Breast Milk Oligosaccharides: Their Role in Immune Reactions and Potential Role in Allergy Prevention

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. 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. BMOs have a significant contribution to the positive effect of breast milk over a child; they ensure healthy microbial colonization 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. Keywords: breast milk oligosaccharides, children, food allergy, cow's milk protein allergy, immunity, tolerance.