Cruz J R, Gil L, Cano F, Caceres P, Pareja G
Program on Infection, Nutrition and Immunology, Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala.
Acta Paediatr Scand. 1988 Sep;77(5):658-62. doi: 10.1111/j.1651-2227.1988.tb10726.x.
A prospective study to assess whether milk IgA antibodies against Escherichia coli heat labile-toxin protect breast-fed children against labile toxin-induced gastroenteritis was carried out among infants of a marginal urban area in Guatemala. One hundred and thirty children were kept under surveillance for diarrhea by periodic home visits. Stool specimens were collected from each child routinely every 2-3 weeks and during diarrheal episodes, to study the excretion of labile toxin-producing Escherichia coli. Milk samples from the children's mothers were obtained concomitantly with the fecal specimens of the infants to be analyzed for anti-labile toxin antibodies. Twenty infections by heat-labile toxin-producing Escherichia coli as a sole agent were documented among breast-fed infants. Nine of these infections resulted in gastroenteritis, while the remaining 11 were asymptomatic. At the time of infection children who became sick were ingesting breast milk with significantly (p = 0.028) lower titers of antilabile toxin IgA than those who remained healthy. Only one of the 8 infected children receiving breast milk with high titers (greater than or equal to 256) of anti labile toxin IgA developed diarrhea, compared to 8 of the 12 subjects being fed milk with low titers (less than or equal to 64) (p = 0.025). This is the first report documenting protection by IgA antibodies in milk against labile toxin-induced gastroenteritis in infected breast-fed infants.
在危地马拉一个边缘城区的婴儿中开展了一项前瞻性研究，以评估母乳中针对大肠杆菌不耐热毒素的IgA抗体是否能保护母乳喂养的儿童免受不耐热毒素引起的肠胃炎。通过定期家访对130名儿童的腹泻情况进行监测。每2 - 3周定期从每个儿童以及腹泻发作期间采集粪便样本，以研究产不耐热毒素大肠杆菌的排泄情况。在采集婴儿粪便样本的同时，获取其母亲的乳汁样本，用于分析抗不耐热毒素抗体。在母乳喂养的婴儿中记录到20例由产不耐热毒素大肠杆菌单独引起的感染。其中9例感染导致肠胃炎，其余11例无症状。在感染时，患病儿童摄入的母乳中抗不耐热毒素IgA的滴度显著低于（p = 0.028）健康儿童。在8名接受抗不耐热毒素IgA高滴度（大于或等于256）母乳的感染儿童中，只有1例出现腹泻，而在12名接受低滴度（小于或等于64）母乳的儿童中有8例出现腹泻（p = 0.025）。这是首份记录母乳中IgA抗体对感染的母乳喂养婴儿不耐热毒素引起的肠胃炎具有保护作用的报告。
