RESUMEN
OBJECTIVE: To compare the presence of neutralizing antibodies against SARS-CoV-2 found in the breast milk and blood of vaccinated lactating women with those not vaccinated. DATA SOURCE: The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under CRD42021287554 and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Cohort, case-control, and cross-sectional studies that evaluated antibodies against SARS-CoV-2 in the milk and blood of vaccinated mothers and had as control group unvaccinated mothers were eligible. Health Sciences Descriptors (DeCs), Medical Subject Headings (MeSH) and Emtree descriptors were used for the Virtual Health Library (VHL), Medical Literature Analysis and Retrieval System Online (Medline/Pubmed), and Embase databases, respectively. In the Web of Science and Scopus, the strategy was adapted. No restrictions on the publication period and language were set. DATA SYNTHESIS: The search identified 233 records, of which 128 duplicates and 101 papers that did not meet the inclusion criteria were excluded. Hence, four cohort studies were eligible. Nursing mothers vaccinated with the Pfizer-BioNTech and Moderna vaccines showed antibodies against SARS-CoV-2 in their blood and breast milk. CONCLUSIONS: Vaccinated lactating women had higher levels of immunoglobulin G (IgG) and A (IgA) in serum and breast milk than unvaccinated women.
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Anticuerpos Neutralizantes , Vacunas contra la COVID-19 , COVID-19 , Lactancia , Leche Humana , SARS-CoV-2 , Humanos , Femenino , Leche Humana/inmunología , Leche Humana/virología , Vacunas contra la COVID-19/inmunología , Anticuerpos Neutralizantes/sangre , Lactancia/inmunología , SARS-CoV-2/inmunología , COVID-19/prevención & control , COVID-19/inmunología , Anticuerpos Antivirales/sangreAsunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Recién Nacido/inmunología , Leche Humana/inmunologíaRESUMEN
Introdução: Alguns estudos verificaram que a vacinação contra o coronavírus SARS COV-2 induz resposta efetiva de titulação de anticorpos neutralizantes no sangue e leite materno. No entanto, a maioria dos artigos publicados considerou a transferência de imunidade mãe-feto em mulheres recuperadas da COVID-19 e não vacinadas e/ou analisaram leite e/ou sangue isoladamente. Objetivo: Comparar o quantitativo de anticorpos neutralizantes contra o SARS-CoV-2 no leite e no sangue das lactantes vacinadas em relação àquelas não vacinadas. Métodos: Revisão sistemática nas bases de dados Biblioteca Virtual em Saúde, Pubmed, Embase, Web of Science e Scopus de acordo com as diretrizes do PRISMA e registrada no PROSPERO sob o n° CRD42021287554. Foram elegíveis estudos de coorte, caso-controle e transversal que avaliaram a presença de anticorpos neutralizantes contra o SARS-CoV-2 no leite e no sangue de lactantes vacinadas e que tiveram como grupo controle lactantes não vacinadas. Por sua vez, foram excluídos relatos de casos, revisão sistemática com ou sem meta-análise, artigos que analisaram os anticorpos em mulheres infectadas ou não lactantes, e ainda aqueles que não trouxeram nos seus resultados os dados de comparação entre os grupos que receberam ou não a vacina. Foi avaliado o risco de viés de todos os artigos incluídos através da ferramenta de avaliação Newcastle-Ottawa Scale. Resultados: As buscas nas bases de dados identificaram 233 registros. Após a remoção de 128 que estavam duplicados, foram lidos os títulos e resumos de 105 e excluídos 94 destes. Com a leitura na íntegra de 11 artigos, 4 estudos de coorte foram considerados elegíveis e, incluídos nesta revisão sistemática. Os resultados destes estudos apontaram que, após a vacinação com os imunizantes Pfizer-BioNTech e Moderna, as lactantes apresentaram níveis elevados de anticorpos neutralizantes IgG e IgA anti-SARS-CoV-2 tanto no sangue quanto no leite materno, sendo o nível sanguíneo consideravelmente maior. Conclusão: Como ainda não existem vacinas disponíveis para uso em menores de seis meses e as lactantes vacinadas contra o vírus SARS-CoV-2 apresentam maior expressão de anticorpos em relação àquelas não vacinadas, é provável que, além da proteção materna contra COVID-19, a imunização também forneça imunidade neonatal através da amamentação.
