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Does low IgA in human milk predispose the infant to development of cow's milk allergy?

Abstract

We sought a relationship between total and cow's milk-specific IgA levels in colostrum and human milk and subsequent development of cow's milk allergy (CMA) in the breast-fed infant. The study included 87 nursing mothers and their infants (age, 2 d to 7 mo), followed prospectively up to 1 y. At 1 y, 48 mothers (69% with an atopic constitution) had an infant with CMA, verified by clinical cow's milk challenge, eight (38% with an atopic constitution) had a baby who had had protracted infantile colic but no CMA (disease control group), and 31 (23% with an atopic constitution) had a healthy infant. Total breast-milk IgA was measured by radial immunodiffusion, and IgA antibodies to cow's milk were measured by ELISA during the breast-feeding period. The levels of total and cow's milk-specific IgA antibodies in colostrum and human milk were significantly lower in the mothers whose baby later developed CMA [estimated third day value, 0.38 g/L (95% confidence interval, 0. 24-0.82)] than in the ones whose infant remained healthy or had had infantile colic but not CMA [0.82 g/L (95% confidence interval, 0. 99-1.51); p < 0.05]. The infants developed CMA significantly more often if the concentration of total IgA antibodies in milk was <0.25 g/L, when measured between 6 d and 4 wk postpartum [sensitivity, 0. 55; specificity, 0.92; odds ratio, 14.7 (95% confidence interval, 3. 1-70.2); p < 0.001]. The levels of cow's milk-specific IgA positively correlated with the levels of total IgA but not with the development of CMA in the infant. The levels of total or cow's milk-specific IgA did not correlate with maternal atopy. IgA antibodies in colostrum and human milk may prevent antigen entry at the intestinal surface of the breast-fed infant. A low IgA content in human milk may lead to defective exclusion of food antigens and thus predispose an offspring to develop food allergies.

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  • Authors+Show Affiliations

    ,

    Department of Dermatology, Helsinki University Central Hospital, FIN-00029 HUCH, Helsinki, Finland.

    , ,

    Source

    Pediatric research 48:4 2000 Oct pg 457-62

    MeSH

    Animals
    Breast Feeding
    Cattle
    Colostrum
    Enzyme-Linked Immunosorbent Assay
    Humans
    Immunodiffusion
    Immunoglobulin A
    Infant, Newborn
    Milk
    Milk Hypersensitivity
    Milk, Human
    Prospective Studies
    Skin Tests

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    11004235

    Citation

    Järvinen, K M., et al. "Does Low IgA in Human Milk Predispose the Infant to Development of Cow's Milk Allergy?" Pediatric Research, vol. 48, no. 4, 2000, pp. 457-62.
    Järvinen KM, Laine ST, Järvenpää AL, et al. Does low IgA in human milk predispose the infant to development of cow's milk allergy? Pediatr Res. 2000;48(4):457-62.
    Järvinen, K. M., Laine, S. T., Järvenpää, A. L., & Suomalainen, H. K. (2000). Does low IgA in human milk predispose the infant to development of cow's milk allergy? Pediatric Research, 48(4), pp. 457-62.
    Järvinen KM, et al. Does Low IgA in Human Milk Predispose the Infant to Development of Cow's Milk Allergy. Pediatr Res. 2000;48(4):457-62. PubMed PMID: 11004235.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Does low IgA in human milk predispose the infant to development of cow's milk allergy? AU - Järvinen,K M, AU - Laine,S T, AU - Järvenpää,A L, AU - Suomalainen,H K, PY - 2000/9/27/pubmed PY - 2000/10/21/medline PY - 2000/9/27/entrez SP - 457 EP - 62 JF - Pediatric research JO - Pediatr. Res. VL - 48 IS - 4 N2 - We sought a relationship between total and cow's milk-specific IgA levels in colostrum and human milk and subsequent development of cow's milk allergy (CMA) in the breast-fed infant. The study included 87 nursing mothers and their infants (age, 2 d to 7 mo), followed prospectively up to 1 y. At 1 y, 48 mothers (69% with an atopic constitution) had an infant with CMA, verified by clinical cow's milk challenge, eight (38% with an atopic constitution) had a baby who had had protracted infantile colic but no CMA (disease control group), and 31 (23% with an atopic constitution) had a healthy infant. Total breast-milk IgA was measured by radial immunodiffusion, and IgA antibodies to cow's milk were measured by ELISA during the breast-feeding period. The levels of total and cow's milk-specific IgA antibodies in colostrum and human milk were significantly lower in the mothers whose baby later developed CMA [estimated third day value, 0.38 g/L (95% confidence interval, 0. 24-0.82)] than in the ones whose infant remained healthy or had had infantile colic but not CMA [0.82 g/L (95% confidence interval, 0. 99-1.51); p < 0.05]. The infants developed CMA significantly more often if the concentration of total IgA antibodies in milk was <0.25 g/L, when measured between 6 d and 4 wk postpartum [sensitivity, 0. 55; specificity, 0.92; odds ratio, 14.7 (95% confidence interval, 3. 1-70.2); p < 0.001]. The levels of cow's milk-specific IgA positively correlated with the levels of total IgA but not with the development of CMA in the infant. The levels of total or cow's milk-specific IgA did not correlate with maternal atopy. IgA antibodies in colostrum and human milk may prevent antigen entry at the intestinal surface of the breast-fed infant. A low IgA content in human milk may lead to defective exclusion of food antigens and thus predispose an offspring to develop food allergies. SN - 0031-3998 UR - https://www.unboundmedicine.com/medline/citation/11004235/Does_low_IgA_in_human_milk_predispose_the_infant_to_development_of_cow's_milk_allergy L2 - http://dx.doi.org/10.1203/00006450-200010000-00007 DB - PRIME DP - Unbound Medicine ER -