Zhang Guicheng, Lai Ching Tat, Hartmann Peter, Oddy Wendy H, Kusel Merci M H, Sly Peter D, Holt Patrick G
School of Public Health, Curtin University, Perth, WA, Australia.
Pediatr Allergy Immunol. 2014 Oct;25(6):544-51. doi: 10.1111/pai.12265.
The impact of breast milk feeding on susceptibility to asthma in childhood is highly controversial, due in part to failure of the majority of studies in the area to adequately account for key confounders exemplified by respiratory infection history, plus the effects of recall bias.
As part of a prospective cohort study on the role of respiratory infections in asthma development in high-risk children, we measured the concentration of a panel of anti-infective proteins in maternal milk samples and analyzed associations between these and subsequent atopy-, infection-, and asthma-related outcomes prospectively to age 10 years.
We observed significant but transient inverse associations between the concentration of milk proteins and susceptibility to upper respiratory infections in year 1 only, and parallel but positive transient associations with early lower respiratory infections and atopy. No associations were seen with asthma-related outcomes.
Breast milk feeding may influence the expression of inflammatory symptoms associated with respiratory infections and atopy in early life, but these effects appear to be inconsistent and transient. The heterogeneous nature of breast-feeding effects suggests it may influence systemic immunoinflammatory function at several different levels.
母乳喂养对儿童哮喘易感性的影响极具争议，部分原因在于该领域的大多数研究未能充分考虑以呼吸道感染史为代表的关键混杂因素，以及回忆偏倚的影响。
作为一项关于呼吸道感染在高危儿童哮喘发病中作用的前瞻性队列研究的一部分，我们测量了母乳样本中一组抗感染蛋白的浓度，并前瞻性地分析了这些蛋白与随后至10岁时的特应性、感染及哮喘相关结局之间的关联。
我们仅在第1年观察到乳蛋白浓度与上呼吸道感染易感性之间存在显著但短暂的负相关，以及与早期下呼吸道感染和特应性平行但呈正的短暂相关。未发现与哮喘相关结局存在关联。
母乳喂养可能会影响生命早期与呼吸道感染和特应性相关的炎症症状的表达，但这些影响似乎并不一致且是短暂的。母乳喂养效果的异质性表明它可能在几个不同水平上影响全身免疫炎症功能。
