Protection against cholera in breast-fed children by antibodies in breast milk
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Breast milk IgA antibodies against cholera do not prevent Vibrio cholerae 01 colonization in infants. However, these antibodies do protect colonized children from developing cholera disease.
Area of Science:
- Immunology
- Pediatrics
- Infectious Diseases
Background:
- Cholera remains a significant public health concern, particularly in areas with limited sanitation.
- Breast milk is known to contain various protective factors, including antibodies, against enteric pathogens.
Purpose of the Study:
- To investigate the protective role of immunoglobulin A (IgA) antibodies in breast milk against Vibrio cholerae 01 colonization and disease in breast-fed infants and children.
- To determine if breast milk IgA antibody levels correlate with protection against cholera.
Main Methods:
- Prospective study involving 93 mother-child pairs from cholera-affected families.
- Collection of breast milk and assay for IgA antibodies against cholera toxin and lipopolysaccharide.
- Monitoring of infants and children for Vibrio cholerae 01 colonization and diarrheal disease over 10 days.
Main Results:
- Thirty infants (32%) became colonized with V. cholerae 01, and 19 (20%) developed cholera disease.
- No significant difference in breast milk IgA antibody levels was observed between colonized and non-colonized children.
- Children who developed cholera disease had significantly lower levels of both cholera toxin and lipopolysaccharide IgA antibodies in their breast milk compared to asymptomatic colonized children.
Conclusions:
- Breast milk IgA antibodies do not prevent colonization by Vibrio cholerae 01 in infants and children.
- Breast milk IgA antibodies appear to confer protection against cholera disease in children who are already colonized with Vibrio cholerae 01.
Abstract:
We performed a prospective study to examine whether the IgA antibodies against cholera that are present in breast milk protect breast-fed infants and children against colonization with Vibrio cholerae 01 and disease. Among families of patients with cholera, we collected breast milk from mothers who had not had diarrhea in the previous week and monitored them and their breast-fed children for cholera colonization and diarrhea for 10 days. Breast milk was assayed for IgA antibodies to cholera toxin and lipopolysaccharide. Ninety-three mother--child pairs were studied; 30 infants became colonized with V. cholerae 01 and disease developed in 19. There were no differences between the antibody levels in milk fed to children who became colonized and in milk fed to children who did not. However, among the children who became colonized, those who had diarrhea drank breast milk containing significantly lower levels of both kinds of cholera antibodies than were present in the milk consumed by children who had no symptoms. We conclude that breast-milk antibodies against cholera do not appear to protect children from colonization with V. cholerae 01 but do protect against disease in those who are colonized.