Cow milk allergy: Its clinical aspects, mechanisms, and innovative mitigation strategies beyond enzymatic hydrolysis

Min He, Jun Hu, Jiaxin Deng et al. Journal of Functional Foods, Volume 130, 2025, 106933. 

Highlights

• The current understanding of cow milk allergy is presented.

• The role of enzymatic hydrolysis against allergenicity and its limitations are described.

• More effective innovative strategies that can degrade cow milk allergens are discussed.

Abstract: 

Graphical abstract

Cow milk allergy (CMA) is one of the most common food allergies. Traditional methods for reducing milk allergenicity, such as enzymatic hydrolysis, have limitations, including incomplete allergen degradation and the potential for residual allergenicity. This review aims to provide the current understanding of CMA, including its risk factors, allergen profile, immune mechanisms, and management strategies. It then examines the role of enzymatic hydrolysis in mitigating allergenicity, its applications, and its inherent limitations.

Exploring the Association Between Vitamin D and IL-10 in Allergic Parthenium Contact Dermatitis Patients

Xavier A, Selvarajan S, Das S, et al. (June 07, 2025) Cureus 17(6): e85515. doi:10.7759/cureus.85515

Abstract

Introduction

The imbalance between pro- and anti-inflammatory mediators was suggested to be a contributory factor to the manifestations of allergic parthenium dermatitis. Inadequate circulating vitamin D and IL-10 levels can significantly influence the course of this allergic dermatitis.

Objective

The objective was to study the association between circulating IL-10 levels and vitamin D status in patients with parthenium dermatitis.

Materials and methods

Patients attending the dermatitis clinic were screened for eligibility, and 88 individuals were recruited.

Prevalence, Change and Burden of Systemic Corticosteroid Use in Type 2 Inflammation Associated Diseases Over 25 Years – A Nationwide Danish Study

Håkansson KEJ, Skov IR, Andersen SAW et al. J Asthma Allergy. 2025;18:967-981

https://doi.org/10.2147/JAA.S525508

Background: Systemic corticosteroid use in type 2 inflammation-associated diseases including asthma, atopic dermatitis, allergic rhinitis, and chronic rhinosinusitis has been associated with adverse outcomes, and corticosteroid-sparing treatments are available.

Objective: Assess temporal changes in systemic corticosteroid use and the impact of type 2 inflammation multimorbidity (eg multiple concurrent type 2 inflammation-associated diseases) and specialist assessment on systemic corticosteroid exposure.
Methods: Using nationwide databases, all Danish adults with asthma, atopic dermatitis, allergic rhinitis, or chronic rhinosinusitis, based on hospital diagnoses or redeemed prescriptions between 1997 and 2021 were included in an open, serial cross-sectional cohort.

Changes of (A) prevalence of systemic corticosteroid (SCS) use and
(B) absolute number of systemic corticosteroid users in a cohort of
1,616,609 Danish adults with monomorbid type 2
inflammation-associated disease

Results: Over 25 years, a total of 2,151,209 Danish adults were included. Of those with a single diagnosis (type 2 inflammation monomorbidity),13.9% had asthma, 19.2% allergic rhinitis, 52.9% atopic dermatitis, and 14.0% chronic rhinosinusitis. In terms of type 2 inflammation multimorbidity, 75.1% of included individuals had one, 21.3% two and 3.5% three diagnoses, respectively.

Practical Algorithm on Topical Treatment of Flaring Atopic Dermatitis (AD) With or Without Secondary Infection

Schachner LA, Hebert AA, Sidbury R, et al. J Drugs Dermatol. 2025;24(6):621-630. doi:10.36849/JDD.8967

Abstract

Acute exacerbations or flares are a key characteristic of atopic dermatitis (AD), often associated with sleep deprivation, as well as experiences of stigmatization, social withdrawal, anxiety, and depression. Local skin colonization with Staphylococcus aureus (SA) is a key contributor to AD, particularly to AD flares. Treating SA-driven active AD, especially in cases where skin that is secondarily infected complicates management, calls for a carefully balanced approach that serves to calm AD activity and clear local infection and SA related colonization.

