Division of Pediatric Allergy and Immunology & Center for Food Allergy, University of Rochester School of Medicine and Dentistry, Rochester, New York.
Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, New York.
Ann Allergy Asthma Immunol. 2019 Aug;123(2):133-143. doi: 10.1016/j.anai.2019.04.022. Epub 2019 Apr 29.
To summarize the literature on immunomodulatory effects of breast milk on sensitization and possible mechanisms of action.
Animal and human studies in PubMed that assessed breastfeeding or breast milk composition in food allergy.
All recent studies and some older key publications focusing on this topic.
Human milk composition is highly variable among mothers, which can affect the developing infant immune system. Human milk also affects the infant gut microbiome, which is associated with food allergy. High levels of human milk immune factors (IgA, cytokines, oligosaccharides) are associated with reduced risk of food allergy in the infant; it remains uncertain whether these are directly protective or biomarkers of transferred protection. Animal studies highlight potential mechanisms of protection provided by antigens, transforming growth factor β, and immunocomplexes, yet their relevance is poorly understood in humans. The role of food antigens in human milk in initial sensitization or tolerance induction is unclear.
The protection against allergy development provided by human milk may be attributable to the effect on the infant gut microbiome or direct effects on immune system. Studies evaluating the effect of breastfeeding and human milk composition on food allergy are needed.
总结母乳对致敏的免疫调节作用的文献，并探讨其可能的作用机制。
在 PubMed 中检索评估母乳喂养或母乳成分与食物过敏的关系的动物和人类研究。
所有近期的研究和一些关注该主题的较老的关键出版物。
母乳成分在母亲之间差异很大，这可能会影响发育中的婴儿免疫系统。母乳还会影响婴儿肠道微生物群，而肠道微生物群与食物过敏有关。高水平的母乳免疫因子（IgA、细胞因子、低聚糖）与婴儿食物过敏风险降低相关；但尚不确定这些是直接保护作用还是保护作用转移的生物标志物。动物研究强调了抗原、转化生长因子β和免疫复合物提供的潜在保护机制，但这些在人类中的相关性尚不清楚。母乳中食物抗原在初始致敏或诱导耐受中的作用尚不清楚。
母乳对过敏发展的保护作用可能归因于对婴儿肠道微生物群的影响或对免疫系统的直接影响。需要研究评估母乳喂养和母乳成分对食物过敏的影响。
