Do artificial oligosaccharides in infant formula reduce the risk of atopic disease and allergies similar to human milk oligosaccharides

Allergies and atopic diseases constantly increase over the last decades. Genetic predisposition alone does not explain this epidemic rise. Consequently environmental factors have to play an important role. Especially early infant nutrition is thought to have a great impact on atopy development and its clinical manifestations. Human milk is broadly recommended as the best nutrition for infants. This indicates that in cases where breast-feeding is not an option infant formula should match human milk as close as possible. Therefore beneficial components of human milk should not be absent in infant formula. As important factors among, human milk oligosaccharides (HMO) have been identified. HMO are almost absent in bovine milk and therefore in bovine milk based infant formula. Broadly accepted are the prebiotic functions of HMO. Increasing evidence suggests various other beneficial functions of HMO like inhibition of pathogens upon competitive binding. The specific functions of HMO are thought to be determined by their various structures. HMOs are promising modulators of allergy and atopic disease development. Currently artificial synthesized oligosaccharides (GOS/FOS) are added to infant formula in order to mimic properties of HMOs. The molecular structures of enzymatically synthesized GOS and plant-derived FOS are much simpler and differ significantly from the highly complex structures of HMOs thus, it is unlikely that they can mimic all of the structure dependent functions of HMOs. The aim of this thesis is to investigate if and how artificially synthesized oligosaccharides can mimic functions of naturally occurring HMO especially in regard to allergy and atopic disease development. General factors that possibly contribute to the atopy epidemic, mechanisms of the pathophysiology of atopy and its clinical manifestations as well as the role of some human milk components herein will be discussed first.