Boix-Amorós Alba, Collado Maria Carmen, Van't Land Belinda, Calvert Anna, Le Doare Kirsty, Garssen Johan, Hanna Heather, Khaleva Ekaterina, Peroni Diego G, Geddes Donna T, Kozyrskyj Anita L, Warner John O, Munblit Daniel
Institute of Agrochemistry and Food Technology, National Research Council (IATA-CSIC), Valencia, Spain.
In-VIVO Global Network, an affiliate of the World Universities Network (WUN), New York, New York, United States.
Nutr Rev. 2019 Aug 1;77(8):541-556. doi: 10.1093/nutrit/nuz019.
A large number of biologically active components have been found in human milk (HM), and in both human and animal models, studies have provided some evidence suggesting that HM composition can be altered by maternal exposures, subsequently influencing health outcomes for the breastfed child. Evidence varies from the research studies on whether breastfeeding protects the offspring from noncommunicable diseases, including those associated with immunological dysfunction. It has been hypothesized that the conflicting evidence results from HM composition variations, which contain many immune active molecules, oligosaccharides, lactoferrin, and lysozyme in differing concentrations, along with a diverse microbiome. Determining the components that influence infant health outcomes in terms of both short- and long-term sequelae is complicated by a lack of understanding of the environmental factors that modify HM constituents and thereby offspring outcomes. Variations in HM immune and microbial composition (and the differing infantile responses) may in part explain the controversies that are evidenced in studies that aim to evaluate the prevalence of allergy by prolonged and exclusive breastfeeding. HM is a "mixture" of immune active factors, oligosaccharides, and microbes, which all may influence early immunological outcomes. This comprehensive review provides an in-depth overview of existing evidence on the studied relationships between maternal exposures, HM composition, vaccine responses, and immunological outcomes.
人乳（HM）中已发现大量生物活性成分，在人体和动物模型研究中均有证据表明，母亲接触某些物质会改变人乳成分，进而影响母乳喂养婴儿的健康结局。关于母乳喂养能否保护后代免受包括免疫功能障碍相关疾病在内的非传染性疾病影响，研究证据并不一致。据推测，相互矛盾的证据源于人乳成分的差异，其中包含多种免疫活性分子、低聚糖、乳铁蛋白和溶菌酶，其浓度各不相同，且伴有多样的微生物群。由于缺乏对改变人乳成分从而影响后代结局的环境因素的了解，确定影响婴儿短期和长期后遗症健康结局的成分变得复杂。人乳免疫和微生物组成的差异（以及不同的婴儿反应）可能部分解释了旨在通过长期纯母乳喂养评估过敏患病率的研究中所存在的争议。人乳是免疫活性因子、低聚糖和微生物的“混合物”，所有这些都可能影响早期免疫结局。本综述全面深入地概述了关于母亲接触物质、人乳成分、疫苗反应和免疫结局之间已研究关系的现有证据。
