What is Cow's Milk Specific IgE?
Specific IgE to cow's milk is directed against caseins, beta-lactoglobulin, and alpha-lactalbumin. Sensitisation reflects prior allergen exposure and T-helper-2 class switching rather than disease per se; the detected IgE is the circulating counterpart of allergen-bound IgE on mast cells and basophils. Casein-dominant IgE tends to track persistent, heat-stable reactivity, whereas IgE confined to heat-labile whey proteins may accompany tolerance of baked milk.