母乳中转化生长因子－β1和白细胞介素－10与婴儿过敏性疾病的关系

Relationship between transforming growth factor-β1 and interleukin-10 in breast milk and allergic diseases in infants

目的探讨母乳中转化生长因子－β1（transforming growth factor-β1，TGF－β1）和白细胞介素－10（interleukin－10，IL－10）与婴儿过敏性疾病的关系。方法对191例孕产妇（过敏组99例，非过敏组92例）及其足月产子女进行前瞻性研究，应用酶联免疫吸附试验方法测定母血、脐血、初乳和成熟乳中TGF－β1与IL－10的含量。分析过敏组与非过敏组母血、脐血、初乳和成熟乳中TGF-β1与IL-10含量的差异及其与婴儿随访6个月内过敏性疾病发生的关系。TGF-β1、IL－10和IgE以中位数（M）和范围表示。组间和组内差异比较采用非参数检验。结果非过敏组母血中IgE含量为30750Iu／L（6600～410000IU／L），低于过敏组E50000IU/L（7100～610000IU／L）]，差异有统计学意义（Z=-3．444，P=0．001）。非过敏组和过敏组成熟乳中TGF-β1、IL-10及IgE的含量差异没有统计学意义。过敏组初乳中TGF-β1、IL-10及IgE的含量分别为2300pg／ml（620～7000pg／m1）、12．8pg／ml（7．5～560．0pg／ml）和7000IU／L（5100～56000IU／L），均比非过敏组高[1830pg／ml（1240-9400pg／ml）、11．1pg／ml（7．2-630．0pg／ml）和6700Iu／L（5200-35000IU/L）]，差异均有统计学意义（Z分别=-2．215、-2．730和-2．706，P均〈0．05）。不论在非过敏组还是过敏组，脐血中TGF-β1和IL-10的含量均高于母血，IgE的含量低于母血；初乳中TGF-β1、IL-10及IgE的含量明显高于成熟乳，差异均有统计学意义（P均〈0．05）。随访6个月，过敏组婴儿过敏性疾病的发生率（59．6％，59／99）明显高于非过敏组（21．7％，20／92）（χ^2=28．177，P=0．000）；完成初乳喂养者过敏性疾病的发生率（44．5％，73／164）明显高于未完成初乳喂养者（22．2％，6／27）（χ^2=4．749，P=0．029）。结论初乳中TGF-β1和IL-10的高含量对过敏性疾病的发生没有保护作用。完成初乳喂养的婴儿过敏性疾病发生率明显增高，初乳可能对过敏性疾病的发生产生某些影响。

Objective To verify the relationship between transforming growth factor-β1（TGF- β1） and interleukin-10 （IL-10） in breast milk and allergic diseases development in infants. Methods Totally 191 mothers （99 allergics and 92 controls） and their full-term newborns participated in this prospective study on development of children atopy. Maternal blood, cord blood, colostrum and mature milk were assayed for TGF-β1 and IL-10 by enzyme-linked immunosorbent assay. Infants underwent pediatrician evaluation for allergic diseases at six months old. Concentrations of TGF-β1 and IL-10 from allergic and non-allergic mothers and prevalence of allergic diseases of infants were compared. Results The level of IgE in allergic mothers was 30 750 IU/L（6600-410 000 IU/L）, lower than that in non-allergic mothersl-50 000 IU/L（7100- 610 000 IU/L）]（Z=-3. 444,P=0. 001）. No difference in the concentration of TGF-β1, IL-10 and IgE in mature milk was observed between allergic and non-allergic mothers. TGF-β1, IL-10 and IgE levels in colostrum of allergic mothers were 2300 pg/ml（620-7000 pg/ml）, 12.8 pg/ml（7.5 560.0 pg/ml）and 7000 IU/L（5100-56 000 IU/L）, significantly higher than those in non-allergic mothers[1830 pg/ml（1240-9400 pg/rnl）, 11. 1 pg/ml （7.2-630.0 pg/ml）and 6700 IU/L（5200-35 000 IU/L）] （Z=-2. 215, -2. 730 and -2. 706,P〈0.05）.In both allergic and non allergic mothers, TGF-β1 and IL-10 levels in cord blood were higher than those in maternal blood, while IgE was lower. TGF β1 and IL-10 and IgE levels in colostrum were higher than mature milk（P〈0.05）. At six months old, the prevalence of allergic diseases of infants from allergic mothers（59.6 %, 59/99） was significantly higher than those from non-allergic mothers （21. 7%, 20/92） （χ^2= 28. 177, P = 0. 000）. The prevalence of allergic diseases of infants who completed two weeks＇ colostrum fed after birth （44.5%, 73/164） was significantly higher than those who did not （22.2%,6/27）（Z2 =4. 749,P=0. 029）. Conclusions High concentration of TGF-β1 and IL-10 in eolostrum does not show any protective effect against allergic diseases in infants. The prevalence of allergic diseases of colostrum-fed infants is significantly higher than non colostrum-fed infants, showing that colostrum-fed might play a role in allergic diseases development.