Abstract
Background
The protective effect of breastfeeding on celiac disease (CD) onset is controversial. We studied a wide range of milk components in milk produced by celiac mothers following long-term gluten-free diet (GFD) in comparison to milk produced by healthy mothers.
Methods
Breast-milk samples from celiac (n = 33) and healthy (n = 41) mothers were obtained during the first year of lactation. A panel of bioactive components was analyzed by enzyme-linked immunosorbent assay in the aqueous fraction. We studied molecules involved in defenses, immunoregulation, and strengthening of the gut–epithelial barrier.
Results
During late lactation (from 6 to 12 months after delivery), the content of total immunoglobulin A (IgA) and IgM was significantly lower in the milk produced by celiac patients. Nevertheless, gliadin (GFD)-specific IgA relative contribution was higher in this group, in contrast to tetanus toxoid-specific antibodies. The balance between pro-inflammatory and anti-inflammatory molecules was different. While interleukin-6, tumor necrosis factor-α, and monocyte chemoattractant protein-1 were most frequently found in samples from celiac mothers, soluble Toll-like receptor-2 prevalence was lower.
Conclusions
We describe differences between the innate and adaptive immune profile of milk produced by celiac and healthy mothers. These results might explain previous controversial reports about breastfeeding and CD protection.
Impact
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In spite of a long-term adherence to GFD, the milk produced by mothers with CD exhibit a different immune profile, in relation with some immunoregulatory factors and antibody content.
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This work shows a more comprehensive characterization of milk from celiac mothers, including macronutrients, lysozymes, growth factors, and immunoregulatory components that had not been studied before.
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The present study widens the available data regarding the characteristics of human milk of celiac mothers following GFD.
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Further follow-up studies of the health of children who were breastfed by celiac mothers will be necessary in order to also estimate the impact of the present results therein.
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Acknowledgements
We are deeply grateful to the donors of milk samples and to ACELU for its contribution to the essential communication logistics. We thank L. Carroscia, M.D. and the technical staff of HMB for their invaluable collaboration. We also thank José Fuentes for his assistance with statistical analysis, and A.I. Zambrana, M.Sc. for proofreading this manuscript. This work was supported by the Consejo Sectorial de Investigación Científica – Universidad de la República (CSIC ID – 205/2015 to E.V.), a postgraduate scholarship to E.V. (Agencia Nacional de Innovación e Investigación—ANII), and the Programa de Desarrollo de las Ciencias Básicas (PECECIBA; to A.H., E.V., and C.R.-C.).
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The author’s responsibilities were as follows: E.V. contributed to design, experimental analysis, and revision of the manuscript. A.H. contributed to the conception, design, discussion, drafting, and revision of the manuscript. A.P. and L.F. contributed to the logistics to obtain milk samples and the analyses of macronutrients. V.C. performed logistic regression analyses of data. C.R.-C. contributed with technical assistance in experimental work and discussion.
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Villamil, E., Rodríguez-Camejo, C., Puyol, A. et al. Immune profiling of breast milk from mothers with treated celiac disease. Pediatr Res 89, 488–495 (2021). https://doi.org/10.1038/s41390-020-0901-y
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DOI: https://doi.org/10.1038/s41390-020-0901-y
