Cow’s Milk Allergy Prevention: It takes 2 to build tolerance

T cell epitopes and specific dietary synbiotics – together towards early life cow’s milk allergy prevention: takes two to build tolerance

23rd April 2018: Today, during World Allergy Week, Atanaska Kostadinova will publicly defend her PhD thesis highlighting the potential to induce oral tolerance through controlled exposure to protein fragments or peptides and the use of a prebiotic alone, or a synbiotic combination of pre- and pro-biotics. In addition, the utilisation of a novel delivery system to enhance bioavailability of the peptides will be discussed

For many years, the primary focus of allergy management has been allergen avoidance, however increasing evidence supports a different nutritional approach to allergy management

Cow’s Milk Allergy and the allergic march

The prevalence of allergic diseases is rising dramatically worldwide, affecting 30–40% of the global population. Although most infants with CMA outgrow their allergy by school age, an increasing number may have persistent symptoms or develop other, secondary allergies later in life – also referred to as the ‘allergic march’. For many years, the primary focus of allergy management has been allergen avoidance, however increasing evidence supports an active approach to develop oral tolerance. This can have a broader impact than simple symptom resolution, benefitting health in later life. More information on allergy and its dietary management can be found here

A combined nutritional approach to Cow’s Milk Allergy prevention

In her thesis Atanaska demonstrated that a combination of a hydrolyzed whey protein and unique non-digestible oligosaccharides elicits a stronger preventive effect than the isolated individual ingredients. Likewise, the allergic response was reduced when specific T cell epitope-containing peptides from β-Lactoglobulin (one of the main allergenic proteins in cow’s milk) were administered to mice in parallel with a diet containing short- and long-chain oligosaccharides and Bifidobacterium breve M-16V prior to allergic sensitization. In addition, the use of a novel delivery system based on poly(lactic-co-glycolic acid) (PLGA) also facilitated the T cell-epitope containing peptides to partially prevent the whey-induced allergic skin response.

This interesting thesis highlights several dietary interventions which might support the development of oral tolerance and contribute to future CMA prevention strategies.


Atanaska’s promotor is prof. dr. J Garssen, Professor of Immunopharmacology of Nutrition at Utrecht University and Research Director Immunology, Danone Nutricia Research, The Netherlands, and co-promotors are dr. L.M.J. Knippels, Utrecht University, Division of Pharmacology and Danone Nutricia Research, The Netherlands and dr. L.E.M. Willemsen, Division of Pharmacology Utrecht University.



Date and time public defence: Monday 23rd April 2018 at 14:30 hrs.

Location: The Academiegebouw, Utrecht, The Netherlands.

Before the ceremony a symposium with international speakers will be organized starting at 9.00 am Lecture room M2.01, David de Wied Building, Utrecht University.

Find out more about the symposium here

Find out more about the thesis here

Find out more about Danone Nutricia Research’s work on allergy here