Background
Human milk is thought to reduce infant atopy risk. The biologic mechanism for this protective effect is not fully understood.
Objectives
We tested the hypothesis that infant consumption of four microRNAs (miR-146b-5p, miR-148b-3p, miR-21–5p, and miR-375–3p) in human milk would be associated with reduced atopy risk.
Design
The Breast Milk IMPACT Study involved a cohort of mother-infant dyads who planned to breastfeed beyond four months. Infant consumption of the four human milk microRNAs in the first six months was calculated as the product of milk microRNA concentration and the number of human milk feeds, across three lactation stages: early milk (0–4 weeks), transitional milk (4–16 weeks), and mature milk (16–24 weeks). The primary outcome was infant atopy in the first year, defined as atopic dermatitis, food allergies, or wheezing. The final analysis included 432 human milk samples and 7,824 weeks of longitudinal health data from 163 dyads.
Results
Seventy-three infants developed atopy. Forty-one were diagnosed with atopic dermatitis (25%), 33 developed food allergy (20%), and 10 had wheezing (6%). Eleven developed > 1 condition (7%). Infants who did not develop atopy consumed higher levels of miR-375–3p (d = 0.18, P = 0.022, adj P = 0.044) and miR-148b-3p (d = 0.23, P = 0.007, adj P = 0.028). Consumption of miR-375–3p (X2 = 5.7, P = 0.017, OR = 0.92, 95% CI = 0.86, 0.99) was associated with reduced atopy risk. Levels of miR-375–3p increased throughout lactation (r = 0.46, F = 132.3, P = 8.4 × 10−34) and were inversely associated with maternal body mass (r = -0.11, t = -2.1, P = 0.032).
Conclusions
This study provides evidence that infant consumption of miR-375–3p may reduce atopy risk.
Atopic dermatitis (AD) is a chronic inflammatory skin condition impacting approximately 15% of children worldwide. 1 The incidence of AD has increased over the last 50 years, with approximately 60% of individuals developing symptoms in the first 12 months of life. 2 Predisposition to AD may be influenced by medical and demographic traits, environmental factors, and underlying immunologic phenotypes.Epidermal barrier breakdown is a key driver of AD. 3 Causes of epidermal breakdown are multifactorial, resulting from genetic,
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