牛乳蛋白引发自身免疫性疾病:神话还是现实?

V. Borba, A. Lerner, T. Matthias, Y. Shoenfeld
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引用次数: 2

摘要

人类在11000年前开始喝哺乳动物的奶。如今,牛奶、山羊奶和绵羊奶约占世界牛奶产量的87%。在西方工业化国家,牛奶是主要的饮食成分,尤其是加工食品中的牛奶,对牛奶成分过敏和自身免疫性疾病的高发率正在上升。当过敏性牛奶蛋白面对不成熟和敏感的儿童免疫系统时,它可能对未来的健康构成威胁。一些研究有力地证明,儿童时期接触食物过敏原会增加自身免疫性疾病的风险,如1型糖尿病、乳糜泻、炎症性肠病、类风湿关节炎、多发性硬化症、神经精神疾病等。“自身免疫马赛克”阐明了人类自身免疫性疾病表达的多样性和多因子起源。越来越多的证据表明,口腔耐受、食物抗原和自身免疫性疾病之间存在很大的重叠。各种各样的机制被假设来解释这些实体之间的联系,主要涉及分子模仿、共享表位、交叉反应现象、宿主肠道通透性增强、微生物组/菌群失调比例的变化,甚至涉及鸟分枝杆菌亚种副结核感染。如今,人们正在评估不同种类的牛奶和乳制品对人体健康的潜在益处。同样,牛奶衍生的营养保健品,如牛初乳,声称具有许多临床优势,特别是其免疫调节能力。本文旨在探讨牛奶蛋白对人体健康的影响,强调其与免疫介导和自身免疫性疾病的关系。
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Bovine Milk Proteins as a Trigger for Autoimmune Diseases: Myth or Reality?
Humans started to drinkmammal’s milk 11,000 years ago. Nowadays, cow, goat and sheep milks account for about 87% of the world milk production. The high incidence of allergies to cow’s milk components and autoimmune diseases is rising in the Western industrialized countries, where milk is a major dietary component, especially in processed foods. When allergenic milk proteins face immature and susceptible immune system in children it might represent a threat for future health. Several studies support strong evidences that exposure to dietary allergens during childhood can increase the risk of developing autoimmune diseases, such as type 1 diabetes, celiac disease, inflammatory bowel disease, rheumatoid arthritis, multiple sclerosis, neuropsychiatric disorders, among others. The "Mosaic of Autoimmunity" elucidates the diversity and multifactorial origin of autoimmune disease expression in humans. Growing evidence suggests a large overlap between oral tolerance, food antigens and autoimmune diseases. Assorted mechanisms have been hypothesized to explain the connection between these entities, mainly involving molecular mimicry, shared epitopes, cross-reactivity phenomena, enhanced hosts gut permeability, change in microbiome/ dysbiome ratio and even involving Mycobacterium avium subspecies paratuberculosis infection. Nowadays, different kinds of milk and dairy products are being evaluated for a potential benefit in human health. Likewise, milk derived nutraceutical products, such as bovine colostrum, claim many clinical advantages especially for its immune modulatory capabilities. The aim of this review is to explore the impact of cow’s milk protein son human health, emphasizing its relationship with immune mediated and autoimmune diseases.
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