Cow's milk allergens (CMA)

Cow's milk allergens are a heterogeneous group of proteins found in bovine milk that trigger immune-mediated hypersensitivity reactions, collectively known as cow's milk allergy (CMA). These allergens are categorized into two main fractions: caseins, which include alpha-s1, alpha-s2, beta, and kappa-caseins (Bos d 8-12), and whey proteins, such as alpha-lactalbumin (Bos d 4) and beta-lactoglobulin (Bos d 5). These proteins are highly stable and resistant to heat and proteolytic digestion, allowing them to maintain their allergenicity within the gastrointestinal tract. CMA is one of the most prevalent food allergies in early childhood, presenting with symptoms ranging from mild urticaria and gastrointestinal distress to severe, life-threatening anaphylaxis. While the standard of care has traditionally been strict dietary avoidance, these allergens are now utilized as the active pharmaceutical ingredients in oral immunotherapy (OIT) to induce clinical desensitization. In such therapies, the allergens are administered in gradually increasing doses to modulate the patient's immune system toward a state of tolerance, often in combination with adjunctive biological therapies like omalizumab or dupilumab to mitigate allergic side effects.

Other names

Cow's milk proteinsBovine milk allergensBos d proteinsCaseinsWhey proteinsAlpha-lactalbumin (Bos d 4)Beta-lactoglobulin (Bos d 5)Bovine serum albumin (Bos d 6)Bovine immunoglobulins (Bos d 7)Casein (Bos d 8)Alpha-s1-casein (Bos d 9)Alpha-s2-casein (Bos d 10)Beta-casein (Bos d 11)Kappa-casein (Bos d 12)Bovine lactoferrin (Bos d 14)

Induction of oral tolerance through gradual desensitization of the immune system by controlled exposure to the allergens (Oral Immunotherapy).