Antenatal Influenza A-Specific IgA, IgM, and IgG Antibodies in Mother's Own Breast Milk and Donor Breast Milk, and Gastric Contents and Stools from Preterm Infants.

Veronique Demers-Mathieu,Rachel L Martin,David C Dallas,Robert K Huston,Andi M Markell,Elizabeth A Mcculley

doi:10.3390/nu11071567

Veronique Demers-Mathieu, Rachel L Martin + Show 4 more

Open Access

https://doi.org/10.3390/nu11071567

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Abstract

Antenatal milk anti-influenza antibodies may provide additional protection to newborns until they are able to produce their own antibodies. To evaluate the relative abundance of milk, we studied the antibodies specific to influenza A in feeds and gastric contents and stools from preterm infants fed mother’s own breast milk (MBM) and donor breast milk (DBM). Feed (MBM or DBM) and gastric contents (MBM or DBM at 1 h post-ingestion) and stool samples (MBM/DBM at 24 h post-ingestion) were collected, respectively, from 20 preterm (26–36 weeks gestational age) mother-infant pairs at 8–9 days and 21–22 days of postnatal age. Samples were analyzed via ELISA for anti-H1N1 hemagglutinin (anti-H1N1 HA) and anti-H3N2 neuraminidase (anti-H3N2 NA) specificity across immunoglobulin A (IgA), immunoglobulin M (IgM), and immunoglobulin G (IgG) isotypes. The relative abundance of influenza A-specific IgA in feeds and gastric contents were higher in MBM than DBM at 8–9 days of postnatal age but did not differ at 21–22 days. Anti-influenza A-specific IgM was higher in MBM than in DBM at both postnatal times in feed and gastric samples. At both postnatal times, anti-influenza A-specific IgG was higher in MBM than DBM but did not differ in gastric contents. Gastric digestion reduced anti-H3N2 NA IgG from MBM at 21–22 days and from DBM at 8–9 days of lactation, whereas other anti-influenza A antibodies were not digested at either postnatal times. Supplementation of anti-influenza A-specific antibodies in DBM may help reduce the risk of influenza virus infection. However, the effective antibody dose required to induce a significant protective effect remains unknown.

Highlights

Infants are susceptible to influenza infections and cannot be vaccinated before six months of age [1,2]
The relative abundance of H1N1 HA- (Figure 2) and H3N2 NA-specific immunoglobulin A (IgA) (Figure 2) were 3.6and 2-fold higher, respectively, in mother’s own breast milk (MBM) than donor breast milk (DBM) feeds given at 8–9 days of postnatal age but did not differ at 21–22 days
H1N1 HA- (10- and 3-fold) and H3N2 NA-specific immunoglobulin M (IgM) (13- and 8-fold) were higher in MBM than in DBM feeds given at 8–9 days and 21–22 days of postnatal age, respectively

Summary

Introduction

Infants are susceptible to influenza infections and cannot be vaccinated before six months of age [1,2]. Antenatal vaccination helps protect the infant against influenza infection [4,5,6,7]. In addition to the changes in blood, antenatal vaccination increases secretion of influenza-specific antibodies into breast. Milk anti-influenza antibodies may provide additional protection to newborns until they are able to produce antibodies against the virus [9]. Regardless of whether a mother was recently vaccinated, their breast milk typically contains some influenza-specific Ig as they were likely exposed to the virus or vaccinated in the past [10]. These milk antibodies may be protective against influenza infection [9]

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