Observational studyNutrients2025
Clinical Phenotypes of Severe Cow's Milk Protein Allergy with Various Responses to Amino Acid-Based Formula.
Observational study in Nutrients, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe symptoms of cow's milk allergy (CMA) can vary widely in severity and course, so diagnosis and treatment are still challenging.
objectiveThis study aims to establish the phenotype of severe CMA in children with the greatest improvement following the application of amino acid-based formula (AAF).
methodsThis is a post hoc analysis of data from the multicenter, real-life study assessing the clinical effectiveness of a 5-week AAF intervention in 232 infants with severe CMA. A cluster analysis based on symptom severity at the 1st visit was performed. The differences in the severity scale of each symptom before and after the intervention were assessed and compared within and between clusters. The clustering results were validated in a separate cohort of infants with CMA (n = 157).
resultsThree clusters were identified: cluster A (38.8% of patients) with moderate-to-severe gastrointestinal symptoms, cluster B (34.1%) with severe skin symptoms, and cluster C (25.9%) with combined moderate-to-severe gastrointestinal and severe skin symptoms. In the validation cohort, three clusters with the same pattern of symptoms were observed among children with moderate-to-severe CMA. The multivariate model of linear regression showed that severity score reductions after AAF treatment were significantly higher in cluster C than in clusters A and B, in children with a positive family history of allergy, and in children with growth retardation at baseline.
conclusionSymptoms of severe CMA in children are grouped into three distinct phenotypes-gastrointestinal, skin, and combined gastrointestinal and skin. The most significant improvement after AAF implementation was obtained in patients with a combined phenotype.
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