Human colostrum contains an activity that inhibits the production of IL-2

Cytokines and appetite-regulating hormones in human milk and associations with infant growth across four sites in a longitudinal cohort: The Mothers, Infants and Lactation Quality Study

INTRODUCTION

In resource-poor settings, mother-infant dyads are commonly exposed to environmental factors increasing the risk of infectious diseases and possibly influencing the cytokine profile of human milk (HM). Hormones in HM have been proposed to influence appetite-regulation and possibly growth in exclusively breastfed infants.

OBJECTIVE

To compare cytokines and appetite-regulating hormone (ARH) concentrations in HM of mothers from four contrasting populations and investigate associations with infant growth.

METHOD

HM samples from 825 mothers participating in the Mothers, Infants and Lactation Quality Study from Bangladesh (BD), Brazil (BR), Denmark (DK) and The Gambia (GM) were collected between 1-3.5 months postpartum and analysed for tumour-necrosis factor-α, interferon (IFN)-γ, interleukin (IL)-1β, IL-4, IL-6, IL-8, IL-10, IL-33, and insulin, leptin and adiponectin. Infant growth was measured twice between 1-5.99 months postpartum. Analysis of covariance was used to compare geometric means of HM markers between the four sites and associations between HM markers and infant growth were investigated using linear regression analysis.

RESULTS

Differences in geometric means of all HM cytokines and ARHs were found among the four study sites after adjustment for possible explanatory variables. Lowest levels of most HM cytokines were found in BD, whereas highest levels of IFN-γ, IL-4, IL-10 and IL-33 were found in DK. In GM, cytokines and ARHs were inversely associated with weight-for-age and weight-for-length Z-scores.

CONCLUSION

We showed significant differences in HM composition of cytokines and ARHs among the four countries. Highest levels of T helper cell type 2 cytokines, which is typically related to increased risk of atopic diseases, were found in DK. The results may reflect the influence of different environmental exposures in the four sites on HM composition, which may be associated with infant growth in GM.

Cytokines in human milk

Epidemiologic studies conducted in the past 30 years to investigate the protective functions of human milk strongly support the notion that breastfeeding prevents infantile infections, particularly those affecting the gastrointestinal and respiratory tracts. However, more recent clinical and experimental observations also suggest that human milk not only provides passive protection, but also can directly modulate the immunological development of the recipient infant. The study of this remarkable defense system in human milk has been difficult because of its biochemical complexity, the small concentration of certain bioactive components, the compartmentalization of some of these agents, the dynamic quantitative and qualitative changes of milk during lactation, and the lack of specific reagents to quantify these agents. However, a host of bioactive substances, including hormones, growth factors, and immunological factors such as cytokines, have been identified in human milk. Cytokines are pluripotent polypeptides that act in autocrine/paracrine fashions by binding to specific cellular receptors. They operate in networks and orchestrate the development and functions of immune system. Several different cytokines and chemokines have been discovered in human milk in the past years, and the list is growing very rapidly. This article will review the current knowledge about the increasingly complex network of chemoattractants, activators, and anti-inflammatory cytokines present in human milk and their potential role in compensating for the developmental delay of the neonate immune system.

Effect of breast milk of healthy and allergic mothers on in vitro stimulation of cord blood lymphocytes

Maternal milk has beneficial effects on the development and function of the newborn's immune system. Whether the milk of allergic mother has the same effects as the milk of healthy mothers is not yet quite clear. To contribute to the characterization of its immunomodulatory action, we tested the effect of milk of healthy and allergic mothers on the proliferation and immunoglobulin formation in cultures of cord blood mononuclear leucocytes (CBML) of newborns of healthy and allergic mothers. CBML proliferation was tested by (3)H-thymidine incorporation, IgM, IgG and IgA production by reverse ELISPOT. CBML response was examined in unstimulated cultures and after stimulation with polyclonal activators in the presence or absence of colostrum or milk. The cells of children of allergic mothers have a significantly higher proliferative activity than those of children of healthy mothers. Maternal colostrum/milk in high doses markedly suppresses cell proliferation after stimulation with polyclonal activators, whereas lower milk doses in the cultures have no such effect and exert a rather stimulatory action. Immunoglobulin production by cord blood lymphocytes is also different in the two groups of children. Low basal immunoglobulin formation is increased after stimulation with a strong polyclonal activator of B cells--Bacillus firmus, CBML of children of allergic mothers produce more IgA than those of children of healthy mothers. The stimulated production of all immunoglobulin classes in cells of children of healthy mothers is still enhanced by colostrum/milk. Children of allergic mothers show a markedly increased production of only IgM and IgA. The effect of healthy and allergic colostrum and milk on cell proliferation and immunoglobulin production is similar. The lymphocytes of children of allergic mothers differ from the lymphocytes of children of healthy mothers in their proliferative activity and the ability to form immunoglobulin already at birth.

A review of the effects of breastfeeding on respiratory infections, atopy, and childhood asthma

The etiology of childhood asthma is not fully understood. Early exposure to certain respiratory infections may be protective for atopy and/or asthma whereas some infections have been suggested to exert the opposite effects. Wheezing lower respiratory illness (LRI) in the first year of life and atopy are independently associated with increased risk for current asthma in childhood and their effects are mediated via different causal pathways. These risk factors are multiplicative when they operate concommitantly within individual children. Exclusive breastfeeding protects against asthma via effects on both these pathways, as well as through other as yet undefined mechanisms. Furthermore, exclusive breastfeeding may protect against asthma and may reduce the incidence of lower respiratory illness, especially respiratory syncytial virus (RSV). We have previously demonstrated a protective effect of exclusive breastfeeding on asthmatic traits in children. The aim of this review was to clarify this protective association from intermediate associations with respiratory infections, atopy, or through other facets of breastfeeding. The bioactivity of breast milk and subsequent pathways that may act upon the development of asthma in children are explored.