Introduction: Some studies have found that vaccination against the SARS-COV-2 coronavirus induces an effective titration response of neutralizing antibodies in blood and breast milk. However, most published articles considered the transfer of mother fetus immunity in women recovered from COVID-19 and not vaccinated and/or analyzed milk and/or blood alone. Objective: To compare the amount of neutralizing antibodies in the milk and blood of vaccinated infants for SARS-CoV-2. Methods: Systematic review in the Virtual Health Library, Pubmed, Embase, Web of Science and Scopus databases in accordance with PRISMA guidelines and registered in PROSPERO under number CRD42021287554. Cohort, case-control and cross-sectional studies that evaluated the presence of neutralizing antibodies against SARS-CoV-2 in the milk and blood of vaccinated infants and that had unvaccinated infants as a control group were eligible. In turn, case reports, systematic review with or without meta-analysis, articles that analyzed antibodies in infected or non-lactating women, and even those that did not bring in their results data for comparison between the groups that received or not the vaccine. The risk of bias of all included articles was assessed using the Newcastle Ottawa Scale assessment tool. Results: Database searches identified 233 records. After removing 128 that were duplicates, the titles and abstracts of 105 were read and 94 were excluded. With the full reading of 11 articles, 4 cohort studies were considered eligible and included in this systematic review. The results of these studies showed that, after vaccination with the immunizers Pfizer-BioNTech and Moderna, the nursing mothers had high levels of anti-SARS-CoV-2 IgG and IgA neutralizing antibodies both in the blood and in breast milk, with the blood level considerably bigger. Conclusion: As there are still no vaccines available for use in infants under six months of age and lactating women vaccinated against the SARS-CoV-2 virus have a higher expression of antibodies compared to those not vaccinated, it is likely that, in addition to maternal protection against COVID-19, immunization also provides neonatal immunity through breastfeeding.
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Humanos , Lactante , Lactancia Materna , Vacunas contra la COVID-19 , Leche Humana/inmunología , Estudios de Casos y ControlesRESUMEN
BACKGROUND: The protective effect of breastfeeding on celiac disease (CD) onset is controversial. We studied a wide range of milk components in milk produced by celiac mothers following long-term gluten-free diet (GFD) in comparison to milk produced by healthy mothers. METHODS: Breast-milk samples from celiac (n = 33) and healthy (n = 41) mothers were obtained during the first year of lactation. A panel of bioactive components was analyzed by enzyme-linked immunosorbent assay in the aqueous fraction. We studied molecules involved in defenses, immunoregulation, and strengthening of the gut-epithelial barrier. RESULTS: During late lactation (from 6 to 12 months after delivery), the content of total immunoglobulin A (IgA) and IgM was significantly lower in the milk produced by celiac patients. Nevertheless, gliadin (GFD)-specific IgA relative contribution was higher in this group, in contrast to tetanus toxoid-specific antibodies. The balance between pro-inflammatory and anti-inflammatory molecules was different. While interleukin-6, tumor necrosis factor-α, and monocyte chemoattractant protein-1 were most frequently found in samples from celiac mothers, soluble Toll-like receptor-2 prevalence was lower. CONCLUSIONS: We describe differences between the innate and adaptive immune profile of milk produced by celiac and healthy mothers. These results might explain previous controversial reports about breastfeeding and CD protection. IMPACT: In spite of a long-term adherence to GFD, the milk produced by mothers with CD exhibit a different immune profile, in relation with some immunoregulatory factors and antibody content. This work shows a more comprehensive characterization of milk from celiac mothers, including macronutrients, lysozymes, growth factors, and immunoregulatory components that had not been studied before. The present study widens the available data regarding the characteristics of human milk of celiac mothers following GFD. Further follow-up studies of the health of children who were breastfed by celiac mothers will be necessary in order to also estimate the impact of the present results therein.
