Heated Milk Desensitization Shows No Benefit and Higher Anaphylaxis Risk in Cow's Milk Allergy: Study
A small prospective, double-blind study in children with IgE-mediated cow's milk allergy (CMA) found that heated cow's milk desensitization offers no clear immunologic advantage over conventional raw milk oral immunotherapy. Both approaches resulted in similar reductions in IgE levels; however, the heated milk group experienced a substantially higher rate of anaphylaxis (50%) compared to the raw milk group (15.4%). These findings suggest that heated milk desensitization does not improve efficacy and may increase safety risks in pediatric cow’s milk allergy management. The study was published in the Iranian Journal of Asthma Allergy and Immunology by Masoud M. and colleagues.
This trial was conducted to analyze and compare the immunologic effects of desensitization using heated cow’s milk products versus conventional desensitization with raw milk in children above 2 years suffering from IgE-mediated cow’s milk allergy.
This study was a double-blind, prospective trial that took place at the allergy department of the Children’s Medical Center between 2016 and 2017. A total of 25 patients, aged 2 years or older, with a proven IgE-mediated cow’s milk allergy, participated in the study. Patients were allocated to one of two groups, either traditional desensitization to raw milk (n=13) or to heated cow’s milk products (n=12), administered as part of desensitization therapy. The median age of participants in the raw group was 3.92 ± 1.44 years, and those in the heated group were 4.50 ± 1.73 years. Clinical symptoms as well as immunologic changes, such as blood levels of IgE, eosinophilia, and regulatory T-cells, were measured before and after the treatment protocol.
Key Results
• The incidence of anaphylaxis was higher in the heated milk group than in the raw milk group (50% versus 15.4%).
• The incidence of urticaria and angioedema did not significantly differ between the two groups.
• The level of serum IgE was reduced following desensitization in both groups; there was no significant difference between the two.
• The proportion of CD4+Foxp3+ regulatory T cells and CD4+CD25+ cells increased in both treatment groups; however, the value of change was smaller in the heated milk group and did not achieve statistical significance.
• The number of eosinophils was greater in the heated milk group than in the raw milk group following desensitization; however, there was no statistical significance.
Heated cow’s milk product desensitization did not show any appreciable immunologic or clinical benefit over the standard desensitization method in children with cow’s milk allergy. The result indicates the lack of any significant effect of heated milk on the IgE levels, eosinophil counts, or regulation of regulatory T-cell response in comparison to standard desensitization regimens. Larger clinical trials would be appropriate to validate the current observation and provide a better understanding of the effects of desensitization using heated cow’s milk.
Reference:
Movahedi, M., Bahraminia, E., & Amirzargar, A. (2025). Comparison of Oral Desensitization with Heated Cow's Milk Products with Conventional Desensitization Method in Children with Cow's Milk Allergy. Iranian journal of allergy, asthma, and immunology, 24(6), 734–740.https://doi.org/10.18502/ijaai.v24i6.20152
