The importance of molecular studies in the diagnosis and
monitoring of IgE-mediated cow’s milk protein allergy in
children: a pilot study

Maria Popielarz; Agnieszka Kowalczyk; Julia Tworowska; Magdalena Żbikowska-Götz; Zbigniew Bartuzi; Aneta Krogulska

doi:10.5114/ada.2025.157979

eISSN: 2299-0046
ISSN: 1642-395X

Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii

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6/2025
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abstract:

Original paper

The importance of molecular studies in the diagnosis and monitoring of IgE-mediated cow’s milk protein allergy in children: a pilot study

Maria Popielarz

¹

,

Agnieszka Kowalczyk

¹

,

Julia Tworowska

¹

,

Magdalena Żbikowska-Götz

²

,

Zbigniew Bartuzi

²

,

Aneta Krogulska

¹

Department of Paediatrics, Allergology and Gastroenterology, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland
Department of Allergology, Clinical Immunology and Internal Diseases, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Poland

Adv Dermatol Allergol 2025; XLII (6): 537–548

DOI: https://doi.org/10.5114/ada.2025.157979

Online publish date: 2026/01/12

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AMA

Popielarz M, Kowalczyk A, Tworowska J, Żbikowska-Götz M, Bartuzi Z, Krogulska A. The importance of molecular studies in the diagnosis and
monitoring of IgE-mediated cow’s milk protein allergy in
children: a pilot study. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii. 2025;42(6):537-548. doi:10.5114/ada.2025.157979.

APA

Popielarz, M., Kowalczyk, A., Tworowska, J., Żbikowska-Götz, M., Bartuzi, Z.,  & Krogulska, A. (2025). The importance of molecular studies in the diagnosis and
monitoring of IgE-mediated cow’s milk protein allergy in
children: a pilot study. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, 42(6), 537-548. https://doi.org/10.5114/ada.2025.157979

Chicago

Popielarz, Maria, Agnieszka Kowalczyk, Julia Tworowska, Magdalena Żbikowska-Götz, Zbigniew Bartuzi,  and Aneta Krogulska. 2025. "The importance of molecular studies in the diagnosis and
monitoring of IgE-mediated cow’s milk protein allergy in
children: a pilot study". Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii 42 (6): 537-548. doi:10.5114/ada.2025.157979.

Harvard

Popielarz, M., Kowalczyk, A., Tworowska, J., Żbikowska-Götz, M., Bartuzi, Z.,  and Krogulska, A. (2025). The importance of molecular studies in the diagnosis and
monitoring of IgE-mediated cow’s milk protein allergy in
children: a pilot study. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, 42(6), pp.537-548. https://doi.org/10.5114/ada.2025.157979

MLA

Popielarz, Maria et al. "The importance of molecular studies in the diagnosis and
monitoring of IgE-mediated cow’s milk protein allergy in
children: a pilot study." Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, vol. 42, no. 6, 2025, pp. 537-548. doi:10.5114/ada.2025.157979.

Vancouver

Popielarz M, Kowalczyk A, Tworowska J, Żbikowska-Götz M, Bartuzi Z, Krogulska A. The importance of molecular studies in the diagnosis and
monitoring of IgE-mediated cow’s milk protein allergy in
children: a pilot study. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii. 2025;42(6):537-548. doi:10.5114/ada.2025.157979.

Introduction
Cow’s milk protein allergy (CMPA) affects up to 3% of the paediatric population. The most reliable diagnostic tool for CMPA is oral food challenge (OFC), which may carry risks for the patient.

Aim
The aim of this study was to assess the usefulness of molecular testing for CMPA in diagnosing and evaluating tolerance acquisition in children with IgE-dependent allergy to this food.

Material and methods
The study included 49 children (average age: 2 years and 8 months) with an IgE-dependent allergy CMPA. Data from medical history was analysed at two time points, including the assessment of allergen-specific IgE (asIgE) against cow’s milk extract, a-lactalbumin, -lactoglobulin, casein, and bovine serum albumin, measured using the fluoroimmunoenzymatic assay (FEIA). Additionally, results from OFC with baked and raw cow’s milk were included.

Results
For both baked and raw milk allergies, the best marker for clinical reactivity was the asIgE level for casein (≥ 7.01 kU/l; AUC = 0.869 for baked milk and ≥ 5.96 kU/l; AUC = 0.710 for raw milk). The optimal asIgE level, measured by FEIA, to assess the risk of anaphylaxis during the OFC with baked milk was ≥ 7.01 kU/l for casein (AUC = 0.60). The marker for anaphylaxis in the course of OFC with raw milk was asIgE for -lactoglobulin ≥ 1.71 kU/l (AUC = 0.724). For monitoring CMPA, the most useful markers were asIgE for casein, milk extract, and both a-lactalbumin and -lactoglobulin.

Conclusions
For both baked and raw milk allergies, the best marker for clinical reactivity remains casein. Testing for cow’s milk allergens using solely molecular methods is insufficient for diagnosing and monitoring CMPA.

keywords:

The importance of molecular studies in the diagnosis and monitoring of IgE-mediated cow’s milk protein allergy in children: a pilot study

Maria Popielarz 1 , Agnieszka Kowalczyk 1 , Julia Tworowska 1 , Magdalena Żbikowska-Götz 2 , Zbigniew Bartuzi 2 , Aneta Krogulska 1

cow’s milk allergy, food allergy, allergen specific immunoglobulin E, oral food challenge, component resolved diagnostics, molecular

Maria Popielarz

¹

,

Agnieszka Kowalczyk

¹

,

Julia Tworowska

¹

,

Magdalena Żbikowska-Götz

²

,

Zbigniew Bartuzi

²

,

Aneta Krogulska

¹