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Biomedical subjects

L Mellander

Publications and source records attributed to L Mellander.

62 records · Page 4Linked to original sources

Food and immunological development.

The infant's host defence is deficient in IgA for mucosal protection and also in IgG2 for protection against encapsulated bacteria. The baby is provided with about one gram a day of milk secretory IgA antibodies against most intestinal microorganisms and also food proteins. These milk antibodies together with a number of other defence factors in the milk protect the baby against gastrointestinal and respiratory infections. Maternal undernutrition does not necessarily diminish the milk IgA concentration or 24 hour output. The infant seems to be low in secretory IgA antibodies for several months as studied in saliva. It is of great importance to protect mucosal membranes especially the intestinal mucosa, so that its nutrient uptake is not disturbed. Infections in infancy especially in the gastrointestinal tract is an important cause of undernutrition. The human milk antibodies against cow's milk and soy protein may decrease the exposure to these food proteins during weaning and possibly decrease the risk of developing allergy. Soy oil can contain soy protein, which may explain some food intolerance reactions.

Animals↗

The secretory IgA system in the neonatal period.

It is still not known when the secretory IgA response, important for defence of the mucous membranes, becomes fully competent in the human infant. The infant is, however, provided with 0.25--0.5 g of secretory IgA/day via the maternal milk. The milk contains secretory IgA antibodies against a wide variety of antigens from microorganisms, including bacteria, viruses and parasites. Many of the antibodies are directed against important virulence factors such as bacterial pili, enterotoxins, capsular polysaccharides and endotoxic lipopolysaccharides. The passive transfer of antibodies through the milk may explain why breast-fed infants are resistant to enteric infections in particular. The antibodies in the milk are often directed against antigens in the mother's milieu and intestine. An entero-mammary gland link, possibly consisting of lymphoid cells homing from the Peyer's patches in the intestine to the mammary gland, has been suggested. A limited selective uptake of oligomeric IgA from serum in exocrine glands, including the mammary glands, has also been indicated. Whichever the mechanism, the antibodies transferred via breast milk are composed to meet the needs of the infant.

Adolescent↗

Defence of mucous membranes by antibodies, receptor analogues and non-specific host factors.

Most infections reach man via the mucosal membranes, and more than half of the lymphoid system is found in connection with mucosae. The major antibodies found on mucous membranes are secretory IgA, which function primarily by binding microorganisms and thereby preventing their contact with the host tissues. The optimal mode of immunization to obtain a secretory IgA response is not well defined. Repeated mucosal exposure with antigen may result in oral tolerance, with decreasing circulating antibodies but a remaining secretory IgA response. The secretory IgA response is usually short-lived and can be difficult to boost. IgM as well as IgG antibodies may add to host defence at the mucosal level, but when engaged, they usually induce inflammation in host tissues. Analogues to bacterial receptors on mucosal epithelium may be present in exocrine secretions such as human milk. During an attack on the host, it is possible that such receptor analogues may aid in the prevention of attachment of bacteria to mucous membranes used as an initial site. A number of non-specific host factors support mucosal defence. One of them is lactoferrin. Lactoferrin deficiency seems to result in recurrent bacterial infections, suggesting its importance in normal host defence.

Administration, Oral↗

Immunogenicity and reactogenicity of rhesus rotavirus vaccine given in combination with oral or inactivated poliovirus vaccines and diphtheria-tetanus-pertussis vaccine.

