What motivates us?
Breast milk is nature’s gift with still many unknowns and assumptions on its benefits and mechanisms of actions. We aim to establish the matches and, importantly, the possible mismatches, between what the infant needs for healthy development and the nutrition that they are provided. We want to reveal what is needed to make breast milk more likely to prevent conditions such as allergy, malaria or growth failure.
How do we achieve our goals?
Our team values kindness, collaborations, supportiveness, rigour, and dedication. Impossible is a non-existent term to us. We test our hypotheses in our unique preclinical models for the study of maternal-child dyads and development. With our collaborators, we validate our findings in birth cohorts. Our team is generously supported by the Larsson Rosenquist Foundation.
What are our current projects?
Children show a high susceptibility to both infectious and allergic disease, revealing deficiencies of the developing immune system in its two main arms: immune defences and regulation. Progressively, the infant’s immune system will acquire the ability to mount tightly regulated responses that are tailored to the target. This ability will be key for a lifelong protection from infectious and non-infectious disease such as allergy, cancer and metabolic disease. Elucidating which modifiable factors influence health trajectory is needed for successful for prevention of disease. We focus our research on breastmilk, a physiological help for the newborn. We investigate the role of breast milk in the 3 main axes that condition health:
- The milky way to infectious disease prevention
We know that breast milk is the best to prevent gastro- intestinal and respiratory infections. We are investigating areas where breastmilk is not the best such as helminths infection or Malaria. We also explore new areas where knowledge is still scarce such as COVI-19 prevention.
- Establishing nutritional protective and risk factors for allergy in early life
Food allergy represents a major burden affecting the quality of life of 300 million people worldwide and 10% of one-year-olds in Australia. Our research investigates whether the very first milk, colostrum, would be the solution to decrease the burden of food allergy. We also investigate whether prebiotic fibre supplementation during pregnancy and breastfeeding creates breastmilk that is more likely to reduce food allergy in offspring.
- Colostrum, the missing link for healthy growth
The rates of both infant undernutrition and overweight are alarmingly high and we know that early growth will play a major role in later life susceptibility to metabolic disease. We investigate the importance of colostrum in healthy growth through its impact on immunity and microbiota (1, 2). In many cases, and in many parts of the world, newborns do not receive the full amount of colostrum. We investigate whether this insufficient intake will affect child development. This research will promote child health through support for families and improved hospital practice.
What are our main discoveries?
Pioneering the concept of allergy prevention by immune tolerance induction through breastmilk. In 2008, we challenged the paradigm of allergen avoidance for allergy prevention and demonstrated that egg allergen shedding in maternal milk would educate the infant immune system and decrease egg allergy susceptibility (3). We confirmed this in a birth cohort study (4). We further elucidated the factors required to increase allergy prevention by allergen shedding in breastmilk such as Vitamin A (5) and TGF-beta in breastmilk (6) or maternal immunization (7, 8). Recently, we have uncovered an unexpected risk factor for respiratory but also food allergy: respiratory house dust mite allergens in breast milk (9-11). Our recent review in the first ranked journal in Allergy (JACI) highlights the importance of allergen in breast milk for immune system education (12). This knowledge will guide infant tailored preventive approaches to efficiently decrease the burden of allergy (12).
New paradigm for the prevention of infectious disease: vaccinating through breast milk
Based on our observation that some allergens in maternal milk stimulate a long-term immune response in the offspring, we proposed that transfer of microbial antigens in breastmilk may be the most efficient way to vaccinate infants. In collaboration with Thomas Egwang, Uganda, we have demonstrated the premises of this hypothesis in the context of malaria (published in JAMA Pediatrics, top 1%)(13). This hypothesis is detailed in a review requested by the Bill and Melinda Gates Foundation and published in a top 1% journal, Lancet Infectious Disease (14).
Respiratory allergens as promoters of gut inflammatory bowel disease
Since finding respiratory allergens in breast milk, we hypothesised that respiratory house dust mite allergen should pass through the gut to reach the milk and could therefore contribute to the physiopathology of inflammatory bowel disease. We proved this hypothesis using human gut samples. This work has been published in Gut (top 1%)(15) and has been highlighted in an editorial and a video by the journal (https://www.youtube.com/watch?v=pbJoDCLfXKo&t=105s). This work illustrates the wide implications of our fundamental research on neonatal gut immune ontogeny.