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1.
mBio ; 12(1)2021 02 09.
Artigo em Inglês | MEDLINE | ID: mdl-33563823

RESUMO

Whether mother-to-infant SARS-CoV-2 transmission can occur during breastfeeding and, if so, whether the benefits of breastfeeding outweigh this risk during maternal COVID-19 illness remain important questions. Using RT-qPCR, we did not detect SARS-CoV-2 RNA in any milk sample (n = 37) collected from 18 women following COVID-19 diagnosis. Although we detected evidence of viral RNA on 8 out of 70 breast skin swabs, only one was considered a conclusive positive result. In contrast, 76% of the milk samples collected from women with COVID-19 contained SARS-CoV-2-specific IgA, and 80% had SARS-CoV-2-specific IgG. In addition, 62% of the milk samples were able to neutralize SARS-CoV-2 infectivity in vitro, whereas milk samples collected prior to the COVID-19 pandemic were unable to do so. Taken together, our data do not support mother-to-infant transmission of SARS-CoV-2 via milk. Importantly, milk produced by infected mothers is a beneficial source of anti-SARS-CoV-2 IgA and IgG and neutralizes SARS-CoV-2 activity. These results support recommendations to continue breastfeeding during mild-to-moderate maternal COVID-19 illness.IMPORTANCE Results from prior studies assaying human milk for the presence of SARS-CoV-2, the causative virus of COVID-19, have suggested milk may act as a potential vehicle for mother-to-child transmission. Most previous studies are limited because they followed only a few participants, were cross-sectional, and/or failed to report how milk was collected and/or analyzed. As such, considerable uncertainty remains regarding whether human milk is capable of transmitting SARS-CoV-2 from mother to child. Here, we report that repeated milk samples collected from 18 women following COVID-19 diagnosis did not contain SARS-CoV-2 RNA; however, risk of transmission via breast skin should be further evaluated. Importantly, we found that milk produced by infected mothers is a source of anti-SARS-CoV-2 IgA and IgG and neutralizes SARS-CoV-2 activity. These results support recommendations to continue breastfeeding during mild-to-moderate maternal COVID-19 illness as milk likely provides specific immunologic benefits to infants.


Assuntos
Anticorpos Neutralizantes/metabolismo , Anticorpos Antivirais/metabolismo , Leite Humano/imunologia , Complicações Infecciosas na Gravidez/imunologia , /imunologia , Adulto , Mama/virologia , Aleitamento Materno , /virologia , Feminino , Humanos , Lactente , Transmissão Vertical de Doença Infecciosa , Masculino , Leite Humano/virologia , Mães , Gravidez , Complicações Infecciosas na Gravidez/virologia , RNA Viral/isolamento & purificação , /isolamento & purificação
2.
Curr Nutr Rep ; 10(1): 71-75, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33394459

RESUMO

PURPOSE OF REVIEW: Breastfeeding is beneficial to both the newborn and the mother. During the COVID-19 pandemic, concerns have been raised on whether the SARS-CoV-2 virus could be transmitted from COVID-19 positive mother to the newborn through breastmilk. The purpose of this review is to examine the available evidence on the risks of transmission of infection from COVID-19 mothers to their newborns through breastfeeding. RECENT FINDINGS: Data is very limited in this regard, with only a few smaller case series, and case reports have been published so far. In most of the studies, breastmilk samples from COVID-19 mothers tested negative for the virus. In the case reports where the virus was detected in breastmilk and the infants were diagnosed with COVID-19, it remained unclear whether the disease was transmitted through breastmilk or direct contact or through delivery. Another hypothesis is that the viral antibodies could pass to the newborn passively through breastmilk of COVID-19 positive mothers and give immunity to the child, but data is minimal. Based on the currently available limited evidence and recognizing the benefits of breastfeeding, it may be concluded that if the health of the mother and her newborn allows, direct breastfeeding or extracted breastmilk should be encouraged by the healthcare providers after a careful discussion of the risks of vertical transmission to the mother and her family. Preventive measures should be taken by COVID-19 mothers to prevent droplet transmission of infection to the infants while breastfeeding.


