The role of breastfeeding in improving allergy outcomes in early childhood is still unclear. Evidence suggests that immune mediators in human milk (HM) play a critical role in infant immune maturation as well as protection against atopy/allergy development. We investigated relationships between levels of immune mediators in colostrum and mature milk and infant outcomes in the first year of life. In a large prospective study of 398 pregnant/lactating women in the United Kingdom, Russia and Italy, colostrum and mature human milk (HM) samples were analysed for immune active molecules. Statistical analyses used models adjusting for the site of collection, colostrum collection time, parity and maternal atopic status. Preliminary univariate analysis showed detectable interleukin (IL) 2 and IL13 in HM to be associated with less eczema. This finding was further confirmed in multivariate analysis, with detectable HM IL13 showing protective effect OR 0.18 (95% CI 0.04–0.92). In contrast, a higher risk of eczema was associated with higher HM concentrations of transforming growth factor β (TGFβ) 2 OR 1.04 (95% CI 1.01–1.06) per ng/mL. Parental-reported food allergy was reported less often when IL13 was detectable in colostrum OR 0.10 (95% CI 0.01–0.83). HM hepatocyte growth factor (HGF) was protective for common cold incidence at 12 months OR 0.19 (95% CI 0.04–0.92) per ng/mL. Data from this study suggests that differences in the individual immune composition of HM may have an influence on early life infant health outcomes. Increased TGFβ2 levels in HM are associated with a higher incidence of reported eczema, with detectable IL13 in colostrum showing protective effects for food allergy and sensitization. HGF shows some protective effect on common cold incidence at one year of age. Future studies should be focused on maternal genotype, human milk microbiome and diet influence on human milk immune composition and both short- and long-term health outcomes in the infant.

Cytokines and growth factors in colostrum and mature milk may play an important role in infant immune maturation, and may vary significantly between populations. We aimed to examine associations between environmental and maternal factors, and human milk (HM) cytokine and growth factor levels. We recruited 398 pregnant/lactating women in the United Kingdom, Russia, and Italy. Participants underwent skin prick testing, questionnaire interview, and colostrum and mature milk sampling. HM cytokine and growth factor levels were quantified by electro-chemiluminescence. We found significant geographical variation in growth factor levels, but no evidence of variation between sites in cytokine detectability. There was an inverse correlation between time of milk sampling and growth factor levels in colostrum for Hepatocyte Growth Factor (HGF) and TGFβ1 and TGFβ3, but not TGFβ2, and levels were significantly higher in colostrum than mature milk for all growth factors. The kinetics of decline were different for each growth factor. Cytokines were present at much lower levels than growth factors, and the decline over time was less consistent. HM growth factors and cytokine levels vary between populations for unknown reasons. Levels of HM mediators decline at different rates postpartum, and these findings suggest specific biological roles for HM growth factors and cytokines in early postnatal development.

Background. Staphylococus aureus (S. aureus) colonization is revealed in 80-84% of patients with atopic dermatitis (AD). There are no results on S. aureus susceptibility to antibiotics in children with AD within the period 2002-2004 to 2007-2009 years. Methods. S. aureus susceptibility to antibiotics was evaluated in 62 children with AD in 2002-2004 years and in 199 children in 2007-2009 years. S. aureus susceptibility and resistance to antibiotics were evaluated as frequencies (q) and their 95% confidential intervals (CI 95%) with MS «Excell». results. S. aureus antibiotic susceptibility in AD children is increased to ciprofloxacin since 2002-2004 to 2007-2009 [0,54 (0,42..0,67) /0,85 (0,80..0,91)] and is not changed to ceftriaxone [0,57 (0,44..0,70) /0,64 (0,57..0,71)], oxacillin [0,75 (0,64..0,86)/0,71 (0,64..0,78)] and cefuroxime [0,61 (0,49..0,74)/0,58 (0,36..0,80)]. Erythromycin susceptibility of S. aureus is 7 times reduced [0,71 (0,60..0,82)/0,10 (0,06..0,14)]; chloramphenicol susceptibility is 2 times reduced [0,79 (0,69..0,90)/0,33 (0,09..0,57)]. There is a decline of S. aureus antibiotic susceptibility to penicillin, ampicillin, linkomycin. Conclusion. Ceftriaxone may be the antibiotic of choice in children with severe infected AD. Oxacillin and cefuroxime should be recommended as an alternative choice.

Background. Staphylococus aureus (S. aureus ) function in atopic dermatitis (AD) children skin is double-handed: an infectious trigger and an allergen. The study was aimed to evaluate a frequency of S. aureus enterotoxins IgE work out in children with infected AD skin and to compare IgE levels with infected AD severity. Methods. Specific IgE to S. aureus enterotoxins A and B (ImmunoCap, Phadia AB, Sweden) detected in serum of 90 children with infected AD. IgE levels were compared to severity of infected AD (Mann—Whitney Utest). Results. Specific IgE>0,35 kUA/l to S. aureus enterotoxin A frequency was of 0,29; to enteritoxin B 0,36; to one of them 0,43. IgE to S. aureus enterotoxins were elevated in 16 children with therapy resistant AD in compare to other cases of AD (р=0,00183). Conclusion. In children with infected AD S. aureus enterotoxins A or/and B are revealed in 25—50% of cases. In children with therapy resistant AD specific IgE level to enterotoxins is elevated in comparison to severe or average AD children.

There is some evidence to suggest that colostrum/breast milk immunological composition have potential in infant gut immunity modulation early in life. Objective. To assess levels of cytokines in colostrum and breast milk in atopic and non-atopic mothers, and in those, who have self-reported allergy. Patients and methods. 277 Moscow women were recruited as a part of an International (Great Britain, Russia, Italy) study assessing immune composition of colostrum and breast milk. Skin prick-tests were used to assess sensitization in recruited women. Electrochemiluminiscence of colostrum and breast milk samples for HGF, IFN-γ, IL-2, IL-4, IL-5, IL-10, IL-12, IL-13, TGF β1, TGF β2, TGF β3 was performed in a Flow Cytometry Lab, Imperial College London. Results. In 19,4% of Moscow women a sensitization to one or more allergens was revealed. According to univariate analysis colostrum and/or breast milk levels of TGF β1, TGF β3, HGF, IL-5, IL-10 and IFN-γ were higher in sensitized women. No difference in IL-2, IL-4, IL-12, IL-13, TGF β2 levels was revealed in relation to sensitization. Conclusion. Cytokine and growth factors differences of colostrum and breast milk samples from Moscow women allow to assume the lack of IL-4 and IL-13 shift of cytokine and growth factors in relation to sensitization.