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Temporary neonatal exposure to whole and hydrolysed cow's milk proteins. Studies of macromolecular absorption and immunological variables

Juvonen, Pekka O LU (1999)
Abstract (Swedish)
Popular Abstract in Swedish

Intag av födoämnesantigen resulterar normalt i induktion av oral tolerans, men klinisk och immunologisk betydelse av kortvarig neonatal exponering för komjölksproteiner är inte klarlagt. Syftet med detta arbete var att studera prospektivt effekten av olika uppfödningsregimen under de tre första levnadsdagarna. Påverkan på makromolekylär absorption, antikropps produktion och utveckling av allergiska symptom studerades. Makromolekylär absorption studerades också på barn med akuta symptom av komjölksallergi, och i relation till komjölks- provokation. En grupp bestående av 129 barn randomiserades vid födelsen till en av uppfödningsgrupperna: bröstmjölk (HM), komjölksformula (CMF) eller kasein... (More)
Popular Abstract in Swedish

Intag av födoämnesantigen resulterar normalt i induktion av oral tolerans, men klinisk och immunologisk betydelse av kortvarig neonatal exponering för komjölksproteiner är inte klarlagt. Syftet med detta arbete var att studera prospektivt effekten av olika uppfödningsregimen under de tre första levnadsdagarna. Påverkan på makromolekylär absorption, antikropps produktion och utveckling av allergiska symptom studerades. Makromolekylär absorption studerades också på barn med akuta symptom av komjölksallergi, och i relation till komjölks- provokation. En grupp bestående av 129 barn randomiserades vid födelsen till en av uppfödningsgrupperna: bröstmjölk (HM), komjölksformula (CMF) eller kasein hydrolysat formula under de tre första levnadsdagarna. Formula uppfödda barn erhöll ingen bröstmjölk före fyra dagars ålder, varefter alla barn uppföddes med bröstmjölk i varierande tid. Barnen följdes i tre år. Barn med akuta symtom på komjölksallergi och i relation till komjölksprovokation undersöktes för makromolekylär absorption och serum IgE. Macromolekylär absorption analysarades efter bröstmjölksmål genom att mäta serum halt av humant alpha-lactalbumin (alpha-LA). Totalt serum IgE, serum IgG och IgE antikroppar mot komjölksproteiner och ovalbumin analyserades, liksom sekretoriskt IgA (sIgA) i saliv på barnen och i mödrarnas bröstmjölk.



