Bosire Rose, Guthrie Brandon L, Lohman-Payne Barbara, Mabuka Jennifer, Majiwa Maxwell, Wariua Grace, Mbori-Ngacha Dorothy, Richardson Barbra, John-Stewart Grace, Farquhar Carey
Center for Public Health Research, Kenya Medical Research Institute, Nairobi, Kenya.
Breastfeed Med. 2007 Sep;2(3):129-38. doi: 10.1089/bfm.2007.0009.
Breastmilk chemokines have been associated with increased HIV-1 RNA levels in breastmilk and altered risk of mother-to-child HIV-1 transmission. To characterize CC and CXC chemokines in breastmilk postpartum, we collected breastmilk specimens at regular intervals for 6 months after delivery from women with and without HIV-1 infection and used commercial ELISA kits to measure breastmilk concentrations of MIP-1alpha, MIP-1beta, RANTES, and SDF-1alpha. Among 54 HIV-1-infected and 26 uninfected women, mean chemokine levels were compared cross-sectionally and longitudinally at days 5 and 10, and months 1 and 3 postpartum. For both HIV-1-infected and uninfected women, breastmilk chemokine levels were highest at day 5 for MIP-1alpha, MIP-1beta, and SDF-1alpha, and subsequently decreased. RANTES levels remained constant over the follow-up period among HIV-1-uninfected women, and increased moderately among HIV-1-infected women. For MIP-1beta and RANTES, breastmilk levels were significantly higher among HIV-1-infected women compared to uninfected women early postpartum. In addition, HIV-1-infected women transmitting HIV-1 to their infant had consistently higher breastmilk RANTES levels than those who did not transmit, with the greatest difference observed at 1 month (2.68 vs. 2.21 log10 pg/mL, respectively; p = 0.007). In summary, all four chemokines were most elevated within the first month postpartum, a period of high transmission risk via breastmilk. MIP-1beta and RANTES levels in breastmilk were higher among HIV-1-infected women than among uninfected women, and breastmilk RANTES was positively associated with vertical transmission in this study, consistent with results from our earlier cohort.
母乳中的趋化因子与母乳中HIV-1 RNA水平升高以及母婴HIV-1传播风险改变有关。为了表征产后母乳中的CC和CXC趋化因子,我们在分娩后6个月内定期收集感染和未感染HIV-1的女性的母乳样本,并使用商用ELISA试剂盒测量母乳中MIP-1α、MIP-1β、RANTES和SDF-1α的浓度。在54名感染HIV-1的女性和26名未感染的女性中,在产后第5天和第10天以及产后第1个月和第3个月对趋化因子平均水平进行了横断面和纵向比较。对于感染和未感染HIV-1的女性,MIP-1α、MIP-1β和SDF-1α的母乳趋化因子水平在第5天最高,随后下降。在未感染HIV-1的女性中,RANTES水平在随访期间保持恒定,而在感染HIV-1的女性中则适度升高。对于MIP-1β和RANTES,产后早期感染HIV-1的女性母乳水平明显高于未感染的女性。此外,将HIV-1传播给婴儿的感染HIV-1的女性的母乳RANTES水平始终高于未传播的女性,在1个月时差异最大(分别为2.68对2.21 log10 pg/mL;p = 0.007)。总之,所有四种趋化因子在产后第一个月内升高最为明显,这是通过母乳传播风险较高的时期。感染HIV-1的女性母乳中的MIP-1β和RANTES水平高于未感染的女性,并且在本研究中母乳RANTES与垂直传播呈正相关,这与我们早期队列的结果一致。