Effects of breast milk from allergic and non-allergic mothers on mitogen- and allergen-induced cytokine production

Breast milk contains several components that provide specific immunity and affect the maturation of the infant's immune system. The aim of this study was to analyze the effects of breast milk, on mitogen- and allergen-induced cytokine production from cord blood mononuclear cells (CBMC), and if those effects differ between allergic and non-allergic mothers. The cells were incubated for 96 h with phytohemagglutinin (PHA), ovalbumin or cat dander in the presence of various dilutions of colostrum. Colostrum inhibited both mitogen- and cat-induced IFN-gamma and mitogen-induced interleukin-4 (IL-4) production. The inhibition on IFN-gamma production was to some extent caused by TGF-beta, as the effect was modified when an anti-TGF-beta antibody was added to the cultures. In contrast, colostrum enhanced allergen-induced production of the Th2-like cytokines IL-5 and IL-13, and this was accompanied with increased production of IL-10. No differences were found between allergic and non-allergic mothers. The inhibitory effect of breast milk on IFN-gamma production, which was partly due to the high levels of TGF-beta, together with the enhancing effect on IL-10 secretion, confirm that breast milk is anti-inflammatory. Although the production of IL-5 and IL-13 was enhanced by colostrum, this was accompanied with an increased production of IL-10. Together with the high levels of TGF-beta in breast milk and inhibitory effect of colostrum on IL-4 production, this suggests a possible mechanism whereby breast-feeding may protect against the development of allergy. Despite differences in the composition of breast milk between allergic and non-allergic mothers, the effects of breast milk on cytokine production from CBMC were independent of the atopic status of the mothers.

Differential modulation of the immune response by breast- or formula-feeding of infants

Spontaneous integrin expression on CD4+, CD8+ and CD19+ lymphocytes at 6 months was significantly lower in breastfed than formula-fed infants (p < 0.05). In another study of 59 formula-fed and 64 breastfed 12-month-old children blast transformation and cytokine production by lymphocytes, and T cell changes were measured before and after measles-mumps-rubella vaccination (MMR). Before vaccination, lymphocytes of breastfed children had lower levels of blast transformation without antigen (p < 0.001), with tetanus toxoid (p < 0.02) or Candida (p < 0.04), and lower interferon-gamma production (p < 0.03). Fourteen days after the live viral vaccination, only the breastfed children had increased production of interferon-gamma (p < 0.02) and increased percentages of CD56+ (p < 0.022) and CD8+ cells (p < 0.004). These findings are consistent with a Th1 type response by breastfed children, not evident in formula-fed children. Feeding mode has an important long-term immunomodulating effect on infants beyond weaning.

Cytokines in human milk: properties and potential effects upon the mammary gland and the neonate

Epidemiologic and immunologic studies of breastfed and nonbreastfed infants and investigations of certain biologic activities in human milk led to the identification of immunomodulating agents in human milk. Among them were the cytokines interleukin-1 beta (IL-1 beta); IL-6, IL-8, IL-10, granulocyte-colony stimulating factor, macrophage-colony stimulating factor (M-CSF), tumor necrosis factor-alpha, interferon-gamma, epithelial growth factor (EGF), transforming growth factor-alpha (TGF-alpha), and TGF-beta 2. Interferon-gamma may originate from T cells in milk; EGF, TGF-alpha, TGF-beta, M-CSF, IL-6, and IL-8 may be produced by mammary gland epithelium. Based upon their known functions, we hypothesize that cytokines influence the development and immunologic function of the mammary gland and the neonate. Those in vivo functions remain to be defined by future investigations.

A novel immunosuppressive factor in bovine colostrum blocks activation of the interleukin 2 gene enhancer at the NFAT site

A factor in bovine colostrum (colostrum inhibitory factor, CIF) inhibits interleukin 2 (IL2) production in activated T helper cells by blocking the accumulation of IL2 mRNA. To determine whether CIF blocks at the level of IL2 transcription, we introduced reporter plasmids into the human T leukemia cell line Jurkat by transient transfection. These contained the luciferase gene under the control of either the human IL2 upstream enhancer region (segments -326 to +45) or three repeats of the NFAT element contained within it (segments -255 to -285). Expression of luciferase in these cells was induced by phorbol myristate acetate plus a calcium ionophore. CIF inhibited induction of either construct as did cyclosporine, which is known to block activation of the NFAT element. CIF failed to inhibit several other enhancer elements. The NFAT-controlled luciferase gene system distinguishes CIF from other T cell inhibitory activities present in colostrum, in particular, TGF beta 1 and TGF beta 2 and the glucocorticoids. Stably transfected Jurkat cells behaved similarly to the transiently transfected ones with respect to inhibition by CIF and cyclosporine. The NFAT-luc assay is a useful technique for the rapid, sensitive measurement of CIF or other immunosuppressants with a similar mode of action.

Effect of human colostrum on interleukin-2 production and natural killer cell activity

The effect of human colostrum on the production of interleukin-2 (IL-2) and on natural killer (NK) cell activity by peripheral blood mononuclear cells (PBMC) was investigated in 50 healthy women. At concentrations as low as 0.5%, human colostrum stimulated IL-2 production; at a higher concentration (10%), IL-2 secretion was inhibited. A time and dose dependent inhibitory effect of colostrum on NK cytotoxicity was also observed. This inhibition could be reversed by the addition of human recombinant IL-2 (hrIL-2). The stimulation of IL-2 production induced by human colostrum might compensate for its inhibitory effect on NK cell activity. These findings suggest an additional mechanism by which breast feeding may affect the neonatal immune system.