Study: Drug plus dairy treats dangerous milk allergy

Pediatrician Kari Nadeau, MD, PhD, is using small doses of milk to desensitize children who are allergic to dairy products.

As the most common food allergy, milk allergy affects millions, including 2.5 percent of children under age 3. While some kids outgrow it, others' life-threatening response to dairy products never subsides.

Nine-year-old Ludovica La Rosa was born into an Italian family but until recently was never able to indulge in favorites like lasagna or pizza because of a life-threatening dairy allergy. Her allergy was so severe that the tiniest trace of milk, found in a piece of cured ham, once sent her into shock.

"Her lips were swelling like crazy," Ludovica's father, Gregorio La Rosa, recalled of the family's trip to the emergency room. "The same thing happened to the mucous membrane in her throat. It was really, really scary."

Last year, Ludovica took part in a clinical trial at Stanford University School of Medicine to test a potential cure for milk allergies. The Stanford scientists, along with colleagues at Children's Hospital Boston, recently reported success in effectively treating the condition. Most of the children who took part in the small study, including Ludovica, are no longer allergic to milk.

As the most common food allergy, milk allergy affects millions, including 2.5 percent of children under age 3. While some kids outgrow it, others' life-threatening response to dairy products never subsides.

The new trial combined desensitization therapy with doses of an immune-system drug. In de-sensitization therapy, patients receive small, gradually increasing doses of an allergy trigger until their bodies become accustomed to it. Previous research showed this method could ameliorate milk allergy, but the process often produced severe reactions in patients.

To circumvent these allergic reactions, Ludovica and the 10 other children in the trial received omalizumab, a drug intended to deactivate the immune-system molecules that caused their allergies. After nine weeks on the drug, the research team began giving the children small quantities of milk protein.

"This drug is like a 'protective blanket,'" said Kari Nadeau, MD, PhD, an assistant professor of pediatrics who led the Stanford portion of the study. "We think it possibly protects subjects from having reactions to food allergens during oral immunotherapy."

The children got omalizumab and milk protein together for 16 weeks. Then the investigators stopped the drug but gave the children daily doses of milk (2,000 mg, or about 2 ounces) for eight more weeks. Nine of the 11 children successfully completed an oral milk challenge, drinking about 8 ounces of milk without an allergic reaction. These children began consuming 8 to 12 ounces of dairy per day to maintain their tolerance.

The next step is to conduct larger studies to refine the therapy and expand its applications. "This treatment could be used for other food allergies as well," said Nadeau, noting that a trial for children with peanut allergy is under way in Boston.

For Ludovica and her family, the resolution of her milk allergy has made life easier. Meals out in restaurants are more relaxing, La Rosa said, since the family doesn't have to be constantly vigilant about her every bite. And Ludovica can indulge in a slice of birthday cake just like any other kid.