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Enfermedad Celíaca/inmunología , Leche Humana/inmunología , Adulto , Anticuerpos Antibacterianos/análisis , Autoanticuerpos , Lactancia Materna , Enfermedad Celíaca/dietoterapia , Enfermedad Celíaca/metabolismo , Citocinas/análisis , Dieta Sin Gluten , Femenino , Gliadina/inmunología , Humanos , Inmunoglobulina A/análisis , Inmunoglobulina M/análisis , Leche Humana/química , Muramidasa/análisis , Toxoide Tetánico/inmunología , Receptor Toll-Like 2/análisisRESUMEN
Background: Human milk (HM) is the ideal food for newborn (NB) nutrition, it provides all macro and micronutrients for human growth and development and also contains bioactive compounds, which influence the development of the neonatal digestive and immune systems. The holder pasteurization process is essential to prevent NB infection from donated milk. Therefore, the aim of this study was to check whether or not holder pasteurization could impact the concentration of immune components in HM and the capacity to induce epithelial cell growth. Materials and Methods: The study was performed on raw and holder pasteurized (62.5°C/30 minutes) paired milk samples after submission to the freezing process in both phases. For cytokine and adipokine measurements, ELISA was performed on 40 individual samples of HM from single donors. For analyzes of epithelial cell growth, HuTu-80 cells were cultivated in Minimum Essential Eagle medium with 15% of raw or pasteurized milk, eight pairs of milk were used. Results: The results showed that no alteration was observed in the concentration of cytokine after milk holder pasteurization, and leptin concentration was reduced in holder pasteurized milk. The heat treatment also did not impact the capacity of breast milk to promote intestinal epithelial cell growth. Conclusions: The results showed that donated breast milk pasteurization has a small impact on the HM bioactive concentration compounds. This technique is important to avoid NB infection.
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Bancos de Leche Humana , Leche Humana/inmunología , Pasteurización , Adipoquinas , Lactancia Materna , Citocinas , Células Epiteliales/inmunología , Células Epiteliales/metabolismo , Femenino , Congelación , Humanos , Recién Nacido , Leche Humana/metabolismoRESUMEN
INTRODUCTION: Human milk cannot currently be considered a major source of COVID-19 infection. On the other hand, it can contain specific antibodies that could modulate a possible newborn infection by SARS-CoV-2. MAIN ISSUE: A 32-year-old pregnant woman, gestational age 37 and 3/7 weeks, was admitted with a flu-like syndrome caused by COVID-19. The female newborn was appropriate for gestational age, with a birth weight of 2,890 g, length 48 cm, and head circumference 34 cm. MANAGEMENT: The mother-infant dyad remained in the rooming-in unit during hospitalization, exclusively breastfeeding and following World Health Organization recommendations for contact and airway precautions. On the 3rd day after delivery, two mother's milk samples (3 and 5 mL) were collected by hand expression. The samples were centrifuged for 10 min twice consecutively to separate fat, which was removed, and the remaining material was transferred to another tube to determine anti-SARS-CoV-2 Immunoglobulin A and Immunoglobulin G (ELISA, Kit EUROIMMUN AG, Luebeck, Germany). Anti-SARS-CoV-2 Immunoglobulin A was detected in the two samples evaluated, whose values were 2.5 and 1.9, respectively. No anti-SARSCoV-2 immunoglobulin G was detected. The exclusively-breastfed infant remained well through 45 days of age. CONCLUSION: The presence of SARS-CoV-2 Immunoglobulin A in the milk of mothers infected with COVID-19 may be related to protection against the transmission and severity of the disease in their infants.
