PURPOSE OF THE STUDY.
The authors identified various breast milk cytokines and chemokines that appeared to be related to the presence of infantile atopic dermatitis (AD).
Japanese infants with and without a history of AD at 6 months of age were recruited from January 2007 to May 2008. Each cohort had 49 infants; 35% of the study population and 47% of the control population were female. About 41% were exclusively breast-fed in each group; the remainder was breast- and formula-fed.
The authors compared the chemokine/cytokine profiles in breast milk delivered to infants who developed AD and those who did not. Mothers completed questionnaires regarding their personal atopic histories and feeding methods throughout the study period until the infant was 6 months of age. History of AD was defined as itchy eczema at 6 months of age and having lasted for at least 2 months. Various chemokines and cytokines were measured from the maternal colostrum (collected within 4–5 days after birth) and mature milk (collected 1 month postpartum). In addition, maternal serum total immunoglobulin E (IgE) as well as specific IgE to house dust mite and Japanese cedar pollen were measured.
There were significant differences between the study and control populations in the concentrations of interleukin (IL)-1β and IL-12p40 in the colostrum. There were significantly higher levels of IL-4, eotaxin, granulocyte colony–stimulating factor, granulocyte macrophage colony–stimulating factor, interferon-α2, and MIP-1α in the mature milk of the study group. Maternal atopic history and IgE levels were not related to cytokine/chemokine concentrations in the breast milk. Logistic regression analyses indicated that high levels of eotaxin in the mature milk were a risk factor for developing AD at 6 months of age.
The results suggest that several mature breast milk pro-inflammatory chemokines/cytokines, including those more characteristic of allergic inflammation (especially eotaxin), are potential biomarkers for development of AD in early infancy.
Previous studies have usually indicated that breastfeeding, compared with whole milk–based formulas, is generally protective of atopic disease, particularly AD. However, there are conflicting studies, some indicating that breastfeeding may be a risk factor for AD. This study, although limited by small size and the study design being cross-sectional, suggests that breast milk inflammatory biomarkers may play a role by affecting infantile intestinal and immune system development. In particular, they reported that eotaxin, which is involved in the chemotaxis and activation of eosinophils, was a risk factor for developing AD. Whether a biomarker or a causal factor, these insights may provide better avenues for prediction and prevention of atopic disease.
- Copyright © 2013 by the American Academy of Pediatrics