Soluble immunoglobulin A in breast milk is inversely associated with atopic dermatitis at early age: the PASTURE cohort study

L Orivuori; G Loss; C Roduit; J-C Dalphin; M Depner; J Genuneit; R Lauener; J Pekkanen; P Pfefferle; J Riedler; M Roponen; J Weber; E von Mutius; C Braun-Fahrländer; O Vaarala; PASTURE Study Group

doi:10.1111/cea.12199

Soluble immunoglobulin A in breast milk is inversely associated with atopic dermatitis at early age: the PASTURE cohort study

Clin Exp Allergy. 2014 Jan;44(1):102-12. doi: 10.1111/cea.12199.

Authors

L Orivuori¹, G Loss, C Roduit, J-C Dalphin, M Depner, J Genuneit, R Lauener, J Pekkanen, P Pfefferle, J Riedler, M Roponen, J Weber, E von Mutius, C Braun-Fahrländer, O Vaarala; PASTURE Study Group

Collaborators

PASTURE Study Group:
Maija-Riitta Hirvonen, Anne Hyvärinen, Anne M Karvonen, Sami Remes, Marjut Roponen, Pekka Tiittanen, Marie-Laure Dalphin, Vincent Kaulek, Gisela Büchele, Martin Depner, Markus Ege, Michael Kabesch, Petra Pfefferle, Harald Renz, Bianca Schaub, Gert Doekes, Remo Frei

Affiliation

¹ Department of Vaccination and Immune Protection, National Institute for Health and Welfare, Helsinki, Finland.

PMID: 24102779
DOI: 10.1111/cea.12199

Abstract

Background: The role of breastfeeding for the development of atopic diseases in childhood is contradictory. This might be due to differences in the composition of breast milk and levels of antimicrobial and anti-inflammatory components.

Objective: The objective of this study was to examine whether levels of total immunoglobulin A (IgA) or transforming growth factor-β1 (TGF-β1) in breast milk were associated with the risk of developing atopic dermatitis (AD), atopic sensitization or asthma at early age taking breastfeeding duration into account.

Methods: The birth cohort study PASTURE conducted in Finland, France, Germany and Switzerland provided 610 breast milk samples collected 2 months after delivery in which soluble IgA (sIgA) and TGF-β1 levels were measured by ELISA. Duration of breastfeeding was assessed using weekly food frequency diaries from month 3 to month 12. Data on environmental factors, AD and asthma were collected by questionnaires from pregnancy up to age 6. Atopic status was defined by specific IgE levels in blood collected at the ages of 4 and 6 years. Multivariate logistic regression models were used for statistical analysis.

Results: Soluble IgA and TGF-β1 levels in breast milk differed between countries, and sIgA levels were associated with environmental factors related to microbial load, for example, contact to farm animals or cats during pregnancy, but not with raw milk consumption. sIgA levels were inversely associated with AD up to the of age 2 years (P-value for adjusted linear trend: 0.005), independent of breastfeeding duration. The dose of sIgA ingested in the first year of life was associated with reduced risk of AD up to the age of 2 (aOR, 95% CI: 0.74; 0.55-0.99) and 4 years (0.73; 0.55-0.96). No clear associations between sIgA and atopy or asthma up to age 6 were observed. TGF-β1 showed no consistent association with any investigated health outcome.

Conclusion and clinical relevance: IgA in breast milk might protect against the development of AD.

Keywords: IgA; TGF-β; asthma; atopic dermatitis; atopy; breast milk; childhood; farming.

MeSH terms

Adult
Age Factors
Animals
Breast Feeding
Child
Child, Preschool
Cohort Studies
Dermatitis, Atopic / epidemiology
Dermatitis, Atopic / immunology*
Dermatitis, Atopic / metabolism
Diet
Environment
Europe
Female
Humans
Immunoglobulin A / immunology*
Immunoglobulin A / metabolism
Infant
Infant, Newborn
Milk
Milk, Human / chemistry
Milk, Human / immunology*
Milk, Human / metabolism
Pregnancy
Surveys and Questionnaires
Transforming Growth Factor beta1 / metabolism

Substances

Immunoglobulin A
Transforming Growth Factor beta1