| Summary: | 碩士 === 國立臺灣大學 === 臨床醫學研究所 === 93 === Exclusive breast-feeding is relevant to preventing or postponing the development of atopic diseases, such as cow’s milk allergy, atopic dermatitis, allergic rhinitis, and asthma. However, its exact protective effect remains controversial. Individual variations and immunologic complexity in the composition of the breast milk might account for the conflicting findings. The immunologic factors in milk of allergic mothers may differ from that of non-allergic mothers resulting in different effects of breast feeding on offspring’s immunity. The aims of this study are to 1) define the cellular composition of colostrum in allergic and non-allergic mothers, 2) investigate the Th1/Th2 cytokines in colostrum from allergic and non-allergic mothers, 3) define the levels of decoy receptor 3 (DcR3) in serum and colostrum from allergic and non-allergic mothers.
From June 2003 to September 2004, specimens of colostrum were obtained from allergic (n=32) and non-allergic (n=60) mothers 3 to 5 days post-partum. Clinical data including maternal age, delivery method, gravida, parity, and parental smoking history were collected. Information about maternal atopy (allergic rhihinitis, atopic dermatitis, and asthma) and family history of atopy were obtained by questionnaires. Maternal blood was analyzed for total IgE, and CAP specific IgE antibodies against common allergens. Subjects were defined as “allergic group” when both antigen-specific antibodies were detected and clinical atopic symptoms were reported. Double negative with atopic history and serology were defined as “non-allergic group”.
Milk leucocyte subsets were counted using a light microscopy. By enzyme-linked immunosorbent assay (ELISA) techniques, Th1 cytokines (IFN-r, IL-12p70, IL-18) and Th2 cytokines (IL-4 and IL-10) were investigated in colostrum samples. DcR3 levels in maternal serum and colostrum were also measured by commercial ELISA kit.
Most colostrum samples contained large numbers of lipid-filled macrophages (>90%), small numbers of lymphocytes and neutrophils, and scanty basophils and eosinophils. Counts of eosinophils and basophils did not increase in colostrum from allergic mothers. There were no significant differences of total cell counts and percentages of different leucocytes in colostrum between allergic and non-allergic mothers. Low levels of IFN-γ, IL-4, and IL-10 could be detected in a few samples. IL-12p70 (60%) and IL-18 (70%) were more common found in colostrum. All cytokines detected in this study showed no significant differences between the two groups. Serum concentrations of DcR3 were higher in allergic mothers compared with non-allergic mothers (1.88±2.15 ng/ml vs 4.74±7.78 ng/ml, p = 0.014). Significant positive correlation was noted between the levels of serum DcR3 and total IgE level, particularly in the allergic group (r = 0.614, p < 0.001). DcR3 could be detected in 30% to 40% of colostrum samples. There were no significant differences of colostrum DcR3 levels between the two groups.
Conclusions: Cellular composition, concentrations of IFN-γ, IL-12p70, IL-18, IL-4, IL-10 and DcR3 in colostrum were not altered by the presence of maternal atopy. DcR3 levels in serum were higher in allergic mothers compared with non-allergic mothers. However, the clinical significance of increased serum DcR3 levels in allergic mothers and the role of milk DcR3 should be further clarified.
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