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Grobben M, Juncker HG, van der Straten K, Lavell AHA, Schinkel M, Buis DTP, Wilbrink MF, Tejjani K, Claireaux MAF, Aartse A, de Groot CJM, Pajkrt D, Bomers MK, Sikkens JJ, van Gils MJ, van Goudoever JB, van Keulen BJ. Decreased Passive Immunity to Respiratory Viruses through Human Milk during the COVID-19 Pandemic. Microbiol Spectr 2022; 10:e0040522. [PMID: 35762813 PMCID: PMC9431045 DOI: 10.1128/spectrum.00405-22] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 06/11/2022] [Indexed: 11/20/2022] Open
Abstract
Infants may develop severe viral respiratory tract infections because their immune system is still developing in the first months after birth. Human milk provides passive humoral immunity during the first months of life. During the COVID-19 pandemic, circulation of common respiratory viruses was virtually absent due to the preventative measures resulting in reduced maternal exposure. Therefore, we hypothesized that this might result in lower antibody levels in human milk during the pandemic and, subsequently, decreased protection of infants against viral respiratory tract infections. We assessed antibody levels against respiratory syncytial virus (RSV), Influenza virus, and several seasonal coronaviruses in different periods of the COVID-19 pandemic in serum and human milk using a Luminex assay. IgG levels against RSV, Influenza, HCoV-OC43, HCoV-HKU1, and HCoV-NL63 in human milk were reduced with a factor of 1.7 (P < 0.001), 2.2 (P < 0.01), 2.6 (P < 0.05), 1.4 (P < 0.01), and 2.1 (P < 0.001), respectively, since the introduction of the COVID-19 restrictions. Furthermore, we observed that human milk of mothers that experienced COVID-19 contained increased levels of IgG and IgA binding to other respiratory viruses. Passive immunity via human milk against common respiratory viruses was reduced during the COVID-19 pandemic, which may have consequences for the protection of breastfed infants against respiratory infections. IMPORTANCE Passive immunity derived from antibodies in human milk is important for protecting young infants against invading viruses. During the COVID-19 pandemic, circulation of common respiratory viruses was virtually absent due to preventative measures. In this study, we observed a decrease in human milk antibody levels against common respiratory viruses several months into the COVID-19 pandemic. This waning of antibody levels might partially explain the previously observed surge of hospitalizations of infants, mostly due to RSV, when preventative hygiene measures were lifted. Knowledge of the association between preventative measures, antibody levels in human milk and subsequent passive immunity in infants might help predict infant hospital admissions and thereby enables anticipation to prevent capacity issues. Additionally, it is important in the consideration for strategies for future lockdowns to best prevent possible consequences for vulnerable infants.
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Affiliation(s)
- Marloes Grobben
- Department of Medical Microbiology and Infection Prevention, Amsterdam Infection and Immunity Institute, University of Amsterdam, Amsterdam, the Netherlands
| | - Hannah G. Juncker
- Department of Pediatrics, Amsterdam Reproduction & Development Research Institute, Emma Children’s Hospital, University of Amsterdam, Amsterdam, the Netherlands
- Center for Neuroscience, Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, the Netherlands
| | - Karlijn van der Straten
- Department of Medical Microbiology and Infection Prevention, Amsterdam Infection and Immunity Institute, University of Amsterdam, Amsterdam, the Netherlands
| | - A. H. Ayesha Lavell
- Department of Internal Medicine, Amsterdam Institute for Infection and Immunity, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Michiel Schinkel
- Center for Experimental and Molecular Medicine, Amsterdam Institute for Infection and Immunity, University of Amsterdam, Amsterdam, the Netherlands
| | - David T. P. Buis
- Department of Internal Medicine, Amsterdam Institute for Infection and Immunity, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Maarten F. Wilbrink
- Department of Pediatrics, Amsterdam Reproduction & Development Research Institute, Emma Children’s Hospital, University of Amsterdam, Amsterdam, the Netherlands
| | - Khadija Tejjani
- Department of Medical Microbiology and Infection Prevention, Amsterdam Infection and Immunity Institute, University of Amsterdam, Amsterdam, the Netherlands
| | - Mathieu A. F. Claireaux
- Department of Medical Microbiology and Infection Prevention, Amsterdam Infection and Immunity Institute, University of Amsterdam, Amsterdam, the Netherlands
| | - Aafke Aartse
- Department of Virology, Biomedical Primate Research Centre, Rijswijk, the Netherlands
| | - Christianne J. M. de Groot
- Department of Obstetrics and Gynaecology, Amsterdam Reproduction & Development Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Dasja Pajkrt
- Department of Pediatrics, Amsterdam Reproduction & Development Research Institute, Emma Children’s Hospital, University of Amsterdam, Amsterdam, the Netherlands
| | - Marije K. Bomers
- Department of Internal Medicine, Amsterdam Institute for Infection and Immunity, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Jonne J. Sikkens
- Department of Internal Medicine, Amsterdam Institute for Infection and Immunity, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Marit J. van Gils
- Department of Medical Microbiology and Infection Prevention, Amsterdam Infection and Immunity Institute, University of Amsterdam, Amsterdam, the Netherlands
| | - Johannes B. van Goudoever
- Department of Pediatrics, Amsterdam Reproduction & Development Research Institute, Emma Children’s Hospital, University of Amsterdam, Amsterdam, the Netherlands
| | - Britt J. van Keulen
- Department of Pediatrics, Amsterdam Reproduction & Development Research Institute, Emma Children’s Hospital, University of Amsterdam, Amsterdam, the Netherlands
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