Assuntos
Aleitamento Materno , Leite Humano/virologia , Gestantes , Anticorpos Antivirais , Estudos de Casos e Controles , Estudos de Coortes , Feminino , Humanos , Recém-Nascido , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Leite Humano/imunologia , Mães , Pandemias/prevenção & controle , Gravidez
5.
Rev Esp Salud Publica ; 942020 Jul 09.
Artigo em Espanhol | MEDLINE | ID: mdl-32643708

RESUMO

The SARS-CoV-2 pandemic has had a major impact on birth care and lactation. The lack of knowledge regarding the transmission mechanisms and the potential risks for the mother and the newborn, even when the vertical transmission of the virus has not been demonstrated, has led to the abandonment of practices such as skin-to-skin and the early initiation of breastfeeding (BF), which offer great benefits for maternal and child health. Taking into account the available scientific evidence and the protective effect of BF, the World Health Organization (WHO), and other organisms recommend, in cases of suspected or confirmed SARS-CoV-2 infection of the mother, maintaining mother-child contact and BF, adopting preventive measure procedures to minimize the risk of contagion. These measures include hand hygiene, before and after contact with the newborn and the use of a mask. If a temporary separation of mother and child is required, it is recommended to feed the newborn with expressed breast milk. The presence of IgA antibodies against SARS-CoV-2 has been confirmed in the milk of infected women, so BF could reduce the clinical impact of the disease in the infant, if it becomes infected.


Assuntos
Infecções por Coronavirus/prevenção & controle , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Leite Humano/virologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Anticorpos Antivirais/análise , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Feminino , Higiene das Mãos , Humanos , Imunoglobulina A/análise , Lactente , Recém-Nascido , Máscaras , Leite Humano/imunologia , Pneumonia Viral/epidemiologia , Espanha , Organização Mundial da Saúde
6.
J Dairy Sci ; 103(8): 6782-6797, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32600770

RESUMO

For breast-fed infants, human milk is a source of various nutrients (e.g., proteins, peptides, antibodies) and bioactive components that promote neonatal growth and protect infants from viral and bacterial infection. Moreover, in terms of infant nutrition and protection the functions of many human milk components are very different from those of blood and other biological fluids of healthy adults. For example, catalytic antibodies ("abzymes") with synthetic activities (protein, oligosaccharide, and lipid kinase activities) have been found in human breast milk that are absent in the blood of healthy people. Abzymes with hydrolyzing functions have been detected not only in milk, but also in the blood of patients with autoimmune diseases. Obviously, feeding newborns human milk has a very specific role and it is a unique aspect of mammalian nutrition. Ribonuclease and DNase autoantibodies or abzymes are found in milk and blood of lactating women, but not in blood sera of healthy men and nonpregnant woman. Here, we present the first evidence that human milk secretory IgA molecules (sIgA) can effectively hydrolyze ribooligonucleotides containing 23 different bases [(pN)23 ribooligonucleotides] and 4 microRNAs: miR-9-5p, miR-219-2-3p, miR-137, and miR-219a-5p. Ribonuclease activity is an inherent property of sIgAs. We showed that 7 individual sIgAs hydrolyzed the ribooligonucleotides (pA)23, (pU)23, and (pC)23 nonspecifically and with comparable efficiency, whereas hydrolysis of the 4 microRNAs by sIgAs was site-specific. Sites of hydrolysis of 4 microRNAs by IgG from blood of patients with schizophrenia have been previously identified. The sites of hydrolysis of 4 microRNAs by sIgA-abzymes were very different from the previously identified sites of hydrolysis by IgG in patients with schizophrenia. In addition, in contrast to IgG, milk sIgAs efficiently hydrolyzed microRNAs in their loop and duplex regions.


