Human Milk Oligosaccharide profiles and allergic disease up to 18 years.

Abstract: Background Human Milk Oligosaccharides (HMO) are a diverse range of sugars secreted in breast milk that have direct and indirect effects on immunity. The profiles of HMOs produced differ between mothers. Objective To determine the relationship between maternal HMO profiles and offspring allergic diseases up to 18 years Methods Colostrum and early lactation milk samples were collected from 285 mothers enrolled in a high allergy risk birth cohort, the Melbourne Atopy Cohort Study. Nineteen HMOs were measured. Profiles/patterns of maternal HMOs were determined using latent class analysis. Details of allergic disease outcomes including, sensitization, wheeze, asthma, and eczema were collected at multiple follow-ups up to 18 years. Adjusted logistic regression analyses and generalized estimating equations were used to determine the relationship between HMO profiles and allergy. Results The levels of several HMOs were highly correlated with each other. Latent class analysis determined seven distinct maternal milk profiles with memberships of 10 and 20%. Compared to offspring exposed to the neutral Lewis HMO profile, exposure to acidic Lewis HMOs was associated with higher risk of allergic disease and asthma over childhood (OR asthma at 18 yrs 5.82 (CI 1.59, 21.23)), whilst exposure to the acidic predominant profile was associated with a reduced risk of food sensitization.(12 yrs OR 0.08 (0.01,0.67)). Conclusion In this high-allergy-risk birth cohort, some profiles of HMOs were associated with increased and some with decreased allergic disease risks over childhood. Further studies are needed to confirm these findings and realize the potential for intervention.