Detection of specific antibodies in cord blood, infant and maternal saliva and breast milk to staphylococcal toxins implicated in sudden infant death syndrome (SIDS)
Detection of specific antibodies in cord blood, infant and maternal saliva and breast milk to staphylococcal toxins implicated in sudden infant death syndrome (SIDS)
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DOI：
10.1016/j.femsim.2004.06.010
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发表时间：
2004-09-01
影响因子：
--
通讯作者：
Telford, DR
中科院分区：
文献类型：
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作者：
Harrison, LM;Morris, JA;Telford, DR
婴儿猝死综合征(SID)的常见细菌毒素假说是，鼻咽细菌毒素可引发缺乏/低水平抗体可中和毒素的婴儿死亡。本研究的目的是调查金黄色葡萄球菌鼻咽携带情况，并测定其对中毒性休克综合征毒素(TSST-1)和葡萄球菌肠毒素C(SEC)的免疫水平。这两种毒素都与小岛屿发展中国家的病例有关。73名母亲和她们的婴儿(39名男性和34名女性)参加了这项研究。这些婴儿的出生日期平均分布在一年中。在婴儿中，金黄色葡萄球菌携带率随着年龄的增长而显著下降(P<；0.001)。40%至50%的婴儿在出生后的头三个月内被金黄色葡萄球菌定植，49%的分离株产生一种或两种葡萄球菌毒素。在出生后三个月内，母亲和婴儿的鼻咽携带金黄色葡萄球菌之间存在显著的相关性(P<；0.001)。婴儿及其母亲的金黄色葡萄球菌携带率与脐带血、成人唾液或母乳中TSST-1或SEC抗体水平没有显著相关性。被金黄色葡萄球菌定植的婴儿的唾液IgA至TSST-1水平高于培养阴性的婴儿。用定量ELISA法分析脐血标本，TSST-1和SEC结合的抗体阳性率分别为95.5%和91.8%。孕妇血清中TSST-1和SEC抗体水平在不同脐带血样本间存在显著差异。孕妇年龄、出生体重和季节性显著影响与TSST-1或SEC结合的免疫球蛋白水平。对出生后1个月的婴儿唾液标本进行TSST-1和SEC检测，唾液IgA对TSST-1和SEC的检测阳性分别为11%和5%。到两个月大时，这些比例分别增加到36%和33%。与不使用假人的婴儿相比，使用假人的婴儿唾液IgA和TSST-1检测呈阳性的婴儿更多。在母乳样本中检测到的TSST-1和SEC的IgA水平在不同母亲之间差异很大。接受TSST-1或SEC抗体水平较低的母乳的婴儿有一种趋势，即唾液中对毒素的抗体水平较高。总而言之，婴儿对小婴儿猝死综合征所涉及的毒素的被动免疫差异很大。婴儿在出生的第一个月就能对TSST-1和SEC产生主动的粘膜免疫反应。(C)2004年欧洲微生物学会联合会。爱思唯尔出版，版权所有。
The common bacterial toxins hypothesis of sudden infant death syndrome (SIDS) is that nasopharyngeal bacterial toxins can trigger events leading to death in infants with absent/low levels of antibody that can neutralise the toxins. The aim of this study was to investigate nasopharyngeal carriage of Staphylococcus aureus and determine levels of immunity in the first year of life to toxic shock syndrome toxin (TSST-1) and staphylococcal enterotoxin C (SEC). Both toxins have been implicated in SIDS cases. Seventy-three mothers and their infants (39 males and 34 females) were enrolled onto the study. The infants had birth dates spread evenly throughout the year. In infants, S. aureus carriage decreased significantly with age (P < 0.001). Between 40% and 50% of infants were colonised with S. aureus in the first three months of life and 49% of the isolates produced one or both of the staphylococcal toxins. There was a significant correlation between nasopharyngeal carriage of S. aureus in mothers and infants in the three months following the birth (P < 0.001). Carriage of S. aureus in infants and their mothers was not significantly associated with levels of antibody to TSST-1 or SEC in cord blood, adult saliva or breast milk. Infants colonised by S. aureus had higher levels of salivary IgA to TSST-1 than infants who were culture negative. Analysis of cord blood samples by a quantitative ELISA detected IgG bound to TSST-1 and SEC in 95.5% and 91.8% of cases respectively. There was a marked variation in levels of maternal IgG to both TSST-1 and SEC among cord blood samples. Maternal age, birth weight, and seasonality significantly affected the levels of IgG binding to TSST-1 or SEC. Analysis of infant saliva samples detected IgA to TSST-1 and SEC in the first month after birth; 11% of samples tested positive for salivary IgA to TSST-1 and 5% for salivary IgA to SEC. By the age of two months these proportions had increased to 36% and 33% respectively. More infants who used a dummy tested positive for salivary IgA to TSST-1 compared to infants who did not use a dummy. Levels of IgA to TSST-1 and SEC detected in the breast-milk samples varied greatly among mothers. There was a trend for infants receiving breast milk with low levels of antibody to TSST-1 or SEC to have higher levels of salivary antibody to the toxins. In conclusion, passive immunity to toxins implicated in SIDS cases varies greatly among infants. Infants are able to mount an active mucosal immune response to TSST-1 and SEC in the first month of life. (C) 2004 Federation of European Microbiological Societies. Published by Elsevier B.V. All rights reserved.