Chantry Caroline J, Israel-Ballard Kiersten, Moldoveanu Zina, Peerson Jan, Coutsoudis Anna, Sibeko Lindiwe, Abrams Barbara
Department of Pediatrics, University of California Davis Medical Center, Sacramento, CA 95817, USA.
J Acquir Immune Defic Syndr. 2009 Jul 1;51(3):264-7. doi: 10.1097/QAI.0b013e3181aa12f2.
Heat-treated expressed breast milk is recommended by the World Health Organization as an option to reduce vertical HIV transmission in resource-poor regions. Flash-heat (FH) is a low technology pasteurization method developed for home use, but its effect on quantity and quality of breast milk immunoglobulins is unknown.
To evaluate FH's effect on breast milk immunoglobulin levels and antigen-binding capacity.
DESIGN/METHODS: Fifty HIV+ mothers in South Africa provided breast milk. Part of each sample served as an unheated control; the remainder was flash-heated. Total and antigen-specific immunoglobulin A (IgA) and immunoglobulin G (IgG) were measured by enzyme-linked immunosorbent assay. Paired t test was performed on log-transformed data.
FH significantly decreased total IgA and IgG concentrations [geometric mean (geometric SD) 318.0 (1.9) vs. 398.2 (1.9) microg/mL and 89.1 (2.7) vs. 133.3 (2.5) microg/mL, P < 0.001 each]. Similar decreases in anti-HIV-1 gp120 IgG, anti-pneumococcal polysaccharide, and anti-poliovirus IgA occurred (P < 0.001 each). Although the latter was most affected, FH retained 66% of the antigen-binding ability. In contrast, binding capacity of IgA and IgG to influenza increased after FH (P = 0.029 and 0.025, respectively).
Most breast milk immunoglobulin activity survives FH, suggesting flash-heated breast milk is immunologically superior to breast milk substitutes. Clinical significance of this decreased immunoglobulin activity needs evaluation in prospective trials.
世界卫生组织推荐使用经过热处理的挤出母乳，作为在资源匮乏地区减少艾滋病毒垂直传播的一种选择。闪蒸加热（FH）是一种为家庭使用而开发的低技术巴氏杀菌方法，但其对母乳免疫球蛋白数量和质量的影响尚不清楚。
评估闪蒸加热对母乳免疫球蛋白水平和抗原结合能力的影响。
设计/方法：南非50名感染艾滋病毒的母亲提供了母乳。每个样本的一部分用作未加热的对照；其余部分进行闪蒸加热。通过酶联免疫吸附测定法测量总免疫球蛋白A（IgA）和免疫球蛋白G（IgG）以及抗原特异性免疫球蛋白A和免疫球蛋白G。对经对数转换的数据进行配对t检验。
闪蒸加热显著降低了总IgA和IgG浓度[几何平均值（几何标准差）分别为318.0（1.9）对398.2（1.9）μg/mL和89.1（2.7）对133.3（2.5）μg/mL，P均<0.001]。抗艾滋病毒-1 gp120 IgG、抗肺炎球菌多糖和抗脊髓灰质炎病毒IgA也出现了类似的下降（P均<0.001）。尽管后者受影响最大，但闪蒸加热仍保留了66%的抗原结合能力。相比之下，闪蒸加热后IgA和IgG与流感的结合能力增加（P分别为0.029和0.025）。
大多数母乳免疫球蛋白活性在闪蒸加热后仍然存在，这表明闪蒸加热的母乳在免疫学上优于母乳替代品。这种免疫球蛋白活性降低的临床意义需要在前瞻性试验中进行评估。