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Anticuerpos Antivirales/metabolismo , COVID-19/inmunología , Inmunoglobulina A/metabolismo , Transmisión Vertical de Enfermedad Infecciosa , Leche Humana/inmunología , Complicaciones Infecciosas del Embarazo/inmunología , SARS-CoV-2/inmunología , Adulto , Biomarcadores/metabolismo , Lactancia Materna , COVID-19/diagnóstico , COVID-19/prevención & control , COVID-19/transmisión , Prueba Serológica para COVID-19 , Femenino , Humanos , Recién Nacido , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , SARS-CoV-2/aislamiento & purificaciónRESUMEN
BACKGROUND: The timing of milk donations to human milk banks ranges from a few days to more than 1 year after delivery, and the Holder method is used for pasteurization. We evaluated the effect of temporal variation and thermal treatment on the immunological properties of milk. METHODS: We analyzed 73 milk samples, raw and after pasteurization, donated at different lactation stages. We studied antibodies, lysozyme, cytokines, soluble receptors, and factors with impact on barrier function. We also evaluated in vitro the capacity of milk to modulate nuclear factor-κB (NF-κB) signaling in an HT-29 epithelial cell line stimulated with tumor necrosis factor-α (TNF-α). RESULTS: With few exceptions, immune components exhibited their highest levels in colostrum, and were stable in the various stages of mature milk. Pasteurization altered the immunological composition of milk, and very drastically for some components. Raw milk of the first year reduced NF-κB activation in HT-29 cells treated with TNF-α to approximately the same extent, and Holder pasteurization significantly affected this capacity. CONCLUSIONS: Overall, the present work reports that mature donated milk is equally valuable over the first year of lactation, but warns about drastic losses of anti-inflammatory properties during Holder pasteurization that could be critical for the health of preterm infants.
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Lactancia , Leche Humana/inmunología , Pasteurización , Adulto , Extracción de Leche Materna , Células Epiteliales/inmunología , Células Epiteliales/metabolismo , Femenino , Células HT29 , Humanos , Bancos de Leche Humana , Leche Humana/metabolismo , FN-kappa B/metabolismo , Factores de Tiempo , Adulto JovenRESUMEN
Breastfeeding provides defense against infectious disease during early life. The mechanisms underlying this protection are complex but likely include the vast array of immune cells and components, such as immunoglobulins, in milk. Simply characterizing the concentrations of these bioactives, however, provides only limited information regarding their potential relationships with disease risk in the recipient infant. Rather, understanding pathogen and antigen specificity profiles of milk-borne immunoglobulins might lead to a more complete understanding of how maternal immunity impacts infant health and wellbeing. Milk produced by women living in 11 geographically dispersed populations was applied to a protein microarray containing antigens from 16 pathogens, including diarrheagenic E. coli, Shigella spp., Salmonella enterica serovar Typhi, Staphylococcus aureus, Streptococcus pneumoniae, Mycobacterium tuberculosis and other pathogens of global health concern, and specific IgA and IgG binding was measured. Our analysis identified novel disease-specific antigen responses and suggests that some IgA and IgG responses vary substantially within and among populations. Patterns of antibody reactivity analyzed by principal component analysis and differential reactivity analysis were associated with either lower-to-middle-income countries (LMICs) or high-income countries (HICs). Antibody levels were generally higher in LMICs than HICs, particularly for Shigella and diarrheagenic E. coli antigens, although sets of S. aureus, S. pneumoniae, and some M. tuberculosis antigens were more reactive in HICs. Differential responses were typically specific to canonical immunodominant antigens, but a set of nondifferential but highly reactive antibodies were specific to antigens possibly universally recognized by antibodies in human milk. This approach provides a promising means to understand how breastfeeding and human milk protect (or do not protect) infants from environmentally relevant pathogens. Furthermore, this approach might lead to interventions to boost population-specific immunity in at-risk breastfeeding mothers and their infants.
