THE INTERACTION OF ANTIBACTERIAL FACTORS IN BREAST MILK
THE INTERACTION OF ANTIBACTERIAL FACTORS IN BREAST MILK
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母乳中抗菌因子的相互作用
DOI：
10.1111/j.1469-8749.1979.tb01706.x
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发表时间：
1979
影响因子：
3.8
通讯作者：
A. Glynn
中科院分区：
文献类型：
--
作者：
M. Adinolfi;A. Glynn
医学杂志和大众传媒定期回顾有关母乳喂养及其对婴儿发病率的影响的问题，基本上讨论集中在两个问题上。第一份报告涉及在技术发达或不发达国家母乳喂养的社会经济方面。第二项研究更为科学，涉及在婴儿生命的免疫关键时期，新鲜母乳提供的保护婴儿免受细菌和病毒侵害的可能机制。在婴儿不太可能获得充足的替代营养的国家，母乳喂养的普及程度急剧下降的原因已经成为几项研究的对象，这里不再讨论。在这篇注释中，我们将总结最近的调查结果，这些结果明确地表明，新鲜的人乳含有保护婴儿免受细菌和病毒感染所需的所有因素，如免疫球蛋白、补体(C)成分、溶菌酶、乳铁蛋白、乳过氧化物酶和活菌素等因素。在人类初乳和乳汁中，就像在唾液、眼泪、鼻液和支气管液等其他分泌物中一样，分泌IgA是主要存在的免疫球蛋白11,12。分泌型IgA比分泌型IgA更能抵抗肠道酶的蛋白水解活性和酸性条件。在初乳中发现了高水平的分泌IgA（接近25mg/ml），而在milkg911J2中则下降到1mg/ml左右。针对几种细菌的抗体已被证明与分泌IgA有关，其中包括针对大肠杆菌的抗体，大肠杆菌通常是导致婴儿腹泻的原因。“2阁下。有充分的证据表明，这种IgA抗体是在乳房中产生的，而不是从血清中提取的；此外，母乳中的IgA含量在喂奶过程中不会下降，这表明乳房可以产生和储存大量的这类维生素a (1 / 3 ~ 1 / 2 ~ 1 / 2 ~ 1 / 2) ~ J ~ ~ ~ ~。除了IgA，初乳和牛奶还含有大量的溶菌酶（LZM）。在人乳中，LZM可能达到400pg/ml附近的值，比奶牛的rmilk“J6”中检测到的水平高3000倍。由于它广泛存在于脊椎动物、无脊椎动物、植物甚至细菌中，LZM被认为是与单核-巨噬细胞系统相关的系统发育原始防御机制的一个组成部分，比更特异性的淋巴细胞-免疫球蛋白系统更古老。IgA和LZM在相同分泌物中的密切联系是有趣的，大约15年前就研究了它们与补体成分之间可能的相互作用。”这些研究的结果表明，虽然补体溶解不发生在分泌IgA单独存在的情况下，但如果补体和IgA都是特异性的，大肠杆菌就会被补体溶解
PERIODICALLY, medical journals and the mass media return to questions concerning breast feeding and its effects on infant morbidity and Basically the discussion converges on two problems. The first regards the socio-economic aspects of breast feeding in either technically advanced or under-developed countries. The second, more scientifically oriented, deals with the possible mechanism of protection of the infant against bacteria and viruses provided by fresh human milk during an immunologically critical period of life. The causes of the dramatic decline in the popularity of breast feeding in countries in which infants are unlikely to receive alternative adequate nutrition have been the object of several studies7J and they will not be discussed again here. In this annotation we will summarise the results of recent investigations which have shown definitively that fresh human milk contains all the factors needed to protect the infant against bacterial and viral infections, factors such as immunoglobulins, components of complement (C), lysozyme, lactoferrin, lactoperoxidase and viable l e u ~ o c y t e s ~ ~ ~ ~ ~ ~ . In human colostrum and milk, as in other secretions such as saliva, tears, nasal and bronchial fluids, secretory IgA is the main immunoglobulin present11,12. Secretory IgA is more resistant to the proteolytic activity of gut enzymes and to acid conditions than is IgA in ~ e r u m l ~ ~ ~ . High levels of secretory IgA have been found in colostrum (near 25mg/ml), with levels declining to about 1mg/ml in milkg911J2. Antibodies against several types of bacteria have been shown to be associated with secretory IgA in including antibodies against E. coli, commonly responsible for infantile diarrhoeap~11.'2J4 . There is good evidence that such IgA antibodies are produced in the breast and are not derived from serum; furthermore, the IgA content of milk does not drop during a feed, suggesting that the breast can produce and store large quantities of this class of i m m u n ~ g l o b u l i n ~ J ~ ~ ~ ~ . In addition to IgA, colostrum and milk contain large quantities of lysozyme (LZM). In human milk, LZM may reach values near 400pg/ml, a level 3000 times higher than that detected in cows' rnilk"J6. Because it occurs widely in vertebrates, invertebrates, plants, and even bacterial7, LZM is considered to be a constituent of a phylogenetically primitive mechanism of defence associated with the monocyte-macrophage system, and older than the more specific lymphocyte-immunoglobulin system. The close association of IgA and LZM in the same secretions is intriguing, and a possible interaction between them and components of complement was investigated about 15 years ago". The results of these studies showed that while complement lysis did not occur in the presence of secretory IgA alone, E. coli were lysed by complement if both specific