Assuntos
Imunoglobulina A Secretora/metabolismo , MicroRNAs/metabolismo , Leite Humano/metabolismo , Ribonucleotídeos/metabolismo , Adulto , Animais , Anticorpos Catalíticos/química , Anticorpos Catalíticos/metabolismo , Feminino , Humanos , Hidrólise , Lactação , Leite Humano/imunologia , Oligossacarídeos/análise
7.
Clin Immunol ; 217: 108510, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32544611

RESUMO

Children, because of having an immature immune system, are usually more prone than the adults to the microbial infections and have more severe symptoms, which is especially true for the newborns, and very young children. However, the review of clinical data from the current COVID-19 pandemic indicates otherwise. We discuss here what are the main features and components of children's immune system, the role of maternal transmission of immunity, and what are the possible explanations for the seemingly lower infection rate and severity of COVI-19 in children.


Assuntos
Betacoronavirus/imunologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/imunologia , Sistema Imunitário/virologia , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/imunologia , Adulto , Fatores Etários , Betacoronavirus/patogenicidade , Criança , Pré-Escolar , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Citocinas/imunologia , Resistência à Doença , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Leite Humano/imunologia , Placenta/imunologia , Placenta/virologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Gravidez
8.
Emerg Microbes Infect ; 9(1): 1467-1469, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32552365

RESUMO

A maternal woman was positive for SARS-CoV-2 tested in throat swabs but negative tested in other body fluids, and she had IgG and IgA detected in breast milk. Her infant negative for SARS-CoV-2 at birth had elevated IgG in serum but quickly decayed. These findings suggest that breastfeeding might have the potential benefit to the neonates.


Assuntos
Anticorpos Antivirais/análise , Betacoronavirus/imunologia , Infecções por Coronavirus/imunologia , Leite Humano/imunologia , Pneumonia Viral/imunologia , Complicações Infecciosas na Gravidez/virologia , Adulto , Anticorpos Antivirais/imunologia , China , Feminino , Humanos , Imunoglobulina A/análise , Imunoglobulina G/análise , Recém-Nascido , Leite Humano/virologia , Pandemias , Gravidez , Complicações Infecciosas na Gravidez/imunologia
9.
J Dairy Sci ; 103(7): 5978-5991, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32418693

RESUMO

Human milk (HM) constitutes the first immunological barrier and the main source of nutrients and bioactive components for newborns. Immune factors comprise up to 10% of the protein content in HM, where antibodies are the major components (mainly IgA, IgG, and IgM). In addition, antibacterial enzymes such as lysozyme and immunoregulatory factors such as soluble cluster of differentiation 14 (sCD14) and transforming growth factor ß2 (TGF-ß2) are also present and play important roles in the protection of the infant's health. Donor milk processed in HM banks by Holder pasteurization (HoP; 62.5°C, 30 min) is a safe and valuable resource for preterm newborns that are hospitalized, but is reduced in major immunological components due to thermal inactivation. We hypothesized that high hydrostatic pressure (HHP) and high-pressure homogenization (HPH) are 2 processes that can be used on HM to reduce total bacteria counts while retaining immunological components. We studied the effects of HHP (400, 450, and 500 MPa for 5 min applied at 20°C) and HPH (200, 250, and 300 MPa, milk inlet temperature of 20°C) applied to mature HM, on microbiological and immunological markers (IgA, IgG, IgM, sCD14, and TGF-ß2), and compared them with those of traditional HoP in HM samples from healthy donors. The HHP processing between 400 and 500 MPa at 20°C reduced counts of coliform and total aerobic bacteria to undetectable levels (<1.0 log cfu/mL) while achieving approximately 100% of immunological component retention. In particular, comparing median percentages of retention of immunological components for 450 MPa versus HoP, we found 101.5 versus 50.5% for IgA, 89.5 versus 26.0% for IgM, 104.5 versus 75.5% for IgG, 125.0 versus 72.5% for lysozyme, 50.6 versus 0.1% for sCD14, and 88.5 versus 61.1% for TGF-ß2, respectively. Regarding HPH processing, at a pressure of 250 MPa and inlet temperature of 20°C, the process showed good potential to reduce coliforms to undetectable levels and total aerobic bacteria to levels slightly above those obtained by HoP. The median percentages of retention of immunological markers for HPH versus HoP were 71.5 versus 52.0%, 71.0 versus 27.0%, 104.0 versus 66.5%, and 30.9 versus 0.2%, for IgA, IgM, IgG, and sCD14, respectively; results did not significantly differ for lysozyme and TGF-ß2. The HPH at 300 MPa produced higher inactivation of immunological components, similar to values achieved with HoP.


