Abstract
Background Transplacental respiratory syncytial virus (RSV) antibody transfer has been characterized, but little is known about the protective effect of breast milk RSV-specific antibodies. Serum antibodies against the prefusion RSV fusion protein (pre-F) exhibit high neutralizing activity. We investigate protection of breast milk pre-F antibodies against RSV acute respiratory infection (ARI). Methods Breast milk at 1, 3, and 6 months postpartum and midnasal swabs during infant illness episodes were collected in mother-infant pairs in Nepal. One hundred seventy-four infants with and without RSV ARI were matched 1:1 by risk factors for RSV ARI. Pre-F immunoglobulin A (IgA) and immunoglobulin G (IgG) antibody levels were measured in breast milk. Results The median breast milk pre-F IgG antibody concentration before illness was lower in mothers of infants with RSV ARI (1.4 [interquartile range {IQR}, 1.1-1.6] log 10 ng/mL) than without RSV ARI (1.5 [IQR, 1.3-1.8] log 10 ng/mL) (P =.001). There was no difference in median maternal pre-F IgA antibody concentrations in cases vs controls (1.7 [IQR, 0.0-2.2] log 10 ng/mL vs 1.7 [IQR, 1.2-2.2] log 10 ng/mL, respectively; P =.58). Conclusions Low breast milk pre-F IgG antibodies before RSV ARI support a potential role for pre-F IgG as a correlate of protection against RSV ARI. Induction of breast milk pre-F IgG may be a mechanism of protection for maternal RSV vaccines.
Original language | English |
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Pages (from-to) | 59-67 |
Number of pages | 9 |
Journal | The Journal of infectious diseases |
Volume | 219 |
Issue number | 1 |
DOIs | |
Publication status | Published - 1 Jan 2019 |
Externally published | Yes |
Keywords
- acute respiratory infection
- breast milk
- IgG and IgA antibodies
- maternal vaccination
- respiratory syncytial virus