In addition to being a source of nutrients for the developing newborn, human milk contains thousands of bioactive compounds, which influence infant health in the short-term as exemplified by its major benefits on infectious disease prevention. Many of the human milk compounds also have the required characteristics to instruct immune development and guide long-term health. Prebiotics, probiotics, and varied antimicrobial molecules all have the potential to shape the composition and function of the establishing gut microbiota, which is known to be a major determinant of immune function. Another and less explored way human milk can instruct long-term immunity is through antigen shedding. Here, we will review the evidence that antigens from maternal environment and more specifically from allergen sources are found in human milk. We will discuss data from rodent models and birth cohorts showing that allergen shedding in breast milk may influence long-term allergy risk. We will uncover the variables that may underlie heterogeneity in oral tolerance induction and allergy prevention in children breast-fed by allergen-exposed mothers. We will focus on the parameters that control antigen transfer to breast milk, on the unique biological characteristics of allergens in breast milk, and on the milk bioactive compounds that were found to influence immune response in offspring. We propose this understanding is fundamental to guide maternal interventions leading to lifelong allergen tolerance.

除了作为发育中的新生儿的营养来源之外，人乳还含有数以千计的生物活性化合物，它们在短期内会影响婴儿的健康，例如它在预防传染病方面的主要益处。许多人乳化合物还具有指导免疫发育和指导长期健康所需的特性。益生元、益生菌和各种抗菌分子都有可能影响正在建立的肠道微生物群的组成和功能，众所周知，肠道微生物群是免疫功能的主要决定因素。另一种鲜为人知的母乳可以指导长期免疫的方式是通过抗原脱落。在这里，我们将回顾在母乳中发现来自母体环境，更具体地说是来自过敏原的抗原的证据。我们将讨论来自啮齿动物模型和出生队列的数据，这些数据表明母乳中的过敏原脱落可能会影响长期过敏风险。我们将揭示可能导致暴露于过敏原的母亲母乳喂养的儿童在口服耐受诱导和过敏预防方面存在异质性的变量。我们将重点关注控制抗原转移到母乳的参数、母乳中过敏原的独特生物学特性，以及被发现影响后代免疫反应的牛奶生物活性化合物。我们认为这种理解对于指导导致终生过敏原耐受的孕产妇干预措施至关重要。我们将揭示可能导致暴露于过敏原的母亲母乳喂养的儿童在口服耐受诱导和过敏预防方面存在异质性的变量。我们将重点关注控制抗原转移到母乳的参数、母乳中过敏原的独特生物学特性，以及被发现影响后代免疫反应的牛奶生物活性化合物。我们认为这种理解对于指导导致终生过敏原耐受的孕产妇干预措施至关重要。我们将揭示可能导致暴露于过敏原的母亲母乳喂养的儿童在口服耐受诱导和过敏预防方面存在异质性的变量。我们将重点关注控制抗原转移到母乳的参数、母乳中过敏原的独特生物学特性，以及被发现影响后代免疫反应的牛奶生物活性化合物。我们认为这种理解对于指导导致终生过敏原耐受的孕产妇干预措施至关重要。