Department of Allergy, Skin and Allergy Hospital, Helsinki University Central Hospital, Helsinki, Finland.
Int Arch Allergy Immunol. 2012;159(2):162-70. doi: 10.1159/000336157. Epub 2012 May 31.
Whether breast milk (BM) can protect against allergy has been studied extensively, with conflicting results. Variations in mothers' BM composition may explain some of the conflicting results. Our aim was to assess the impact of maternal allergy and probiotic intervention on BM food antibodies, transforming growth factor (TGF)-β(2) and interleukin (IL)-10 and their impact on allergy development in children until the ages of 2 and 5.
We measured total IgA, IgA antibodies to cow's milk (CM), casein, β-lactoglobulin and ovalbumin (OVA), TGF-β(2) and IL-10 in 364 colostrum samples and 321 BM samples taken at 3 months from mothers participating in a prospective study evaluating the allergy-preventive effect of probiotics in a cohort with an increased risk for allergy.
CM, casein and OVA antibodies, TGF-β(2) and IL-10 were detectable in most samples. Maternal allergy was associated with raised levels of IgA to casein (p = 0.04) and lower levels of TGF-β(2) (p = 0.006) in mature BM. Probiotic supplementation was associated with increased IL-10 (p = 0.046) and decreased casein IgA antibodies (p = 0.027) in mature BM. High OVA IgA antibodies in colostrum were associated with the development of atopy by the age of 2, while low levels in mature BM were a significant risk factor for the development of eczema by the age of 2. TGF-β(2) levels in BM constituted a risk for development of allergy by the age of 2.
The immunologic composition of BM was only slightly affected by maternal atopy and could be altered by probiotic supplementation. Small effects of BM components on allergy development in children were evident.
母乳(BM)是否可以预防过敏已被广泛研究,但结果存在冲突。母乳成分的差异可能解释了部分冲突的结果。我们的目的是评估母亲过敏和益生菌干预对母乳食物抗体、转化生长因子(TGF)-β(2)和白细胞介素(IL)-10 的影响,以及它们对儿童过敏发展的影响,直到 2 岁和 5 岁。
我们测量了 364 份初乳样本和 321 份 3 个月时母亲母乳样本中的总 IgA、牛乳 IgA 抗体、酪蛋白、β-乳球蛋白和卵清蛋白(OVA)、TGF-β(2)和 IL-10。这些母亲参加了一项前瞻性研究,评估益生菌对过敏高风险队列的预防过敏效果。
大多数样本中都可检测到 CM、酪蛋白和 OVA 抗体、TGF-β(2)和 IL-10。母亲过敏与成熟 BM 中酪蛋白 IgA 水平升高(p = 0.04)和 TGF-β(2)水平降低(p = 0.006)有关。益生菌补充与成熟 BM 中 IL-10 增加(p = 0.046)和酪蛋白 IgA 抗体减少(p = 0.027)有关。初乳中 OVA IgA 抗体水平高与 2 岁时特应性的发展有关,而成熟 BM 中 OVA IgA 抗体水平低是 2 岁时湿疹发展的一个显著危险因素。BM 中的 TGF-β(2)水平是 2 岁时过敏发展的危险因素。
母乳的免疫成分仅受母亲过敏的轻微影响,可通过益生菌补充来改变。母乳成分对儿童过敏发展的影响较小。