Casein allergy K52.2

Casein (Latin caseus "cheese") refers to the protein content of milk. This makes up about 80 % of the total protein content of milk. Together with calcium phosphate, casein forms micelles in milk, which keep the calcium phosphate dissolved and aggregate the milk in the stomach, thus facilitating digestion. The casein content of the milk is processed into cheese and does not enter the whey. It is heat-stable (casein allergy sufferers cannot tolerate even boiled milk!).

A distinction is made between alpha, beta and kappa caseins. Their molecular weights are between 18-25kD. Alpha S1 caseins occur in 5 genetic variants, alpha S2 caseins occur in 4 genetic variants, beta caseins and kappa caseins in 2 genetic variants. Their amino acid sequence is known.

Casein is used to store and transport proteins, calcium and phosphate. Casein is heat stable. 6 major and 3 minor IgE-binding epitopes have been identified. Sensitization to only a single casein fraction is the exception.

Since caseins are not species-specific, allergic reactions are to be expected from the milk of other mammals (especially sheep and goats). The same applies to the various cheese products. In the case of an isolated allergy to cheese products, however, mould sensitisation is usually to be expected.

As casein is a binding and compact substance, it is used in a wide variety of products and applications, such as:

• drinking milk, buttermilk, sour milk, yoghurt, kefir, curd or cheese (particularly high proportions)
• Binder of sausage products

Further into industrially manufactured products like:

• binders and pharmaceutical excipients (caseins are listed in cosmetic products under the INCI designation "casein").
• Colours (casein colours)
• adhesives (especially construction adhesives)
• Jewellery and buttons (made of casein plastic "Galalith")

Insulating materials

The symptoms of casein allergy do not necessarily occur immediately and are therefore often not directly attributable by the person affected. The symptoms are: diarrhoea, stomach pain, flatulence, nausea and even vomiting, listlessness.

Lactose intolerance

Fructose intolerance

Gluten sensitivity

Other food allergies.

In the presence of a casein allergy, dietary measures therapy are mandatory therapeutic measures. Affected persons must abstain from all animal milk products. Thus on cow's milk, goat's milk, mare's milk, camel's milk.

Alternatives to animal milk are vegan products and milk substitutes: soya, oat, almond, rice or coconut milk. The person concerned can test whether cream and butter can be tolerated. These foods have a very low milk protein content and are therefore much better tolerated.

Casein allergy should be distinguished from lactose intolerance. This is an enzyme-induced intolerance to milk sugar (lactose).