Vid 2 månaders ålder registrerades högre alpha-LA koncentrationer i CHF gruppen jämfört med HM och CMF grupperna. Barn som utvecklade syptom vid komjölksprovokation hade tio gånger högre nivåer av alpha-LA i serum jämfört med barnen utan symptom- utveckling. Barn med akuta symptom av komjölks- allergi hade högre nivåer än friska barn. Total serum IgE var lägre i CHF gruppen jämfört med HM gruppen vid 2 och 8 månaders ålder. IgG antikroppsnivåer mot beta-laktoglobulin och bovint serum albumin var högre i CMF och HM grupperna jämfört med CHF gruppen upp till två års ålder. IgG antikroppsnivåer mot kasein var högre i CMF gruppen jämfört med CHF gruppen vid 8 och 12 månaders ålder. IgG antikroppsnivåer mot ovalbumin var lika i alla tre grupperna. Saliv sIgA nivåerna var lika i alla tre grupperna. Det fanns ingen korrelation mellan saliv sIgA, IgG anti- kroppsnivåer eller IgE antikroppsnivåer och antingen atopiska symptom hos barnen eller allergisk hereditet. Som konklusion, exponering för komjölk under de tre första levnadsdagarna stimulerade IgG antikropps- produktion mot komjölksproteiner, denna stimulerande effekt var fortfarande noterbar vid två års ålder. Exponering för kasein hydrolysat neonatalt var associerad med ökad makromolkylär absorption vid två månaders ålder och synes dämpa barnets immunokompetens genom att minska produktion av totalt IgE under de åtta första levnadsmånaderna och IgG antikroppsproduktion mot komjölksproteiner under de två första levnadsåren. (Less)
Abstract
The aim of this work was to study prospectively the effects of different feeding regimens during the first three days of life. A group of 129 infants were randomly assigned at birth to one of three feeding regimens: human milk (HM), cow's milk formula (CMF), or a casein hydrolysate formula (CHF). The formula-fed infants received no human milk until the fourth day of life, after which all infants were breast- fed for a varying period of time. During a 2 years follow-up, effects of different feeding regimens on macromolecular absoprtion (serum content of human alpha-lactalbumin, alpha-LA), antibody production, and development of allergic symptoms were studied. Macromolecular absorption was also studied in 28 children with acute symptoms of... (More)
The aim of this work was to study prospectively the effects of different feeding regimens during the first three days of life. A group of 129 infants were randomly assigned at birth to one of three feeding regimens: human milk (HM), cow's milk formula (CMF), or a casein hydrolysate formula (CHF). The formula-fed infants received no human milk until the fourth day of life, after which all infants were breast- fed for a varying period of time. During a 2 years follow-up, effects of different feeding regimens on macromolecular absoprtion (serum content of human alpha-lactalbumin, alpha-LA), antibody production, and development of allergic symptoms were studied. Macromolecular absorption was also studied in 28 children with acute symptoms of cow's milk allergy and in 76 children in relation to cow's milk challenge. Higher concentrations of S-alpha-LA were found at two months of age in the CHF group than either in the HM or the CMF group. Higher concentrations were also recorded in children who developed a clinical reaction to cow's milk challenge than in those manifesting no reaction.Children with acute symptoms of cow's milk allergy, before treatment with cow's milk free diet had higher levels of alpha-LA than healthy children. Median total S-IgE levels were lower in the CHF group than in the HM group at 2 and 8 months of age. The levels of IgG antibodies to beta-lactoglobulin were higher in the CMF and in the HM group than in the CHF group up to two years. This was particularly obvious in infants who were exclusively breast-fed for longer than two months. There was no significant difference in secretory IgA (sIgA) levels in saliva of infants between the three groups. No correlation was found between the frequency of atopic symptoms in the infants and in the IgG antibody levels or salivary sIgA levels in the infants. The sIgA levels were higher in colostrum than in mature milk. In conclusion, exposure to cow's milk during the first three days of life stimulated IgG antibody production to cow's milk proteins. Casein hydrolyste given neonatally seems to depress the infant's immuno- competence by decreasing production of IgE, and by decreasing IgG antibody production to cow's milk proteins. Exposure to casein hydrolysate was associated with increased absorption of macro- molecules at two months of age. (Less)
Please use this url to cite or link to this publication:
author
opponent
  • Docent Foucard, Tony, Barnkliniken, Akademiska Sjukhuset, S-751 85 Uppsala, Sweden
organization
publishing date
type
Thesis
publication status
published
subject
keywords
beta-lactoglobulin, ovalbumin, cow's milk proteins, antibodies, IgG, IgE, secretory IgA, alpha-lactalbumin, breast-feeding, Pediatrics, Pediatri, early infant feeding, casein hydrolysate, Human milk, cow's milk
pages
129 pages
publisher
Department of Paediatrics, Lund University
defense location
N/A
defense date
1999-10-07 10:15
external identifiers
  • Other:ISRN: LUMEDW//MEBM--1018--SE
language
English
LU publication?
yes
id
0c63e461-27b5-4b50-84fa-6b9c34433265 (old id 39872)
date added to LUP
2007-06-21 11:10:37
date last changed
2016-09-19 08:45:11
@misc{0c63e461-27b5-4b50-84fa-6b9c34433265,
  abstract     = {The aim of this work was to study prospectively the effects of different feeding regimens during the first three days of life. A group of 129 infants were randomly assigned at birth to one of three feeding regimens: human milk (HM), cow's milk formula (CMF), or a casein hydrolysate formula (CHF). The formula-fed infants received no human milk until the fourth day of life, after which all infants were breast- fed for a varying period of time. During a 2 years follow-up, effects of different feeding regimens on macromolecular absoprtion (serum content of human alpha-lactalbumin, alpha-LA), antibody production, and development of allergic symptoms were studied. Macromolecular absorption was also studied in 28 children with acute symptoms of cow's milk allergy and in 76 children in relation to cow's milk challenge. Higher concentrations of S-alpha-LA were found at two months of age in the CHF group than either in the HM or the CMF group. Higher concentrations were also recorded in children who developed a clinical reaction to cow's milk challenge than in those manifesting no reaction.Children with acute symptoms of cow's milk allergy, before treatment with cow's milk free diet had higher levels of alpha-LA than healthy children. Median total S-IgE levels were lower in the CHF group than in the HM group at 2 and 8 months of age. The levels of IgG antibodies to beta-lactoglobulin were higher in the CMF and in the HM group than in the CHF group up to two years. This was particularly obvious in infants who were exclusively breast-fed for longer than two months. There was no significant difference in secretory IgA (sIgA) levels in saliva of infants between the three groups. No correlation was found between the frequency of atopic symptoms in the infants and in the IgG antibody levels or salivary sIgA levels in the infants. The sIgA levels were higher in colostrum than in mature milk. In conclusion, exposure to cow's milk during the first three days of life stimulated IgG antibody production to cow's milk proteins. Casein hydrolyste given neonatally seems to depress the infant's immuno- competence by decreasing production of IgE, and by decreasing IgG antibody production to cow's milk proteins. Exposure to casein hydrolysate was associated with increased absorption of macro- molecules at two months of age.},
  author       = {Juvonen, Pekka O},
  keyword      = {beta-lactoglobulin,ovalbumin,cow's milk proteins,antibodies,IgG,IgE,secretory IgA,alpha-lactalbumin,breast-feeding,Pediatrics,Pediatri,early infant feeding,casein hydrolysate,Human milk,cow's milk},
  language     = {eng},
  pages        = {129},
  publisher    = {ARRAY(0xa6aea20)},
  title        = {Temporary neonatal exposure to whole and hydrolysed cow's milk proteins. Studies of macromolecular absorption and immunological variables},
  year         = {1999},
}