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Vaccine. 2003 Jul 28;21(24):3382-8.
Mucosal immunity: integration between mother and
the breast-fed infant.
Brandtzaeg P.
Laboratory for Immunohistochemistry and
Immunopathology (LIIPAT), Institute of
Pathology, University of Oslo, Rikshospitalet,
N-0027 Oslo, Norway. per.brandtzaeg@labmed.uio.no
Lactating mammary glands are part of an
integrated mucosal immune system with local
production of antibodies, mainly consisting of
secretory immunoglobulin A (SIgA). These
antibodies generally reflect antigenic
stimulation of mucosa-associated lymphoid tissue
(MALT) by common intestinal and respiratory
pathogens. Antibodies in breast milk are thus
highly targeted against infectious agents in the
mother's environment, which are those likely to
be encountered by the infant shortly after
birth. Therefore, breast-feeding represents an
ingenious immunological integration of mother
and child. The mucosae are favored as portals of
entry by most infectious agents, and the
neonatal period is particularly critical in this
respect. Mucosal pathogens are a major killer of
children below the age of 5 years, being
responsible for more than 14 million deaths
annually. Diarrheal disease alone claims a toll
of 5 million children per year in the developing
countries. Epidemiological data suggest that the
risk of dying from diarrhea could be reduced
14-24 times in breast-fed children. A beneficial
clinical effect is also apparent in the
industrialized world, even in relation to
relatively common diseases such as otitis media
and acute lower respiratory tract infections. |
