docruДоктор.РуTitle1727-23782713-2994ООО "ГК "РУСМЕДИКАЛ"10.31550/1727-2378-2023-22-3-81-88docru-324Research ArticleАЛЛЕРГОЛОГИЯALLERGOLOGYОлигосахариды грудного молока: участие в иммунных реакциях и потенциальная роль в профилактике аллергических заболеванийBreast Milk Oligosaccharides: Their Role in Immune Reactions and Potential Role in Allergy Preventionhttps://orcid.org/0000-0002-1711-1693МухаметоваЕ. М.MukhametovaE. M.

Мухаметова Евгения Маратовна — к. м. н., врач-гастроэнтеролог детской клиники

117418, г. Москва, ул. Гарибальди, д. 36

36 Garibaldi Str., Moscow, 117418

mukhametova_e_m@mail.ruДетская клиника «Фэнтези»РоссияFantasy Children’s ClinicRussian Federation202321022025223ПЕДИАТРИЯ8188Copyright © Мухаметова Е.М., 20252025Мухаметова Е.М.Mukhametova E.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://docru.elpub.ru/jour/article/view/324Цель обзора

Цель обзора: описать известные и предполагаемые эффекты олигосахаридов грудного молока (ОГМ) в иммуномодуляции и профилактике аллергических заболеваний, а также представить результаты исследований использования лечебных смесей с добавлением комбинаций из двух ОГМ у детей с аллергией к белкам коровьего молока (АБКМ).

Основные положения

Основные положения. Период младенчества — окно возможностей для профилактики аллергии. Грудное молоко содержит иммуномодулирующие компоненты, в том числе ОГМ, которые защищают младенца в этот критический период. В последние годы выяснены несколько путей воздействия ОГМ на созревание иммунитета, включая их способность модулировать состав микробиоты, усиливать выработку короткоцепочечных жирных кислот, напрямую связываться с патогенами, взаимодействовать с кишечным эпителием и иммунными клетками. Предполагается также, что ОГМ могут быть использованы для профилактики аллергических заболеваний в детском возрасте.

Заключение

Заключение. ОГМ вносят значительный вклад в позитивное влияние грудного молока на ребенка — в обеспечение здоровой микробной колонизации кишечника, подавления воспалительных процессов, иммунной защиты и созревания кишечного барьера. В настоящее время ОГМ считаются одними из наиболее важных биоактивных компонентов грудного молока, поскольку они действуют как антимикробные и противовирусные средства, как модуляторы эпителиальных клеток кишечника, в качестве специфических пребиотиков и эффекторов кишечной микробиоты и в качестве иммуномодуляторов. Тем не менее требуется дополнительное изучение воздействия отдельных ОГМ и их комбинаций на четко определенные клинические и иммунные исходы, включая развитие толерантности и лечебный потенциал при АБКМ.

Aim

Aim: To describe the known and expected effects of breast milk oligosaccharides (BMOs) on immune system modulation and allergy prevention; to present results of the studies of medicated formulas with the addition of a combination of two BMOs in babies with cow's milk protein allergy (CMPA).

Key Points

Key Points. The period of infancy is a window of opportunities for allergy prevention. Breast milk contains immune system modulating components, including BMOs, which protect an infant during this critical period. Recently, a number of BMO impacts over immune system maturity have been found, including their ability to modulate microbiota composition, to enhance expression of short-chain fatty acids, to directly bind to pathogenic agents, and to interact with intestinal epithelium and immune cells. In addition, it is assumed that BMOs can be used for prevention of paediatric allergies.

Conclusion

Conclusion. BMOs have a significant contribution to the positive effect of breast milk over a child; they ensure healthy microbial colonisation of intestines, inflammation inhibition, immune protection, and intestinal barrier maturity. Currently BMOs are considered one of the most important bioactive components of breast milk, since they act both as antimicrobials, antiviral agents and modulators of intestinal epithelial cells, as specific prebiotics, intestinal microbiota effectors and immunomodulating factors. Nevertheless, additional studies of the effect of some BMOs and their combinations on clearly defined clinical and immune outcomes are required, including tolerance and therapeutic potential in CMPA.

олигосахариды грудного молокадетипищевая аллергияаллергия к белкам коровьего молокаиммунитеттолерантностьbreast milk oligosaccharideschildrenfood allergycow's milk protein allergyimmunitytoleranceДанная статья подготовлена при финансовой поддержке компании ООО «Нестле Россия» (Nestle’ Health Science), однако это не оказало влияния на мнение автора.This article was prepared with the financial support from Nestle’ Health Science; however, it has not influenced the author’s opinion.ReferencesMeek J.Y., Noble L.; Section on Breastfeeding. Policy statement: breastfeeding and the use of human milk. Pediatrics. 2022;150(1):e2022057988. DOI: 10.1542/peds.2022-057988Meek J.Y., Noble L.; Section on Breastfeeding. Policy statement: breastfeeding and the use of human milk. Pediatrics. 2022;150(1):e2022057988. DOI: 10.1542/peds.2022-057988Sprenger N., Tytgat H.L.P., Binia A., Austin S. et al. Biology of human milk oligosaccharides: from basic science to clinical evidence. J. Hum. Nutr. 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The authors declare that there are no conflicts of interest present.