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Especificidad de Anticuerpos/inmunología , Bacterias/inmunología , Inmunoglobulina A/inmunología , Inmunoglobulina G/inmunología , Leche Humana/inmunología , Bacterias/patogenicidad , Lactancia Materna , Estudios de Cohortes , Escherichia coli/inmunología , Etiopía/epidemiología , Femenino , Gambia/epidemiología , Ghana/epidemiología , Humanos , Kenia/epidemiología , Mycobacterium tuberculosis/inmunología , Perú/epidemiología , Análisis de Componente Principal , Análisis por Matrices de Proteínas , Proteoma , Salmonella enterica/inmunología , Shigella/inmunología , España/epidemiología , Staphylococcus aureus/inmunología , Streptococcus pneumoniae/inmunología , Suecia/epidemiología , Estados Unidos/epidemiologíaRESUMEN
INTRODUCTION: Preeclampsia (PE) is a systemic inflammatory disease, and its effect on human milk immune components is poorly understood. OBJECTIVE: To investigate whether PE affects human milk cytokine levels. METHODS: This was a prospective observational study involving mothers diagnosed with PE and with singleton pregnancy with no fetal malformation. The following cases were excluded: diabetes, chorioamnionitis, use of illicit drugs and alcohol, mastitis and congenital infection. In total, 228 mothers were studied and divided into two groups matched by gestational age: PE (n = 114) and normotensive (control, n = 114). Colostrum was collected from 24-72 hours postpartum, and mature milk was collected at the end of the first month. Cytokines (IL-1ß, IL-6, IL-8, IL-10, IL-12, and TNF-α) were measured using flow cytometry. A generalized linear model with a gamma distribution was used to analyze the differences between groups versus time interaction. RESULTS: The mean gestational age was 36 weeks. Increased IL-1 and IL-6 levels and reduced IL-12 levels in the colostrum were detected in PE, while in the mature milk, the IL-6 and IL-8 levels were lower than those of the control group. CONCLUSIONS: PE is associated with increased levels of inflammatory cytokines in colostrum and decreased levels in mature milk.
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Calostro/inmunología , Leche Humana/inmunología , Preeclampsia/inmunología , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Recién Nacido , Interleucina-6/análisis , Interleucina-8/análisis , Embarazo , Estudios Prospectivos , Factor de Necrosis Tumoral alfa/análisis , Adulto JovenRESUMEN
BACKGROUND: When feeding preterm infants, donor milk is preferred if the mother's own milk is unavailable. Pasteurization may have detrimental effects on bioactivity, but more information is needed about its effects on the immunological compounds. Research aim: This work has two main aims: evaluate the antibody profile of colostrum and study the quantitative variations in the antibodies' level and specific reactivity after undergoing Holder pasteurization. The authors focused on immunoregulatory components of colostrum (antidietary antibodies and TGF-ß2) in the neonatal gut. METHODS: This is a descriptive cross-sectional study of a convenience sample of 67 donated colostrum samples at different days after delivery, both raw and pasteurized. Antibody profiles were analyzed at different times during breastfeeding, and total and specific antibodies (IgM, IgA, and IgG subclasses) were compared with tetanus toxoid and ovalbumin using enzyme-linked immunosorbent assay. The processing effect on total and specific antibodies, as well as TGF-ß2, was evaluated by paired analyses. RESULTS: No variations in immunological compounds were observed throughout the colostrum stage. The TGF-ß2, antibodies' concentrations, and antibodies' specific reactivity after pasteurization did not vary significantly as days of lactation varied. Changes in antibody levels were dependent on isotype and IgG subclass, and IgG4 showed remarkable resistance to heating. Moreover, the effect of the pasteurization on specific reactivity was antigen dependent. CONCLUSION: The supply of relevant immunological components is stable throughout the colostrum stage. The effects of pasteurization on antibodies depend on isotype, subclass, and specificity. This information is relevant to improving the immunological quality of colostrum, especially for preterm newborns.
