Recent insights in cow's milk protein allergy: Clinical relevance, allergen features, and influences of food processing

Abstract

Background

Milk allergy, particularly in infants and young children, is primarily triggered by cow's milk proteins. The prevalence of milk allergy is on the rise globally, posing significant health risks to affected individuals. Despite the increasing incidence, effective treatment options remain limited, making the development of low- or non-allergenic dairy products crucial.

Scope and approach

This review synthesizes recent advancements in understanding the structural characteristics and epitopes of major milk protein allergens and their sensitization mechanisms. It also critically evaluates the association between food processing and allergenicity, including traditional methods such as heat treatment and enzymatic hydrolysis, as well as emerging technologies like high-pressure processing, ultrasound, electromagnetic waves, and cold plasma. The primary objective is to systematically compare the effectiveness of these techniques in mitigating cow's milk protein allergenicity, with an emphasis on identifying the most efficacious methods.

Key findings and conclusions

Notable advancements in food processing technologies, paired with a comprehensive understanding of milk protein structures, underscore the potential of innovative, targeted processing techniques to effectively mitigate allergenicity. Among these, microwave-assisted targeted enzymatic hydrolysis emerges as a promising technology that can be scaled up for industrial applications. The insights provided aim to support the development of novel processing methods that can eliminate the immunoreactivity of milk proteins, thereby contributing to the creation of low- or non-allergenic dairy products crucial.