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Immunogenicity of cows' milk in man. (Influence of age and of disease on serum antibodies to five cows' milk proteins).

Passive haemagglutination has been used to measure serum antibodies to the five proteins of cows' milk--bovine serum albumin, bovine gamma-globulin, alpha-lactalbumin, beta-lactoglobulin and casein. Titres of antibodies to these proteins, and a composite cows' milk antibody (CMA) score, have been measured in 1,087 sera from children and adults. Antibodies to all five proteins were detected in many specimens. Age and disease influenced not only the absolute titres of antibody, but also the relative distribution of antibodies to the five antigens. In infants aged 2 months the typical pattern was of antibodies only to casein but in the sera of older children and adults antibodies to casein and to BSA were found in low titres and less frequently than antibodies to the other proteins. Children with coeliac disease had higher titres of antibody to bovine gamma-globulin than to other antigens. Serial studies in a patient with cows' milk intolerance illustrate how the pattern of antibodies varies with age, diet and disease.