Saarinen K M, Vaarala O, Klemetti P, Savilahti E
Hospital for Children and Adolescents, University of Helsinki, Finland.
J Allergy Clin Immunol. 1999 Nov;104(5):1093-8. doi: 10.1016/s0091-6749(99)70094-1.
Breast milk contains immune factors that compensate for the underdeveloped defenses of the gut of the newborn infant.
We sought to study the importance of these factors in the immune responses of infants with cows' milk allergy (CMA) to the proteins in cows' milk (CM).
We prospectively followed the development of CMA in 6209 healthy infants and collected samples of colostrum from mothers. Samples from mothers of infants with CMA and from control subjects were analyzed for immunoglobulins, CM-specific antibodies, and cytokines. In infants with CMA, correlations between the concentration of transforming growth factor (TGF)-beta1 in colostrum and the extent of the immune response to CM proteins were studied.
The concentration of TGF-beta1 in colostrum samples from mothers of infants with IgE-mediated CMA (n = 65) was lower (mean, 589 pg/mL; 95% confidence interval [CI], 413-840) than from mothers of infants with non-IgE-mediated CMA (n = 37; mean, 1162 pg/mL; 95% CI, 881-1531; t = 2.57, P =.012). In 126 control subjects the mean concentration was 807 pg/mL (95% CI, 677-963). In the infants with CMA (n = 96-100), the concentration of TGF-beta1 in colostrum was positively correlated with IgA antibodies to beta-lactoglobulin and IgG antibodies to alpha-casein and whole formula and negatively with the diameter of a skin prick test response to CM and lymphocyte stimulation indices to alpha-casein and beta-lactoglobulin.
In an infant prone to having CMA, the TGF-beta1 content of mother's colostrum may promote IgG-IgA antibody production and inhibit IgE- and cell-mediated reactions to CM.
母乳中含有免疫因子,可弥补新生儿肠道防御功能发育不全的问题。
我们试图研究这些因子在牛奶过敏(CMA)婴儿对牛奶(CM)中蛋白质的免疫反应中的重要性。
我们前瞻性地追踪了6209名健康婴儿中CMA的发展情况,并收集了母亲的初乳样本。对患有CMA的婴儿母亲和对照受试者的样本进行免疫球蛋白、CM特异性抗体和细胞因子分析。在患有CMA的婴儿中,研究了初乳中转化生长因子(TGF)-β1浓度与对CM蛋白免疫反应程度之间的相关性。
IgE介导的CMA婴儿(n = 65)母亲的初乳样本中TGF-β1浓度(平均589 pg/mL;95%置信区间[CI],413 - 840)低于非IgE介导的CMA婴儿(n = 37;平均1162 pg/mL;95% CI,881 - 1531;t = 2.57,P =.012)母亲的样本。126名对照受试者的平均浓度为807 pg/mL(95% CI,677 - 963)。在患有CMA的婴儿(n = 96 - 100)中,初乳中TGF-β1浓度与β-乳球蛋白的IgA抗体、α-酪蛋白和全配方奶粉的IgG抗体呈正相关,与对CM的皮肤点刺试验反应直径以及对α-酪蛋白和β-乳球蛋白的淋巴细胞刺激指数呈负相关。
在易患CMA的婴儿中,母亲初乳中的TGF-β1含量可能促进IgG - IgA抗体产生,并抑制对CM的IgE和细胞介导反应。