Bronchomammary axis in the immune response to respiratory syncytial virus

The products of lactation from 26 nursing mothers were sequentially examined over several months for the presence or appearance of antibodies directed against respiratory syncytial virus. Antiviral IgM and IgG were rarely identified in either colostrum or milk. RSV-specific IgA was found in 75% (18/24) of specimens of colostrum; 40% (6/15) and 59% (4/7) of milk samples obtained at three and six months still contained specific IgA antibody. The latter increase was felt to represent boosting of exposed individuals when the virus was present in the community. Infection with the virus was documented in two mothers. Both had specific IgG, IgM, and IgA antibody responses in serum and nasopharyngeal secretions, but response in milk was limited to IgA. These data confirm that antibody to a specific respiratory tract pathogen is present in the products of lactation, that the specific activity is mainly of the IgA class, and that booster responses in milk are exclusively of the IgA class. Since RSV appears to replicate only in the respiratory tract, it is suggested that viral specific antibody activity observed in the mammary gland may be derived from the bronchopulmonary lymphoid tissue.