{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T13:08:36Z","timestamp":1790687316729,"version":"4.1.0"},"reference-count":0,"publisher":"Esmon Publicidad, SA","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Investig Allergol Clin Immunol"],"published-print":{"date-parts":[[2026,2,5]]},"abstract":"<jats:p>Background: Consuming baked milk (BM) may accelerate tolerance in cow\u2019s milk\u2013allergic (CMA) children. In high-risk patients, controlled BM-based oral food challenge (BM-OFC) is recommended, as the benefits can outweigh the risks of a prolonged exclusion diet.\nObjectives: To identify predictive biomarkers for BM-OFC outcomes in a cohort at high risk of anaphylaxis and compare the OFC thresholds for baked and pasteurized cow's milk protein (CMP).\nMethods: We performed a prospective study of children (\u226512 months to &lt;6 years) with a history of CMA. Testing at diagnosis involved prick testing, specific IgE (sIgE) for CM and components, sIgG4, and the basophil activation test (BAT). Patients underwent a BM-OFC aiming for a cumulative dose of 1 g of CM protein. BM-tolerant children subsequently underwent a CM-OFC to confirm CMA.\nResults: The study population comprised 50 patients (66% with a history of anaphylaxis). A reaction was recorded during BM-OFC in 36% of patients (39% with anaphylaxis). The median reactivity threshold was 138 mg of CMP. Risk factors for BM allergy included history of anaphylaxis, age &gt;3 years, elevated CM-sIgE and casein-sIgE, and a positive BAT result. The cut-offs were as follows: &gt;5 mm for skin prick testing with casein, \u22658.5 kUA\/L for CM-sIgE, and \u22655.7 kUA\/L for casein-sIgE. These made it possible to distinguish BM-allergic patients from CMA patients who tolerated BM. Among BM-tolerant patients, the CM-OFC threshold was 270 mg, with 43.8% reacting to &lt;100 mg (40% with anaphylaxis).\nConclusions: BM-OFC is not risk-free. Nevertheless, two-thirds of high-risk CMA children were BM-tolerant and benefited from early introduction of BM products. Patient selection can be guided by biomarkers and a prior history of anaphylaxis to baked goods. The reactivity threshold to pasteurized milk was less than half of the tolerated dose of BM (1000 mg).<\/jats:p>","DOI":"10.18176\/jiaci.1074","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T10:02:44Z","timestamp":1771322564000},"page":"36-46","source":"Crossref","is-referenced-by-count":4,"title":["Biomarkers of Tolerance to Baked Milk in Cow\u2019s Milk\u2013Allergic Children at High Risk of Anaphylaxis"],"prefix":"10.18176","volume":"36","author":[{"given":"Olga","family":"Dom\u00ednguez","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Riggioni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabet","family":"Poyatos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"Jim\u00e9nez-Feijoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Piquer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana","family":"Machinena","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar","family":"Folqu\u00e9","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I\u00f1aki","family":"Ortiz de Landazuri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Torradeflot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime","family":"Lozano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laia","family":"Alsina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariona","family":"Pascal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Montserrat","family":"Alvaro-Lozano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"7491","published-online":{"date-parts":[[2026,2,17]]},"container-title":["Journal of Investigational Allergology and Clinical Immunology"],"original-title":["English"],"deposited":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T10:02:45Z","timestamp":1771322565000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jiaci.org\/summary\/vol36-issue1-num3214"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,5]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,2,17]]},"published-print":{"date-parts":[[2026,2,5]]}},"URL":"https:\/\/doi.org\/10.18176\/jiaci.1074","relation":{},"ISSN":["1018-9068","1698-0808"],"issn-type":[{"value":"1018-9068","type":"print"},{"value":"1698-0808","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,5]]}}}