Assuntos
Leite Humano/imunologia , Adulto , Feminino , Humanos , Pressão Hidrostática , Bancos de Leite , Pasteurização , Temperatura , Adulto Jovem
11.
Pediatrics ; 145(4)2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32161111

RESUMO

The nutritional and immunologic properties of human milk, along with clear evidence of dose-dependent optimal health outcomes for both mothers and infants, provide a compelling rationale to support exclusive breastfeeding. US women increasingly intend to breastfeed exclusively for 6 months. Because establishing lactation can be challenging, exclusivity is often compromised in hopes of preventing feeding-related neonatal complications, potentially affecting the continuation and duration of breastfeeding. Risk factors for impaired lactogenesis are identifiable and common. Clinicians must be able to recognize normative patterns of exclusive breastfeeding in the first week while proactively identifying potential challenges. In this review, we provide new evidence from the past 10 years on the following topics relevant to exclusive breastfeeding: milk production and transfer, neonatal weight and output assessment, management of glucose and bilirubin, immune development and the microbiome, supplementation, and health system factors. We focus on the early days of exclusive breastfeeding in healthy newborns ≥35 weeks' gestation managed in the routine postpartum unit. With this evidence-based clinical review, we provide detailed guidance in identifying medical indications for early supplementation and can inform best practices for both birthing facilities and providers.


Assuntos
Aleitamento Materno/métodos , Prática Clínica Baseada em Evidências , Lactação/fisiologia , Leite Humano/fisiologia , Algoritmos , Peso ao Nascer , Glicemia/metabolismo , Peso Corporal/fisiologia , Extração de Leite/métodos , Colostro/fisiologia , Suplementos Nutricionais , Feminino , Glicogênio/metabolismo , Humanos , Hiperbilirrubinemia/terapia , Recém-Nascido , Método Canguru , Transtornos da Lactação/etiologia , Microbiota/fisiologia , Leite Humano/química , Leite Humano/imunologia , Mães , Fototerapia , Fatores de Risco , Fatores de Tempo
12.
Proc Natl Acad Sci U S A ; 117(14): 7941-7949, 2020 04 07.
Artigo em Inglês | MEDLINE | ID: mdl-32179676

RESUMO

Late-onset sepsis (LOS) is a highly consequential complication of preterm birth and is defined by a positive blood culture obtained after 72 h of age. The causative bacteria can be found in patients' intestinal tracts days before dissemination, and cohort studies suggest reduced LOS risk in breastfed preterm infants through unknown mechanisms. Reduced concentrations of epidermal growth factor (EGF) of maternal origin within the intestinal tract of mice correlated to the translocation of a gut-resident human pathogen Escherichia coli, which spreads systemically and caused a rapid, fatal disease in pups. Translocation of Escherichia coli was associated with the formation of colonic goblet cell-associated antigen passages (GAPs), which translocate enteric bacteria across the intestinal epithelium. Thus, maternally derived EGF, and potentially other EGFR ligands, prevents dissemination of a gut-resident pathogen by inhibiting goblet cell-mediated bacterial translocation. Through manipulation of maternally derived EGF and alteration of the earliest gut defenses, we have developed an animal model of pathogen dissemination which recapitulates gut-origin neonatal LOS.


