lvrachЛечащий ВрачLechaschi Vrach1560-51752687-118110.51793/OS.2021.24.9.007lvrach-809Research ArticleПЕДИАТРИЯ. НЕОНАТОЛОГИЯPEDIATRICS. NEONATOLOGYНовые возможности для управления аллергией у детей на грудном и искусственном вскармливанииNew opportunities for the allergy prevention in brest fed and formula fed infantsБоковскаяО. А.BokovskayaO. A.

Москва

Moscow

ТургановаЕ. А.TurganovaE. A.

Санкт-Петербург

St. Petersburg

АО «ИНФАПРИМ»РоссияINFAPRIM JSCRussian FederationФГБОУ ВО СПбГПМУ Минздрава РоссииРоссияFederal State Budgetary Educational Institution of Higher Education St. Petersburg State Pediatric Medical University of the Ministry of Health of the Russian FederationRussian Federation202117102021093743Copyright © Боковская О.А., Турганова Е.А., 20212021Боковская О.А., Турганова Е.А.Bokovskaya O.A., Turganova E.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.lvrach.ru/jour/article/view/809

В течение последних лет частота встречаемости пищевой аллергии у детей постоянно увеличивается. Одной из наиболее частых причин пищевой аллергии у детей грудного возраста является аллергия на коровье молоко. Распространенность пищевой аллергии коррелирует с растущим объемом исследований и публикаций, изучающих связь факторов окружающей среды с формированием оральной толерантности в раннем возрасте. Управление этим процессом происходит в критический период развития, который получил название «окно возможностей», и ключевая роль принадлежит микробиоте и ее метаболитам. В течение этого периода влияние окружающей среды может иметь долгосрочное воздействие на состав микробиоты, иммунную регуляцию и восприимчивость к болезням. События во время этого критического окна влияют на долгосрочное здоровье человека. Ранняя колонизация сообществом микробов в рамках определенного критического временного окна имеет решающее значение для правильного развития иммунной системы. Грудное молоко остается золотым стандартом вскармливания, но роль его в профилактике пищевой аллергии на сегодняшний день не доказана. Более детальное изучение иммунологических факторов грудного молока и механизмов диалога между микробиотой и иммунной системой, в частности, действия определенных компонентов (пробиотики, пребиотики и метаболиты), помогает разработке новых стратегий профилактики иммуноопосредованных заболеваний, в т. ч. пищевой аллергии. Пребиотики, пробиотики и метаболиты представляют на сегодняшний день огромный интерес для управления аллергией через ускорение формирования иммунологической толерантности не только для первичной, но и для вторичной профилактики при лечении аллергии к белкам коровьего молока.

 In recent years, the incidence of food allergies in children has been steadily increasing. One of the most common causes of food allergy in infants is cow's milk allergy. The prevalence of food allergy correlates with a growing body of research and publications investigating the relationship of environmental factors and immune development inthe newborn. The «window of opportunity» is critical period of early immune development, and the key role belongs to the microbiota and its metabolites. During this period, environmental influences can have long-term effects on microbiota composition, immune regulation, and susceptibility to disease. Events during this critical window affect long-term human health. Early colonization by the microbial community within a certain critical time window is critical for the proper development of the immune system. Breast milk remains the gold standard for feeding, but its role in preventing food allergies has yet to be proven. A more detailed study of the immunological factors of breast milk and the mechanisms of microbiome-immune crosstalk, in particular, the action of certain components (probiotics, prebiotics and metabolites), helps to develop new preventive strategies. Prebiotics, probiotics and metabolites are of great interest today for managing allergies by accelerating the formation of immunological tolerance not only for primary, but also for secondary prevention in the treatment of allergy to cow's milk proteins.

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The authors declare that there are no conflicts of interest present.