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Calostro/inmunología , Leche Humana/inmunología , Pasteurización/estadística & datos numéricos , Calostro/química , Estudios Transversales , Ensayo de Inmunoadsorción Enzimática/métodos , Humanos , Inmunoglobulina A/análisis , Inmunoglobulina G/análisis , Inmunoglobulina M/análisis , Bancos de Leche Humana/organización & administración , Leche Humana/química , Pasteurización/métodos , Pasteurización/normas , Estadísticas no Paramétricas , UruguayRESUMEN
To better understand underlying causes of lower rotavirus vaccine effectiveness in low-middle income countries (LMICs), we measured innate antiviral factors in Nicaraguan mothers' milk and immune response to the first dose of the pentavalent rotavirus vaccine in corresponding infants. No relationship was found between concentrations of innate factors and rotavirus vaccine response.
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Vacuna contra Difteria, Tétanos y Tos Ferina/inmunología , Vacunas contra Haemophilus/inmunología , Inmunidad Innata/inmunología , Leche Humana/inmunología , Vacuna Antipolio de Virus Inactivados/inmunología , Países en Desarrollo , Vacuna contra Difteria, Tétanos y Tos Ferina/administración & dosificación , Femenino , Vacunas contra Haemophilus/administración & dosificación , Humanos , Inmunogenicidad Vacunal/inmunología , Lactante , Masculino , Nicaragua , Vacuna Antipolio de Virus Inactivados/administración & dosificación , Resultado del Tratamiento , Vacunas Combinadas/administración & dosificación , Vacunas Combinadas/inmunologíaRESUMEN
OBJECTIVES: Human milk banks need to extend the suitability of milk for breastfeeding, and for this technological advances are required. Our aim was to establish the capacity of freeze-drying to conserve milk properties without further oxidative deterioration. METHODS: One hundred sixteen healthy women participated from the city of Cordoba (Argentina). Proteins, glucose, triglycerides, polyphenols, and markers (nitrites, superoxide anion, hydroperoxides, lipoperoxides, and γ-glutamyl transpeptidase) were measured in their fresh milk. Samples were then separated for three treatments as follows: freezing and conservation for 6 months at -80°C (F: positive control); freeze-drying for 24 hours at ≤-70°C and ≤1.33 Pa and conservation for 6 months at 4°C (FD: treatment of interest); and freeze-drying for 24 hours at ≤-70°C and ≤1.33 Pa and conservation for 6 months at -80°C (FD+F). Next, analyses were repeated and compared by ANOVA and Tukey tests. RESULTS: Fresh milk showed these values per L as follows: proteins: 12.62 ± 2.51 g, glucose: 4.44 ± 0.25 g, triglycerides: 34.26 ± 0.59 g, polyphenols: 53.27 ± 8.67 mg, nitrites: 62.40 ± 19.09 mg, superoxide: 3,721.02 ± 198.80 OD, hydroperoxides: 7,343.76 ± 294.53 OD, lipoperoxides: 7,349.72 ± 398.72 OD, and γ-glutamyl transpeptidase: 4.66 ± 0.55 IU. Glucose was decreased after F treatment (p < 0.05), all variables were conserved by FD and were not improved by the FD + F combination. CONCLUSIONS: Freeze-drying achieved suitable conservation and may improve bank functioning, by protecting nutritional properties, polyphenol-related functionality, and oxidative integrity of human milk through a 1-day treatment with easy maintenance.