Assuntos
Translocação Bacteriana/imunologia , Receptores ErbB/metabolismo , Infecções por Escherichia coli/imunologia , Escherichia coli/imunologia , Microbioma Gastrointestinal/imunologia , Leite Humano/imunologia , Sepse Neonatal/imunologia , Animais , Animais Recém-Nascidos , Antígenos de Bactérias/imunologia , Antígenos de Bactérias/metabolismo , Aleitamento Materno , Colo/metabolismo , Colo/microbiologia , Modelos Animais de Doenças , Fator de Crescimento Epidérmico/metabolismo , Receptores ErbB/genética , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/metabolismo , Infecções por Escherichia coli/microbiologia , Fezes/química , Fezes/microbiologia , Feminino , Humanos , Recém-Nascido , Recém-Nascido Prematuro/imunologia , Mucosa Intestinal/metabolismo , Mucosa Intestinal/microbiologia , Masculino , Camundongos , Camundongos Transgênicos , Leite Humano/metabolismo , Sepse Neonatal/metabolismo , Sepse Neonatal/microbiologia , Transdução de Sinais/imunologia , Fatores de Tempo
13.
Nutrients ; 12(2)2020 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-32033312

RESUMO

During the first days of life, premature infants have physiological difficulties swallowing, thereby missing out on the benefits of breastfeeding. The aim of this study is to assess the effects of oropharyngeal mother's milk administration in the inflammatory signaling of extremely premature infants. Neonates (n = 100) (<32 week's gestation and/or <1500 g) were divided into two groups: mother's milk group (n = 48), receiving 0.2 mL of oropharyngeal mother's milk every 4 h for the first 15 days of life, and a control group (n = 52), not receiving oropharyngeal mother's milk. Serum concentrations of interleukin (IL) IL-6, IL-8, IL-10, IL-1ra, tumor necrosis factor alpha (TNF-α), and interferón gamma (IFN-γ) were assessed at 1, 3, 15, and 30 days of postnatal life. Maternal and neonatal outcomes were collected. The rate of common neonatal morbidities in both groups was similar. The mother's milk group achieved full enteral feeding earlier, and showed a decrease in Il-6 on days 15 and 30, in IL-8 on day 30, and in TNF-α and INF-γ on day 15, as well as an increase in IL-1ra on days 3 and 15 and in IL-10 on day 30. Oropharyngeal mother's milk administration for 15 days decreases the pro-inflammatory state of preterm neonates and provides full enteral nutrition earlier, which could have a positive influence on the development of the immune system and inflammatory response, thereby positively influencing other developmental outcomes.


Assuntos
Colostro/imunologia , Nutrição Enteral/métodos , Lactente Extremamente Prematuro/imunologia , Doenças do Prematuro/terapia , Leite Humano/imunologia , Biomarcadores/sangue , Citocinas/sangue , Feminino , Humanos , Recém-Nascido , Inflamação , Gravidez , Resultado do Tratamento
14.
Expert Opin Pharmacother ; 21(5): 549-556, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32011188

RESUMO

Introduction: Mortality due to sepsis is still prevalent, peaking at extreme ages of life including infancy. Despite many efforts, the peculiarity of the infant immune system has limited further advances in its treatment. Indeed, neonates experience a dramatic physiological transition from immune tolerance to the maternal antigens to functional maturity. Such a transition is extremely dynamic, as is the pathophysiology of infant sepsis, which is dependent on many infant, maternal, and environmental factors.Areas covered: In this review, the authors critically update and summarize the current paradigm of immunomodulation in infant sepsis. They confirm how exogenous stimulation of the immune system through intravenous immunoglobulin, colony stimulating factors, and granulocyte transfusion have failed to impact on the prognosis of infant sepsis. They also strongly support the beneficial effects of supplementation/replacement therapies with products naturally contained within maternal milk as well as antioxidant compounds.Expert opinion: Breastfeeding is beneficial against sepsis. Knowledge of the neonatal immune system is indeed too limited to effectively strengthen immune response by exogenous interventions, especially in preterm and low-birth-weight infants. Awareness of this limitation should pave the way for future studies (e.g. gender- and omics-based) aimed at better characterizing the infant immune system and promoting a more tailored approach.


