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Publications

Journal Article Review Epublish

PubMed: 42955504 DOI: 10.1007/s11882-026-01299-w

Breast Milk and Allergic Disease Development: Immunological Factors Associated with Eczema, Food Allergy and Wheezing/Asthma.

Curr Allergy Asthma Rep 26(1)

Authors: Alessandra Catalogna, Carlo Agostoni, Simona Barni, Roberto Berni Canani, Laura Carucci, Letizia Ciliberti, Serena Coppola, Antonio Corsello, Gregorio Paolo Milani, Francesca Mori, Rita Nocerino, Bernardo Sousa Pinto, Giulia Carla Immacolata Spolidoro, Mattia Giovannini, Daniel Munblit

Affiliations

  • Allergy and Clinical Immunology Unit, Teramo, Italy.
  • Pediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
  • University of Milano, Milan, Italy.
  • Allergy Unit, Meyer Children's Hospital IRCCS, Florence, Italy.
  • Department of Translational Medical Science, University of Naples Federico II, Naples, 80138, Italy.
  • CEINGE Advanced Biotechnologies Research Center, NutriTechLab, University of Naples Federico II, Naples, 80138, Italy.
  • CEINGE Advanced Biotechnologies Research Center, ImmunoNutritionLab, University of Naples Federico II, Naples, 80138, Italy.
  • Task Force for Microbiome Studies, University of Naples Federico II, Naples, 80138, Italy.
  • ImmunoNutritionLab and NutriTechLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy.
  • Department of Translational Medical Science, University of Naples Federico II, Naples, 80138, Italy. ImmunoNutritionLab and NutriTechLab at the CEINGE Advanced Biotechnologies Research Center, University of Naples Federico II, Naples, Italy.
  • Allergy Unit, Meyer Children's Hospital IRCCS, Florence, Italy. Department of Health Sciences, University of Florence, Florence, Italy.
  • Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
  • Pediatric Gastroenterology Unit, Children's Hospital "G. Di Cristina", ARNAS Civico-Di Cristina-Benfratelli, Palermo, Italy.
  • Department of Pharmacy, Health and Nutritional Sciences, Rende-Pediatric Unit, Società Italiana di Medicina di Emergenza e Urgenza Pediatrica (SIMEUP), University of Calabria, Annunziata Hospital, Cosenza, 87100, Italy.
  • Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, MEDCIDS, University of Porto, Porto, Portugal. Centre for Health Technology and Services Research, Health Research Network, Faculty of Medicine, CINTESIS@RISE, University of Porto, Porto, Portugal.
  • Pediatric Rheumatology Unit, Department of Childhood and Adolescent Medicine, ASST Fatebenefratelli-Sacco, Milan, Italy.
  • Department of Health Sciences, University of Florence, Florence, Italy.
  • Care for Long Term Conditions Division, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.
  • Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.

Abstract

PURPOSE OF REVIEW

Human milk (HM) contains a diverse array of immunological, microbial, and metabolic bioactive factors that may influence early immune maturation and allergic disease susceptibility. This narrative review examines current evidence linking major HM bioactives with eczema, food allergy, and wheezing/asthma, integrating mechanistic findings with human observational and clinical data.

RECENT FINDINGS

Transforming growth factor-β (TGF-β), secretory IgA (sIgA), human milk oligosaccharides (HMOs), cytokines, fatty acids, short-chain fatty acids, the HM microbiome, and extracellular vesicles have all been implicated in pathways relevant to epithelial integrity, microbial colonization, and immune tolerance. However, associations with allergic outcomes are heterogeneous and frequently context dependent. Findings vary according to lactation stage, maternal characteristics, infant susceptibility, microbial exposures, and outcome definition. Mechanistic evidence is often stronger than prospective clinical evidence, and no individual HM component or bioactive profile has yet emerged as a reproducible predictor of allergy protection. Current evidence supports viewing HM as a dynamic maternal-milk-infant biological network rather than as a source of isolated protective factors. Future studies should integrate repeated HM sampling, rigorous allergic phenotyping, and multi-omic approaches to distinguish causal mediators from biomarkers of maternal or infant biology.

MeSH

Milk, Human, Milk, Food Hypersensitivity, Hypersensitivity, Immunologic Factors, Fatty Acids, Volatile, Eczema, Food, Immunoglobulin A, Secretory, Breast, Asthma, Infant, Fatty Acids, Allergy