Cow’s milk protein allergy: new knowledge from a multidisciplinary perspective

Abstract

In recent decades, a higher prevalence, persistence, and severity of cow’s milk protein allergy (CMPA) have been observed. Different hypotheses have been proposed in relation to potential responsible mechanisms, with emphasis on the role of the microbiota in the inductionandmaintenanceofimmunetolerance as well as the importance of establishing a healthy microbiota in an early manner through thepromotionofbreastfeeding,vaginaldelivery, rational use of antibiotics and proton pump inhibitors, along with an early introduction of variedfoods.Theuseofprobioticsandallergenspecific immunotherapy (AIT) come up as the treatment strategies with the greatest evidence in favor of tolerance acquisition. The objective of this review was to describe the information currently available about the immunemechanismsinvolvedinCMPA,therole ofmicrobiota,andfuturetreatmentperspectives.