Assuntos
Doenças do Prematuro/tratamento farmacológico , Sepse Neonatal/tratamento farmacológico , Imunidade Adaptativa/efeitos dos fármacos , Antioxidantes/uso terapêutico , Aleitamento Materno , Humanos , Imunidade Inata/efeitos dos fármacos , Imunoglobulinas/uso terapêutico , Lactente , Recém-Nascido , Recém-Nascido Prematuro , Doenças do Prematuro/imunologia , Leite Humano/imunologia , Sepse Neonatal/imunologia , Caracteres Sexuais , Resultado do Tratamento
15.
Nature ; 577(7791): 543-548, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31915378

RESUMO

Although maternal antibodies protect newborn babies from infection1,2, little is known about how protective antibodies are induced without prior pathogen exposure. Here we show that neonatal mice that lack the capacity to produce IgG are protected from infection with the enteric pathogen enterotoxigenic Escherichia coli by maternal natural IgG antibodies against the maternal microbiota when antibodies are delivered either across the placenta or through breast milk. By challenging pups that were fostered by either maternal antibody-sufficient or antibody-deficient dams, we found that IgG derived from breast milk was crucial for protection against mucosal disease induced by enterotoxigenic E. coli. IgG also provides protection against systemic infection by E. coli. Pups used the neonatal Fc receptor to transfer IgG from milk into serum. The maternal commensal microbiota can induce antibodies that recognize antigens expressed by enterotoxigenic E. coli and other Enterobacteriaceae species. Induction of maternal antibodies against a commensal Pantoea species confers protection against enterotoxigenic E. coli in pups. This role of the microbiota in eliciting protective antibodies to a specific neonatal pathogen represents an important host defence mechanism against infection in neonates.


Assuntos
Anticorpos/imunologia , Escherichia coli Enterotoxigênica/imunologia , Infecções por Escherichia coli/imunologia , Infecções por Escherichia coli/prevenção & controle , Imunidade Materno-Adquirida/imunologia , Recém-Nascido/imunologia , Microbiota/imunologia , Leite Humano/imunologia , Animais , Anticorpos/sangue , Anticorpos/metabolismo , Aleitamento Materno , Reações Cruzadas/imunologia , Infecções por Escherichia coli/microbiologia , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina G/imunologia , Imunoglobulina G/metabolismo , Masculino , Camundongos , Mães , Pantoea/imunologia , Receptores Fc/imunologia , Receptores Fc/metabolismo , Simbiose/imunologia
16.
PLoS One ; 14(12): e0226496, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31887150

RESUMO

OBJECTIVES: Human milk-based fortifiers have shown a protective effect on major complications for very low birth weight newborns. The current study aimed to estimate the cost-effectiveness of an exclusive human milk diet (EHMD) compared to the current approach using cow's milk-based fortifiers in very low birth weight newborns. METHODS: A decision tree model using the health states of necrotising enterocolitis (NEC), sepsis, NEC + sepsis and no complication was used to calculate the cost-effectiveness of an EHMD. For each health state, bronchopulmonary dysplasia (BPD), retinopathy of prematurity (RoP) and neurodevelopmental problems were included as possible complications; additionally, short-bowel syndrome (SBS) was included as a complication for surgical treatment of NEC. The model was stratified into birth weight categories. Costs for inpatient treatment and long-term consequences were considered from a third party payer perspective for the reference year 2017. Deterministic and probabilistic sensitivity analyses were performed, including a societal perspective, discounting rate and all input parameter-values. RESULTS: In the base case, the EHMD was estimated to be cost-effective compared to the current nutrition for very low birth weight newborns with an incremental cost-effectiveness ratio (ICER) of €28,325 per Life-Year-Gained (LYG). From a societal perspective, the ICER is €27,494/LYG using a friction cost approach and €16,112/LYG using a human capital approach. Deterministic sensitivity analyses demonstrated that the estimate was robust against changes in the input parameters and probabilistic sensitivity analysis suggested that the probability EHMD was cost-effective at a threshold of €45,790/LYG was 94.8 percent. CONCLUSION: Adopting EHMD as the standard approach to nutrition is a cost-effective intervention for very low birth weight newborns in Germany.


