Clinical effectiveness of amino acid formula in infants with severe atopic dermatitis and cow's-milk protein allergy

Introduction: The incidences of food allergies and related allergic diseases have been increasing in the recent years. Objective: The aim of this study is to evaluate clinical effectiveness of dietary intervention with amino acid-based formula (AAF) containing 100% free amino acids in the management of severe CMP allergy and atopic dermatitis (AD). Material and methods: Thirty infants aged from 29 days to 11 months with severe AD (Eczema Area and Severity Index [EASI] score >18) and confirmed CMP allergy were enrolled into the study. Twenty two patients have completed the study. The evaluation AAF's clinical effectiveness was carried out on the 7th, 14th and 28th day after reaching the full daily feeding volume. Results: In infants with severe AD (EASI score >18) the involvement of several organs and systems into the pathological process was typical: i.e. in 68% of the cases the skin symptoms were combined with the impaired function of the gastrointestinal tract and changes in the frequency of bowel movement (constipation, diarrhea), appearance of pathological admixtures in feces (mucus, blood), vomiting, etc. Feeding with AAF was associated with reliable reduction of severity not only of isolated skin (98%) but of combined skin and gastrointestinal manifestations of food allergy (82% of the cases). The formula was well tolerated by infants with severe AD and may be used for exclusive feeding of babies with severe CMP allergy. Conclusions: The described positive treatment effects were obtained with the diet duration of 4 weeks, the optimal period for the elemental diet administration needs further investigation.