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Helicobacter pylori acquisition in infancy after decline of maternal passive immunity
B D Gold1, B Khanna, L M Huang
1Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
Insights
Maternal antibodies protect infants from Helicobacter pylori infection for about six months. Infants can acquire H. pylori infection early, with IgM antibodies appearing before IgG during this crucial developmental period.
Area of Science:
- Pediatrics
- Immunology
- Infectious Diseases
Background:
- Helicobacter pylori (H. pylori) infection is a significant global health concern.
- Understanding the infant immune response and transmission dynamics is crucial for early intervention.
Purpose of the Study:
- To evaluate the natural history of H. pylori infection in infants.
- To assess the host immune response, including antibody development.
- To determine H. pylori seroprevalence in Taiwanese mothers and its correlation with infant infection.
Main Methods:
- Longitudinal study of 80 infants and their mothers over 14 months.
- ELISA used to detect H. pylori IgG and IgM antibodies in maternal and infant sera at multiple time points.
- Assessment of passively transferred maternal antibodies and infant-acquired infection.
Main Results:
- Maternal H. pylori IgG seroprevalence was 62.5% in Taiwanese mothers.
- Passively transferred maternal IgG antibodies persisted in infants for approximately 3-6 months.
- H. pylori infection was acquired by 7.5% of infants, with detectable IgM preceding IgG in most cases.
Conclusions:
- Maternal passive IgG antibody transfer protects infants in early life but wanes by six months.
- H. pylori infection can be acquired during infancy in this population.
- Infant immune responses involve detectable, short-lived IgM antibodies that may precede IgG development.
Abstract:
We evaluated the natural history of Helicobacter pylori infection and the host immune response in 80 infants, and determined seroprevalence of H. pylori infection in their Taiwanese mothers. Decline in passively transferred maternal anti-H. pylori IgG antibodies and subsequent H. pylori infection was assessed in infants over 14 mo. A sensitive and specific, 96-well microtiter ELISA for the detection of H. pylori IgG antibodies was used to evaluate maternal serum (single specimen) and their infants (birth, 1, 2, 3, 6, 12, and 14 mo). Sera were also evaluated by ELISA for the presence of anti-H. pylori IgM antibodies in the infants. Maternal H. pylori IgG seroprevalence was 62.5% [50/80; 95% confidence intervals (CI), 51-73%]. All infants born to the 50 seropositive mothers passively acquired maternal H. pylori IgG. Transplacentally transferred maternal anti-H. pylori IgG lasted until about the 3rd mo of life, and disappeared in nearly all the infants by 6 mo of age. Seven and one-half percent of infants (6/80; 95% CI, 3-16%) acquired H. pylori infection; two were born to H. pylori-negative mothers. Among the six IgG seropositive infants, an IgM response specific for H. pylori antigens was detected and appeared to precede the rise in IgG in five. We conclude that maternal passive transfer of IgG antibodies occurs in the infant and disappears by 6 mo of age. H. pylori infection is acquired in infancy in this population; IgM antibodies against H. pylori are detectable, seem short-lived, and appear to precede IgG antibody development.