Immunogenicity and reactogenicity of the oral rhesus rotavirus vaccine (RRV) were assessed among 72 infants (6 weeks old) in Lahore, Pakistan, from August to December 1985. Special emphasis was placed on the possible interaction or interference caused by giving RRV at the time infants received their first polio immunization. RRV was given to the infants at the same time as diphtheria-tetanus-pertussis (DTP), oral poliovirus vaccine (OPV), or inactivated poliovirus vaccine (IPV). The immune response to RRV was assessed by plaque-reduction neutralization 3 weeks after immunization and serum immunoglobulin (Ig) G and IgA antibody levels to poliovirus type 1 were tested by enzyme-linked immunosorbent assay (ELISA) after polio immunizations. Of the infants in the group given RRV with OPV, 50% had a two- to four-fold rise in neutralization titre against rotavirus, compared with 22% in the group given RRV with DTP and 20% in the group given RRV and IPV (P less than 0.05). Interference by live oral polio vaccination in the response to RRV seems unlikely. We observed no significant difference in rates of seroconversion of IgG antibodies to poliovirus type 1 among infants aged 18 and 21 weeks who received RRV and OPV (81%), RRV with delayed OPV (67%), or RRV and IPV (59%). Administration of RRV was safe and was not associated with adverse reactions in the 6 weeks old infants. The low rate of seroconversion to rotavirus suggests that a more antigen-rich vaccine or multiple doses of the same vaccine might produce a better immune response.

Antibodies, Viral↗

The secretory IgA system.

The secretory IgA system is common to all mucosal membranes and is presumably of great importance for their defense. In addition to the secretory IgA antibodies produced in a mucosa in response to a local antigenic stimulus there is a spread of this type of IgA response via committed lymphocytes. They originate from central lymphoid organs in the intestinal (Peyer's patches) and bronchial mucosa (bronchus-associated lymphoid tissue, BALT) which they leave after antigenic exposure. They migrate, or "home", to exocrine glands such as the lacrimal, salivary, mammary and prostatic glands and mucosal membranes of the respiratory, gastrointestinal and genito-urinary tract. Almost half of all lymphocytes may be involved in the production of IgA antibodies. The secretory IgA antibodies are the dominating immunoglobulins in exocrine secretions on mucous membranes. They function primarily by preventing contact between the microbe and the host tissue most commonly attacked in infections, the mucous membrane. The fact that breast-feeding protects the infant against intestinal infections is one good example of the clinical significance of secretory IgA antibodies. This mode of protection can be enhanced by vaccination.

Breast Feeding↗

Intestinal colonization with Enterobacteriaceae in Pakistani and Swedish hospital-delivered infants.

Rectal cultures from Swedish and Pakistani hospital-delivered newborn infants were analysed regarding the early acquisition of enterobacteria. Swedish infants were delivered vaginally, Pakistani infants were delivered either vaginally or by caesarean section. The Swedish infants were all breast-fed, whereas breastfeeding was incomplete and often started late among the Pakistani infants. Both groups of Pakistani infants were more rapidly colonized with enterobacteria than were the Swedish infants. Cultures from Swedish infants seldom yielded more than one kind of enterobacteria; E. coli and Klebsiella were most frequently isolated. E. coli dominated in both Pakistani groups, but especially caesarean section delivered infants were in addition often colonized with Proteus, Klebsiella, Enterobacter or Citrobacter species. Breastfeeding from the first day of life reduced colonization with Klebsiella/Enterobacter/Citrobacter. The results suggest that environmental exposure, delivery mode and early feeding habits all influence the early intestinal colonization with enterobacteria.

Breast Feeding↗

Avidity and titers of the antibody response to two inactivated poliovirus vaccines with different antigen content.

The inactivated poliovirus vaccine is heat stabile, gives high serum IgG concentrations but less pronounced mucosal immunity and must be given as repeated injections. A new enhanced-potency Dutch inactivated vaccine could circumvent these difficulties. We compared antibody concentrations measured as neutralization or ELISA titers, and avidity of serum and salivary antibodies in children vaccinated with three doses of the earlier Swedish vaccine given over nine months or the new antigen-rich vaccine. After three doses, but not after two, serum neutralization titers for type 1 and type 3 poliovirus were higher using the new vaccine but secretory IgA levels in saliva were similar. The avidity of the serum IgG antibodies was significantly higher after two doses of the new vaccine than after three doses of the old. Thus the new vaccine gives excellent antibody responses of high titers and avidities, but should preferably be given in three doses.

Antibodies, Viral↗