The methodological approach included a systematic literature review to inform an expert panel before a face-to-face meeting to develop a practice-based algorithm for managing AD flares with or without secondary infection. A panel of nine experts in dermatology, including both Board-certified dermatologists and pediatric dermatologists, engaged in a discussion followed by an online review to refine the algorithm and to provide clear guidance on the topical treatment of flaring AD with or without AD skin that is secondarily infected.

Sputum quality affects assessment of airway microbiology in childhood asthma

Taylor, S.L., Brooks, C.R., Elms, L. et al. Respir Res 26, 209 (2025). https://doi.org/10.1186/s12931-025-03266-x

Abstract

Background

The analysis of sputum is the principal basis for characterising lower airway microbiology in those with chronic respiratory conditions. For such analysis to be informative, samples that poorly reflect the lower airways must be identified and removed. Our cross-sectional study explored the relationship between the quality of sputum samples and their microbiological content. We further investigated the impact of excluding low quality samples on observed microbiota-disease relationships in childhood asthma.

Methods

Induced sputum was collected from children with or without asthma. Sputum quality was assessed according to squamous cell%, cell viability%, detection of sputum plugs, and salivary α-amylase levels.

Understanding the atopic dermatitis-psoriasis phenotypic switch through a mechanistic epidemiology approach

Kerry Yang, Alexandra Mircescu, Deborah Okusanya, Samiha Mohsen, Danlin Zeng, Sonia Czyz, Isabelle Vallerand, Giovanni Damiani, Christopher G. Bunick, Fatemeh Jafarian. medRxiv 2025.05.25.25328309; doi: https://doi.org/10.1101/2025.05.25.25328309

Abstract

Atopic Dermatitis (AD) and psoriasis (PsO) are two frequent dermatologic conditions that may co-occur in a cluster of patients, yet current understanding of how these two conditions relate to one-another remains poorly understood. One way to better understand their relationship is through a process called phenotypic switching, where AD and PsO can turn into one another. We utilized a pharmacovigilance-based epidemiological approach to better understand this phenomenon. By generating adverse event-related disproportionality signals for various therapies and therapeutic classes used in AD and PsO, several potential mechanisms for the AD-PsO phenotypic switch were uncovered.

Effectiveness and Safety of Respiratory Syncytial Virus Vaccine for US Adults Aged 60 Years or Older

Anderer S.  JAMA. Published online May 30, 2025. doi:10.1001/jama.2025.7762

Key Points

Question  What is the effectiveness of vaccines against respiratory syncytial virus (RSV) among older adults and at-risk subgroups, and are there major adverse events associated with vaccination?

Findings  In this case-control study of 787 822 patients tested for RSV, vaccine effectiveness was approximately 75% among adults aged 60 years or older against RSV-associated acute respiratory infection, urgent care or emergency visits, or hospitalization; effectiveness was less but still substantial among immunocompromised patients. An estimated excess of 11.2 cases of Guillain-Barré syndrome followed administration per 1 000 000 doses of RSV vaccine.

Meaning  These findings suggest that RSV vaccination of older patients is effective even for most immunocompromised patients, but diagnoses of Guillain-Barré syndrome are increased after vaccination.

Abstract

Importance  Respiratory syncytial virus (RSV) is associated with hospitalization and death among older adults.

Uveitis in Adults: A Review

Maghsoudlou P, Epps SJ, Guly CM, Dick AD.  JAMA. Published online May 28, 2025. doi:10.1001/jama.2025.4358

Clinical Features of Uveitis

Abstract

Importance  Uveitis is characterized by inflammation of the uvea—the middle portion of the eye composed of the iris, ciliary body, and choroid—causing eye redness, pain, photophobia, floaters, and blurred vision. Untreated uveitis may cause cataracts, glaucoma, macular edema, retinal detachment, optic nerve damage, and vision loss.

Observations  Uveitis predominantly affects individuals aged 20 to 50 years. Anterior uveitis affects the iris and ciliary body (41%-60% of cases); intermediate uveitis affects the pars plana (attachment point of vitreous humor) and peripheral retina (9%-15%); posterior uveitis involves the choroid and/or retina (17%-23%); and panuveitis involves all uveal layers (7%-32%).