, Sampson HA. Skin testing with natural foods in patients suspected of having food allergies:is it a necessity? J Allergy Clin Immunol 1994;93:1068-70.
• 3. Mc Kellar RC, Milk pasteurization. Journ. Dairy Sci 1981; 64:2138- 2145.
• 4. Kessler HG, Verlag A. Food Engineering and Dairy Technology. Verlag A. 1981. Germany.
• 5. Hurrell RA. Prospects for improving the iron fortification of foods. In: Fomon SJ, Slotkin S. eds. Nutritional anemias.1992. Raven Press, New York
• 6. Ortolani C, Ispano M, Pastorello EA, Ansaloni R, Magri GC. Comparison of results of skin prick test (with fresh foods and commercial food extracts) and RAST in 100 patients with oral allergy syndrome. J Allergy Clin Immunol 1989;83:683-90.
• 7. Ancona GR, Schumacher IC. The use of raw foods as skin testing material in allergic disorders. Calif Med 1950;73:473-5.
• 8. Bock SA, Lee WY, Remigio L, Holst A, May CD. Appraisal of skin tests with food extracts for diagnosis of food hypersensitivity. Clin Allergy 1978;8:559-64.
• 9. Maleki SJ, Casillas AM, Kaza U, Wilson BA, Nesbit JB, Reimoneqnue C, et al. Differences among heat-treated, raw, and commercial peanut extracts by skin testing and immunoblotting. Ann Allergy Asthma Immunol 2010;105:451-7.
• 10. Norgaard A, Skov Ps, Bindslev-Jensen C. Egg and milk allegy in adults:comparison between fresh foods and commercial allergen extracts in skin prick test and histamine release from basophils. Clin Exp Allergy 1992;22:940-7.
• 11. Eigemann PA, Cazla AM, Diagnosis of Ig E mediated food allergy among swiss children with atopic dermatitis. Pediatr Allergy Immunol 2000;11:95-100.
• 12. Boyce JA, Assa’ad A, Burks AW, Jones SM, Sampson HA, Wood RA, et al. Guidelines fort the Diagnosis and Management of Food Allergy in the United States; Report of the NIAID- Sponsored Expert Panel. J Allergy Clin Immunol 2010; 126:51-58.
• 13. Baldo, B.A.. Milk allergies. Aust. J. Dairy Tech. 1984;39: 120–128.
• 14. Ehn, B.M., Ekstrand, B., Bengtsson, U., Ahlstedt, S. Modification of IgE binding during heat processing of the cow's milk allergen betalactoglobulin. J. Agric. Food Chem 2004; 52: 1398–1403.
• 15. Davis, P.J., Williams, S.C. Protein modification by thermal processing. Allergy 1998; 53: 102–105.
• 16. Bu, G.H., Luo, Y.K., Zheng, Z., Zheng, H., 2009. Effect of heat treatment on the antigenicity of bovine α-lactalbumin and β-lactoglobulin in whey protein isolate. Food Agric Immunol 2009; 20: 195–206.
• 17.Kleber, N., Maier, S., Hinrichs, J.Antigenic response of bovine β-lactoglobulin influenced by ultra-high pressure treatment and temperature. Innovat. Food Sci. Emerg. Tech 2007; 8: 39–45.
• 18. Hanson, L.A., Mansson, I., 1961. Immune electrophoretic studies of bovine milk and milk products. Acta Pediatr. 50: 480–484.
• 19. Lehmann P, Schmidt K, Goerz G. Food hypersensitivity:skin test with commercial food extracts or natural products? Z Hautkr 1990;65:365-6.
• 20. Norgaard A, Bernard H, Wal Jm, Peltre G, Skov PS, Poulsen LK, Bindslev-Jensen C. Allergenicity of individual cow milk proteins in DBPCFC-positive milk allergic adults. J Allergy Clin Immunol. 1996 ;97-237