Assuntos
Displasia Broncopulmonar/economia , Recém-Nascido de muito Baixo Peso/imunologia , Leite Humano/imunologia , Retinopatia da Prematuridade/economia , Retinopatia da Prematuridade/terapia , Sepse/economia , Síndrome do Intestino Curto/economia , Animais , Displasia Broncopulmonar/imunologia , Displasia Broncopulmonar/terapia , Análise Custo-Benefício , Árvores de Decisões , Alemanha , Hospitalização/economia , Humanos , Fórmulas Infantis , Recém-Nascido , Leite/imunologia , Retinopatia da Prematuridade/imunologia , Sepse/imunologia , Sepse/terapia , Síndrome do Intestino Curto/imunologia , Síndrome do Intestino Curto/terapia , Resultado do Tratamento
17.
Stress Health ; 35(5): 681-685, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31691465

RESUMO

Our study aimed to assess the impact of maternal psychological stress on the immunological components of breast milk. Eighty-nine women participated in the study. We assessed general stress, postpartum-specific stress, negative affectivity, salivary cortisol of mother, and secretory immunoglobulin A (sIgA) levels of breast milk 4-6 weeks after delivery. Controlling for the effects of women's age, weight, number, and duration of feedings, postpartum-specific stress was related to reduced sIgA concentration (R2 = .206, beta = -.275, p = .020). This study suggests that the established link between psychological stress and immunity may also extend to the immunity of the newborn by reducing the immunological benefits of breast milk. It also suggests that breastfeeding might be a potential mechanism of the relationship between maternal stress and the health of the offspring. Findings highlight the need for interventions addressing women during the postpartum period, in order to ensure the mother's well-being and the infant's optimal development.


Assuntos
Imunoglobulina A Secretora/metabolismo , Leite Humano/imunologia , Mães/psicologia , Período Pós-Parto/psicologia , Estresse Psicológico/imunologia , Adulto , Aleitamento Materno , Feminino , Grécia , Humanos , Hidrocortisona/metabolismo , Imunoglobulina A Secretora/imunologia , Análise de Regressão , Estresse Psicológico/metabolismo , Adulto Jovem
18.
Nutrients ; 11(10)2019 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-31658692

RESUMO

A growing number of studies are focusing on the associations between human milk (HM) immunological composition and allergic diseases. This scoping review aims to identify statistical methods applied in the field and highlight pitfalls and unmet needs. A comprehensive literature search in MEDLINE and Embase retrieved 13,607 unique records. Following title/abstract screening, 29 studies met the selection criteria and were included in this review. We found that definitions of colostrum and mature milk varied across the studies. A total of 17 out of 29 (59%) studies collected samples longitudinally, but only 12% of these used serial (longitudinal) analyses. Multivariable analysis was used in 45% of the studies, but statistical approaches to modelling varied largely across the studies. Types of variables included as potential confounding factors differed considerably between models. Discrimination analysis was absent from all studies and only a single study reported classification measures. Outcomes of this scoping review highlight lack of standardization, both in data collection and handling, which remains one of the main challenges in the field. Improved standardization could be obtained by a consensus group of researchers and clinicians that could recommend appropriate methods to be applied in future prospective studies, as well as already existing datasets.


Assuntos
Colostro , Hipersensibilidade , Leite Humano , Modelos Estatísticos , Algoritmos , Biomarcadores , Colostro/química , Colostro/imunologia , Métodos Epidemiológicos , Feminino , Humanos , Hipersensibilidade/epidemiologia , Hipersensibilidade/imunologia , Hipersensibilidade/fisiopatologia , Leite Humano/química , Leite Humano/imunologia , Revisões Sistemáticas como Assunto
19.
Nutrients ; 11(10)2019 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-31581741

