Miles Elizabeth A, Childs Caroline E, Calder Philip C
Faculty of Medicine, School of Human Development and Health, University of Southampton, Southampton SO16 6YD, UK.
Institute for Life Sciences, University of Southampton, Southampton SO17 1BJ, UK.
Nutrients. 2021 Jan 16;13(1):247. doi: 10.3390/nu13010247.
The immune system is complex: it involves many cell types and numerous chemical mediators. An immature immune response increases susceptibility to infection, whilst imbalances amongst immune components leading to loss of tolerance can result in immune-mediated diseases including food allergies. Babies are born with an immature immune response. The immune system develops in early life and breast feeding promotes immune maturation and protects against infections and may protect against allergies. The long-chain polyunsaturated fatty acids (LCPUFAs) arachidonic acid (AA) and docosahexaenoic acid (DHA) are considered to be important components of breast milk. AA, eicosapentaenoic acid (EPA) and DHA are also present in the membranes of cells of the immune system and act through multiple interacting mechanisms to influence immune function. The effects of AA and of mediators derived from AA are often different from the effects of the n-3 LCPUFAs (i.e., EPA and DHA) and of mediators derived from them. Studies of supplemental n-3 LCPUFAs in pregnant women show some effects on cord blood immune cells and their responses. These studies also demonstrate reduced sensitisation of infants to egg, reduced risk and severity of atopic dermatitis in the first year of life, and reduced persistent wheeze and asthma at ages 3 to 5 years, especially in children of mothers with low habitual intake of n-3 LCPUFAs. Immune markers in preterm and term infants fed formula with AA and DHA were similar to those in infants fed human milk, whereas those in infants fed formula without LCPUFAs were not. Infants who received formula plus LCPUFAs (both AA and DHA) showed a reduced risk of allergic disease and respiratory illness than infants who received standard formula. Studies in which infants received n-3 LCPUFAs report immune differences from controls that suggest better immune maturation and they show lower risk of allergic disease and respiratory illness over the first years of life. Taken together, these findings suggest that LCPUFAs play a role in immune development that is of clinical significance, particularly with regard to allergic sensitisation and allergic manifestations including wheeze and asthma.
它涉及多种细胞类型和众多化学介质。不成熟的免疫反应会增加感染易感性，而免疫成分之间的失衡导致耐受性丧失则会引发包括食物过敏在内的免疫介导疾病。婴儿出生时免疫反应不成熟。免疫系统在生命早期发育，母乳喂养可促进免疫成熟，预防感染，并可能预防过敏。长链多不饱和脂肪酸（LCPUFA）花生四烯酸（AA）和二十二碳六烯酸（DHA）被认为是母乳的重要成分。AA、二十碳五烯酸（EPA）和DHA也存在于免疫系统细胞的膜中，并通过多种相互作用机制影响免疫功能。AA及其衍生介质的作用通常与n-3 LCPUFA（即EPA和DHA）及其衍生介质的作用不同。对孕妇补充n-3 LCPUFA的研究显示，对脐带血免疫细胞及其反应有一些影响。这些研究还表明，婴儿对鸡蛋的致敏性降低，1岁时特应性皮炎的风险和严重程度降低，3至5岁时持续性喘息和哮喘的风险降低，尤其是母亲习惯性摄入n-3 LCPUFA较少的儿童。喂食含AA和DHA配方奶粉的早产和足月婴儿的免疫标志物与喂食母乳的婴儿相似，而喂食不含LCPUFA配方奶粉的婴儿则不同。接受含LCPUFA（AA和DHA）配方奶粉的婴儿比接受标准配方奶粉的婴儿患过敏性疾病和呼吸道疾病的风险更低。对婴儿补充n-3 LCPUFA的研究报告了与对照组的免疫差异，表明免疫成熟度更高，并且在生命的头几年中患过敏性疾病和呼吸道疾病的风险更低。综上所述，这些发现表明LCPUFA在免疫发育中发挥着具有临床意义的作用，特别是在过敏性致敏和包括喘息和哮喘在内的过敏表现方面。