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Ácidos Grasos/química , Conservación de Alimentos/métodos , Liofilización/métodos , Bancos de Leche Humana , Leche Humana/química , Oxidantes/química , Polifenoles/química , Adulto , Argentina , Ácidos Grasos/análisis , Femenino , Almacenamiento de Alimentos , Humanos , Lactante , Fenómenos Fisiológicos Nutricionales del Lactante , Recién Nacido , Masculino , Fenómenos Fisiologicos Nutricionales Maternos , Leche Humana/inmunología , Oxidantes/inmunología , Polifenoles/análisis , TemperaturaRESUMEN
In the critical phase of immunological immaturity of the newborn, particularly for the immune system of mucous membranes, infants receive large amounts of bioactive components through colostrum and breast milk. Colostrum is the most potent natural immune booster known to science. Breastfeeding protects infants against infections mainly via secretory IgA (SIgA) antibodies, but also via other various bioactive factors. It is striking that the defense factors of human milk function without causing inflammation; some components are even anti-inflammatory. Protection against infections has been well evidenced during lactation against, e.g., acute and prolonged diarrhea, respiratory tract infections, including otitis media, urinary tract infection, neonatal septicemia, and necrotizing enterocolitis. The milk's immunity content changes over time. In the early stages of lactation, IgA, anti-inflammatory factors and, more likely, immunologically active cells provide additional support for the immature immune system of the neonate. After this period, breast milk continues to adapt extraordinarily to the infant's ontogeny and needs regarding immune protection and nutrition. The need to encourage breastfeeding is therefore justifiable, at least during the first 6 months of life, when the infant's secretory IgA production is insignificant.
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Leche Humana/química , Leche Humana/inmunología , Calostro/química , Calostro/inmunología , Humanos , Sistema Inmunológico/inmunologíaRESUMEN
We examined potential risk factors on vaccine virus shedding and antibody seroresponse to human rotavirus vaccine (Rotarix) in Mexican infants. Two doses of Rotarix were administered to infants during the first two visits for their routine childhood immunization (â¼8 and 15weeks of age) in Mexico City. Infant's characteristics and socioeconomic indicators were obtained, including history of long-term feeding practices (exclusively/predominantly breastfed and exclusively/predominantly non-breastfed). Two serum specimens were collected, one during the second rotavirus vaccine visit and one 7weeks later. Stool specimens were collected between days 4-7 after each of the two rotavirus vaccine doses. Rotavirus IgA and IgG titers in serum were determined by enzyme immunoassays (EIA) and rotavirus shedding in stool was assessed by EIA and confirmed by RT-PCR. The overall rotavirus IgA geometric mean titers (GMT) increased significantly post dose 2 from post dose 1 [176 (95%CI: 113-273) to 335 (238-471); p=0.020). Infants who were exclusively/predominantly breastfed were less likely to shed vaccine virus in stool than those who were formula-fed (22% vs. 43%, p=0.016). Infants who were breastfed had lower rotavirus IgA titers than those who were formula-fed after dose 1 [GMT: 145 (84-250) vs. 267 (126-566) p=0.188] and dose 2 [236 (147-378) vs.578 (367-910), p=0.007]. Infants who shed vaccine virus post dose 1 had significantly higher serum IgA GMT than those who did not shed [425 (188-965) vs. 150 (84-266), p=0.038]. Breastfeeding was linked with the reduction of both stool vaccine shedding, and IgA seroresponse. The reduced rotavirus replication in the gut and shedding after dose 1 may explain in part the lower IgA response in serum.
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Anticuerpos Antivirales/sangre , Lactancia Materna , Inmunoglobulina A/sangre , Vacunas contra Rotavirus/inmunología , Rotavirus/inmunología , Rotavirus/fisiología , Esparcimiento de Virus , Heces/virología , Femenino , Humanos , Inmunización , Técnicas para Inmunoenzimas , Inmunogenicidad Vacunal , Lactante , Masculino , México , Leche Humana/inmunología , Rotavirus/aislamiento & purificación , Infecciones por Rotavirus/prevención & control , Vacunas contra Rotavirus/administración & dosificación , Vacunas contra Rotavirus/efectos adversos , Vacunas Atenuadas/administración & dosificación , Vacunas Atenuadas/efectos adversos , Vacunas Atenuadas/inmunología , Replicación ViralRESUMEN
Summary In the critical phase of immunological immaturity of the newborn, particularly for the immune system of mucous membranes, infants receive large amounts of bioactive components through colostrum and breast milk. Colostrum is the most potent natural immune booster known to science. Breastfeeding protects infants against infections mainly via secretory IgA (SIgA) antibodies, but also via other various bioactive factors. It is striking that the defense factors of human milk function without causing inflammation; some components are even anti-inflammatory. Protection against infections has been well evidenced during lactation against, e.g., acute and prolonged diarrhea, respiratory tract infections, including otitis media, urinary tract infection, neonatal septicemia, and necrotizing enterocolitis. The milk’s immunity content changes over time. In the early stages of lactation, IgA, anti-inflammatory factors and, more likely, immunologically active cells provide additional support for the immature immune system of the neonate. After this period, breast milk continues to adapt extraordinarily to the infant’s ontogeny and needs regarding immune protection and nutrition. The need to encourage breastfeeding is therefore justifiable, at least during the first 6 months of life, when the infant’s secretory IgA production is insignificant.