RESUMO

Among the immunologically important bioactive factors present in human milk, lactoferrin (Lf) has emerged as a key player with wide-ranging features that directly and indirectly protect the neonate against infection caused by a variety of pathogens. The concentration of Lf in human milk is lactation-stage related; colostrum contains more than 5 g/L, which then significantly decreases to 2-3 g/L in mature milk. The milk of mothers who are breastfeeding for more than one year is of a standard value, containing macronutrients in a composition similar to that of human milk at later stages. The aim of this study was to evaluate lactoferrin concentration in prolonged lactation from the first to the 48th month postpartum. Lactating women (n = 120) up to 48 months postpartum were recruited to the study. The mean value of lactoferrin concentration was the lowest in the group of 1-12 months of lactation (3.39 ± 1.43 g/L), significantly increasing in the 13-18 months group (5.55 ± 4.00 g/L; p < 0.006), and remaining at a comparable level in the groups of 19-24 month and over 24 months (5.02 ± 2.97 and 4.90 ± 3.18 g/L, respectively). The concentration of lactoferrin in mother's milk also showed a positive correlation with protein concentration over lactation from the first to the 48th month (r = 0.3374; p = 0.0002). Our results demonstrate the high immunology potential of human milk during prolonged lactation and that Lf concentration is close to the Lf concentration in colostrum. Evidence of stable or rising immunoprotein levels during prolonged lactation provides an argument for foregoing weaning; however, breastfeeding must be combined with solid foods meet the new requirements of a rapidly growing six-month or older baby.


Assuntos
Aleitamento Materno , Lactação/metabolismo , Lactoferrina/metabolismo , Leite Humano/metabolismo , Valor Nutritivo , Adulto , Fatores Etários , Desenvolvimento Infantil , Pré-Escolar , Colostro/metabolismo , Feminino , Humanos , Imunidade Inata , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Lactoferrina/imunologia , Masculino , Leite Humano/imunologia , Estado Nutricional , Fatores de Tempo
20.
Molecules ; 24(20)2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31652515

RESUMO

In light of the immunoprotective function of human milk and the incontestable impact of IgG glycosylation on its immune functions, characterization of the sialylation profile of human milk IgG is needed. Lectins as a molecular probe were applied in lectin-IgG-ELISA to analyze the sialylation and galactosylation pattern of skim milk IgG of mothers who delivered at term and prematurely. Well-defined biotinylated lectins were used: Maackia amurensis II (MAA II), Sambucus nigra (SNA), Ricinus communis I (RCA I), and Griffonia simplicifolia II (GSL II) specific to α2,3-Neu5Ac, α2,6-Neu5Ac, Gal(ß1,4)GlcNAc, and agalactosylated glycans, respectively. The sialylation pattern of milk IgG differs qualitatively and quantitatively from maternal plasma IgG and is related to lactation stage and perinatal risk factors. Expression of MAA-, SNA-, and GSL-reactive glycotopes on term milk IgG showed a positive correlation with milk maturation from days 1 to 55. Preterm birth was associated with an increase of MAA-reactive and a decrease of RCA-reactive IgG glycotopes. Moreover, higher SNA- and GSL-reactive and lower RCA-reactive glycoform levels of milk IgG were associated with infection of lactating mothers. Application of a specific and simple method, lectin-IgG-ELISA, reveals the sialylation pattern of milk IgG over milk maturation. However, further investigations are needed in this area.


Assuntos
Imunoglobulina G/metabolismo , Leite Humano/imunologia , Ácido N-Acetilneuramínico/metabolismo , Lectinas de Plantas/metabolismo , Adulto , Ensaio de Imunoadsorção Enzimática , Feminino , Glicosilação , Griffonia/química , Griffonia/metabolismo , Humanos , Imunoglobulina G/química , Infecções/metabolismo , Lactação/imunologia , Lactação/metabolismo , Maackia/química , Maackia/metabolismo , Polissacarídeos/metabolismo , Gravidez , Nascimento Prematuro/metabolismo , Ricinus/química , Ricinus/metabolismo , Sambucus nigra/química , Sambucus nigra/metabolismo
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