Abstract

The postpartum period is an important window during which environmental factors can shape the life-long health of the infant. This time period often coincides with substantial milk consumption either in the form of breast milk or from cow's milk sources, such as infant formulas. Although breast milk is the most beneficial source of nutrients for infants during the first 6 months after birth, its role in regulating food allergy development, through regulation of oral tolerance, is still controversial. Breast milk contains several factors that can impact mucosal immune function, including immune cells, antibodies, microbiota, oligosaccharides, cytokines, and soluble receptors. However, there is considerable variation in the assessed levels of cytokines and soluble receptors between studies and across the lactation period. Most of these cytokines and soluble receptors are absent, or only found in limited quantities, in commercial baby formulas. Differences in content of these pluripotent factors, which impact on both the mother and the neonate, could contribute to the controversy surrounding the role of breast milk regulating oral tolerance. This review highlights current knowledge about the importance of cytokines and soluble receptors in breast milk on the development of oral tolerance and tolerance-relateddisorders. Understanding the mechanisms by which such milk components might promote oral tolerance could aid in the development of improved strategies for allergy prevention.

Highlights

  • Oral tolerance is a state of immune non-responsiveness to antigens consumed by the oral route and derived from diet, environment, or gastrointestinal microbiota [1]

  • Breast milk contains a network of immune mediators, including several cytokines and soluble receptors that have not been well-studied in the development of oral tolerance in neonates

  • Strong evidence suggests a critical role for breast milk-derived immune mediators in preventing the development of allergic diseases, in part through modulation of the neonatal immune system and gastrointestinal tract (GIT) maturation

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Summary

INTRODUCTION

Oral tolerance is a state of immune non-responsiveness to antigens consumed by the oral route and derived from diet, environment, or gastrointestinal microbiota [1]. Failure to develop proper oral tolerance, early in life, has been linked to several diseases, including food allergy, celiac disease, and inflammatory bowel diseases (IBD) [2]. The concept of a “neonatal window of opportunity” has been proposed to describe the prenatal or perinatal period during which dietary and environmental factors can shape the development of the immune system and impact the susceptibility to immune-mediated diseases, including allergy [5]. This period often coincides with substantial milk consumption either in the form of breast milk or infant formulas

Breast Milk Mediators and Tolerance
BREASTFEEDING AND ALLERGIC
TOLERANCE IN EARLY LIFE
RECEPTORS AND ORAL TOLERANCE
Human colostrum References Human milk References
SOLUBLE RECEPTORS
CONCLUSION
Findings
AUTHOR CONTRIBUTIONS
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