Resumo Na fase crítica de imaturidade imunológica do recém-nascido, em especial do sistema imune de mucosas, o lactente recebe grandes quantidades de componentes bioativos através do colostro e do leite materno. O colostro é o reforço imunológico natural mais potente conhecido pela ciência. O aleitamento materno protege o lactente de infecções principalmente por meio dos anticorpos IgA secretores (IgAS), mas também por meio de vários outros fatores bioativos. É surpreendente que os fatores de defesa do leite humano ajam sem causar inflamação e alguns componentes são, de fato, anti-inflamatórios. A proteção contra infecções tem sido bem evidenciada durante a lactação, combatendo, por exemplo, diarreia aguda e prolongada, infecções do trato respiratório, incluindo otite média, infecção do trato urinário, sepse neonatal e enterocolite necrosante. O conteúdo imunológico do leite evolui ao longo do tempo: nas fases iniciais de lactação, IgAS, fatores anti-inflamatórios e, mais provavelmente, as células imunologicamente ativas provêm ajuda adicional para o sistema imune imaturo do neonato. Depois desse período, o leite materno continua a adaptar-se extraordinariamente à ontogenia infantil, às suas necessidades de proteção imune e nutricionais. Entende-se, portanto, a necessidade de se estimular o aleitamento materno pelo menos durante o primeiro semestre de vida, período em que a produção própria de IgA secretória é ainda pouco significativa.
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Humanos , Leche Humana/inmunología , Leche Humana/química , Calostro/inmunología , Calostro/química , Sistema Inmunológico/inmunologíaRESUMEN
Breast milk confers many benefits to the newborn and developing infant. There is substantial support for better long-term outcomes, such as less obesity, diabetes, and cardiovascular disease, in breastfed compared with formula-fed infants. More short-term outcomes, such as incidence and duration of illness, nutrient status, and cognitive development during the first year of life also demonstrate benefits of breastfeeding. Several proteins in breast milk, including lactoferrin, α-lactalbumin, milk fat globule membrane proteins, and osteopontin, have been shown to have bioactivities that range from involvement in the protection against infection to the acquisition of nutrients from breast milk. In some cases, bovine counterparts of these proteins exert similar bioactivities. It is possible by dairy technology to add protein fractions highly enriched in these proteins to infant formula.
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Fórmulas Infantiles/química , Fenómenos Fisiológicos Nutricionales del Lactante , Proteínas de la Leche , Leche Humana/química , Promoción de la Salud , Estado de Salud , Humanos , Lactante , Recién Nacido , Leche Humana/inmunología , Leche Humana/metabolismoRESUMEN
To discuss the potential clinical benefits of lactoferrin in preterm and term infants, as well as in young children and to review information on the burden of neonatal sepsis. Current evidence on the mechanisms that explain the role of human milk in the neonatal and infant anti-infective responses will be briefly reviewed and preclinical research data on the potential mechanisms of action by which lactoferrin may impact infant gut health, gut immune development and functions, including the lactoferrin effects on the neonatal microbiome, will be examined. Finally, updated translational research on lactoferrin will be presented and discussed and the current evidence from prospective randomized controlled trials in neonates, infants, and toddlers will be analyzed. These randomized controlled trials demonstrate that lactoferrin has a clinically significant impact on feeding, the microbiome, and clinical outcomes in neonates and infants.