Immunological effects of alpha-lactalbumin-enriched low-protein infant formula : A randomized controlled trial
(2025) In Journal of Pediatric Gastroenterology and Nutrition- Abstract
Objectives: Breast-fed (BF) have lower risk of infections during infancy compared to those formula-fed (FF). A higher content of alpha-lactalbumin (α-lac) in breast milk, which may promote a more favorable gut microbiota, could be one reason. In this study, we evaluated whether increased concentration of α-lac in low-protein infant formula affects the immune response and the incidence of infections during infancy. Methods: In a double-blinded randomized controlled trial, healthy-term infants (n = 245) received low-protein infant formulas with α-lac-enriched whey (α-lac-EW; 1.75 g protein/100 kcal, 27% α-lac) or casein glycomacropeptide-reduced whey (CGMP-RW; 1.76 g protein/100 kcal, 14% α-lac), or standard formula (SF; 2.2 g protein/100... (More)
Objectives: Breast-fed (BF) have lower risk of infections during infancy compared to those formula-fed (FF). A higher content of alpha-lactalbumin (α-lac) in breast milk, which may promote a more favorable gut microbiota, could be one reason. In this study, we evaluated whether increased concentration of α-lac in low-protein infant formula affects the immune response and the incidence of infections during infancy. Methods: In a double-blinded randomized controlled trial, healthy-term infants (n = 245) received low-protein infant formulas with α-lac-enriched whey (α-lac-EW; 1.75 g protein/100 kcal, 27% α-lac) or casein glycomacropeptide-reduced whey (CGMP-RW; 1.76 g protein/100 kcal, 14% α-lac), or standard formula (SF; 2.2 g protein/100 kcal, 10% α-lac) from 2 to 6 months. BF constituted a reference group. Cytokines and high-sensitivity C-reactive protein (hsCRP) were measured during intervention and infection-related morbidity, and treatment was evaluated until 12 months. Results: Serum interleukin-6 (IL-6) was lower in BF than in all FF groups during intervention (p < 0.001). No other differences in cytokines (tumor necrosis factor alpha [TNF-α], transforming growth factor beta 1 [TGF-β1], TGF-β2, IL-1, IL-10, IL-12, interferon gamma [INF-γ]) or hsCRP were found among the study groups. Infection-related morbidity did not differ among study groups, except slight differences in the use of antibiotics during (α-lac-EW vs. CGMP-RW [p = 0.008]) and after intervention (α-lac-EW vs. BF [p = 0.016]). Conclusions: Increased α-lac concentration in low-protein infant formula to levels similar to breast milk did not affect the cytokine profile and had minor effect on infection-related morbidity. The higher IL-6 concentrations in FF than in BF needs further investigation.
(Less)
- author
- Nilsson, Ulrika T. LU ; Hernell, Olle ; Lönnerdal, Bo ; Jacobsen, Lotte N. ; Nunez-Salces, Maria ; Kvistgaard, Anne S. ; West, Christina and Åkeson, Pia K. LU
- organization
- publishing date
- 2025
- type
- Contribution to journal
- publication status
- epub
- subject
- keywords
- cytokines, gut microbiota, infant nutrition, infectious diseases
- in
- Journal of Pediatric Gastroenterology and Nutrition
- publisher
- Lippincott Williams & Wilkins
- external identifiers
-
- pmid:40910342
- scopus:105015368602
- ISSN
- 0277-2116
- DOI
- 10.1002/jpn3.70189
- language
- English
- LU publication?
- yes
- id
- c4781cdc-f00e-40f6-b58d-d3ba3ee879c8
- date added to LUP
- 2025-11-13 15:44:07
- date last changed
- 2025-11-14 03:00:05
@article{c4781cdc-f00e-40f6-b58d-d3ba3ee879c8,
abstract = {{<p>Objectives: Breast-fed (BF) have lower risk of infections during infancy compared to those formula-fed (FF). A higher content of alpha-lactalbumin (α-lac) in breast milk, which may promote a more favorable gut microbiota, could be one reason. In this study, we evaluated whether increased concentration of α-lac in low-protein infant formula affects the immune response and the incidence of infections during infancy. Methods: In a double-blinded randomized controlled trial, healthy-term infants (n = 245) received low-protein infant formulas with α-lac-enriched whey (α-lac-EW; 1.75 g protein/100 kcal, 27% α-lac) or casein glycomacropeptide-reduced whey (CGMP-RW; 1.76 g protein/100 kcal, 14% α-lac), or standard formula (SF; 2.2 g protein/100 kcal, 10% α-lac) from 2 to 6 months. BF constituted a reference group. Cytokines and high-sensitivity C-reactive protein (hsCRP) were measured during intervention and infection-related morbidity, and treatment was evaluated until 12 months. Results: Serum interleukin-6 (IL-6) was lower in BF than in all FF groups during intervention (p < 0.001). No other differences in cytokines (tumor necrosis factor alpha [TNF-α], transforming growth factor beta 1 [TGF-β1], TGF-β2, IL-1, IL-10, IL-12, interferon gamma [INF-γ]) or hsCRP were found among the study groups. Infection-related morbidity did not differ among study groups, except slight differences in the use of antibiotics during (α-lac-EW vs. CGMP-RW [p = 0.008]) and after intervention (α-lac-EW vs. BF [p = 0.016]). Conclusions: Increased α-lac concentration in low-protein infant formula to levels similar to breast milk did not affect the cytokine profile and had minor effect on infection-related morbidity. The higher IL-6 concentrations in FF than in BF needs further investigation.</p>}},
author = {{Nilsson, Ulrika T. and Hernell, Olle and Lönnerdal, Bo and Jacobsen, Lotte N. and Nunez-Salces, Maria and Kvistgaard, Anne S. and West, Christina and Åkeson, Pia K.}},
issn = {{0277-2116}},
keywords = {{cytokines; gut microbiota; infant nutrition; infectious diseases}},
language = {{eng}},
publisher = {{Lippincott Williams & Wilkins}},
series = {{Journal of Pediatric Gastroenterology and Nutrition}},
title = {{Immunological effects of alpha-lactalbumin-enriched low-protein infant formula : A randomized controlled trial}},
url = {{http://dx.doi.org/10.1002/jpn3.70189}},
doi = {{10.1002/jpn3.70189}},
year = {{2025}},
}