Russian Journal of AllergyRussian Journal of AllergyРоссийский Аллергологический Журнал1810-88302686-682XPublishing House ABV Press149110.36691/RJA1491ReviewsНаучные обзорыReview ArticleActive tolerance development in allergy to cow-based milk proteinsАктивное формирование толерантности при аллергии на белки коровьего молокаhttps://orcid.org/0000-0002-6701-38722960-6185GalimovaAlbina A.ГалимоваАльбина Альбертовна
Russian Federation

MD, Junior Research Associate

м.н.с.

albina86@yandex.ruhttps://orcid.org/0000-0002-6945-11045222-7651VyazankinaSvetlana S.ВязанкинаСветлана Святославовна
Russian Federation

MD

svsvpav@mail.ruhttps://orcid.org/0000-0002-3056-403X2094-2840MakarovaSvetlana G.МакароваСветлана Геннадиевна
Russian Federation

MD, Dr. Sci. (Med.), Professor

д.м.н., профессор

sm27@yandex.ruhttps://orcid.org/0000-0002-1650-652X3893-9946EreshkoOksana A.ЕрешкоОксана Александровна
Russian Federation

MD, Cand. Sci. (Med.)

к.м.н.

ksenya2005@inbox.ruNational Medical Research Center for Children’s HealthНациональный медицинский исследовательский центр здоровья детейLomonosov Moscow State UniversityМосковский государственный университет имени М.В. Ломоносова24122021141220211841161251110202119122021Copyright ©; 2021, Pharmarus Print MediaCopyright ©; 2021, Фармарус Принт Медиа2021Pharmarus Print MediaФармарус Принт Медиаhttps://rusalljournal.ru/raj/article/view/1491

Food allergy is a potentially life-threatening condition without approved pathogenetic treatments other than eliminating the causal allergen and relief of acute allergic conditions. Immunoglobulin G-mediated form of food allergy remains a serious and growing problem worldwide. Its prevalence is steadily increasing and is a severe psychosocial and economic burden for patients and their families. Cow-based milk and products are important components of a child’s diet, which are introduced at their first year of life, which can cause allergic reactions. The traditional management of children with cow-based milk allergy includes eliminating the dairy-free diet, and a significant number of patients form milk protein tolerance by the age of 5 years. However, with persistent forms of allergy to cow-based milk proteins, the need for “active” tactics of patient management to form tolerance arises. Oral immunotherapy is a promising approach to food allergy treatments based on a gradually increased allergen by analogy with standardized immunotherapy for respiratory allergens until reaching a maintenance dose. Each stage of oral immunotherapy should be considered as a personalized therapy.

This review contains an analysis of available studies on the effectiveness of oral immunotherapy in the treatment of cow-based milk protein allergy.

Пищевая аллергия ― это потенциально опасное для жизни состояние, при котором нет одобренных патогенетических методов лечения, кроме элиминации причинного аллергена и купирования острых аллергических состояний. IgE-опосредованная форма пищевой аллергии остаётся серьёзной проблемой во всём мире. Её распространённость неуклонно растёт и является тяжёлым психосоциальным и экономическим бременем для пациентов и их семей. Коровье молоко и продукты на его основе являются важными компонентами рациона ребёнка, которые вводятся в питание детей первого года жизни, однако могут являться причиной аллергичес-ких реакций. Традиционное ведение детей с аллергией к белкам коровьего молока заключается в назначении элиминационной безмолочной диеты, и значительная часть пациентов формирует толерантность к молочным белкам к возрасту 5 лет. Однако при персистирующих формах аллергии к белкам коровьего молока ставится вопрос о необходимости «активной» тактики ведения пациентов с целью формирования толерантности. Оральная иммунотерапия ― многообещающий подход к лечению пищевой аллергии, основанный на поэтапном увеличении принимаемого продукта до достижения поддерживающей дозы, по аналогии со стандартизированной иммунотерапией к респираторным аллергенам. Каждый этап оральной иммунотерапии следует рассматривать как персонифицированную терапию.

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