Savilahti Erkki, Siltanen Mirjami, Kajosaari Merja, Vaarala Outi, Saarinen Kristiina M
Hospital for Children and Adolescents, University of Helsinki, Finland. erkki.savilahtihus.fi
Pediatr Res. 2005 Dec;58(6):1300-5. doi: 10.1203/01.pdr.0000183784.87452.c6.
Specific defense factors in breast milk together with length of breast-feeding and genetic predisposition may modulate the development of allergy. We studied whether IgA, soluble CD14 (sCD14), or transforming growth factor (TGF)-beta in colostrum could affect the development of atopy in children up to age 4. From a cohort of 4676, we selected four groups of children with either long or short exclusive breast-feeding (>3.5 or <0.5 mo); these groups further differed in the presence or absence of atopic heredity. In colostrum from mothers, we measured total IgA, IgA antibodies to cow's milk (CM) and casein, sCD14, and TGF-beta1 and -beta2. The children were divided into three groups: those with no atopic symptoms or IgE, those with allergic symptoms, and those with both outcomes. Mothers of infants later showing atopic symptoms or, in addition, having IgE sensitization (verified atopy) had a lower concentration of IgA casein antibodies in their colostrum than did mothers of infants with no indication of atopy at age 4. Low concentration of IgA casein antibodies was a significant risk for verified atopy. sCD14 levels were lower in colostrum of mothers with infants developing atopic symptoms and IgE sensitization than of those of infants with no atopy. Specific IgA antibodies to CM antigens and sCD14 in colostrum significantly associated with the appearance of both symptomatic and verified atopy by age 4.
母乳中的特异性防御因子、母乳喂养时长以及遗传易感性可能共同调节过敏的发展。我们研究了初乳中的免疫球蛋白A(IgA)、可溶性CD14(sCD14)或转化生长因子(TGF)-β是否会影响4岁以下儿童特应性疾病的发展。在4676名队列研究对象中,我们选取了四组纯母乳喂养时间长或短(>3.5个月或<0.5个月)的儿童;这些组在有无特应性遗传方面也存在差异。我们检测了母亲初乳中的总IgA、针对牛奶(CM)和酪蛋白的IgA抗体、sCD14以及TGF-β1和TGF-β2。儿童被分为三组:无特应性症状或IgE的儿童、有过敏症状的儿童以及兼具这两种情况的儿童。与4岁时无特应性迹象的婴儿的母亲相比,其婴儿后来出现特应性症状或此外还伴有IgE致敏(确诊为特应性疾病)的母亲,其初乳中IgA酪蛋白抗体的浓度较低。低浓度的IgA酪蛋白抗体是确诊为特应性疾病的一个显著风险因素。与婴儿无特应性疾病的母亲相比,其婴儿出现特应性症状和IgE致敏的母亲初乳中的sCD14水平较低。初乳中针对CM抗原的特异性IgA抗体和sCD14与4岁时出现有症状的和确诊的特应性疾病显著相关。