Soluble CD14 in Breast Milk and Its Relation to Atopic Manifestations in Early Infancy

Abstract

Soluble CD14 (sCD14) is one of the immunomodulatory factors in breast milk (BM). Although it may be involved in the prevention of atopic symptoms and sensitization to both food and inhalant allergens, conflicting evidence exists concerning its protective effects. In this study, we investigated the relationship between sCD14 in colostrum and 1-month BM, and the development of atopic dermatitis (AD) and sensitization to food and aeroallergens at 9 months of age in infants who were exclusively or almost exclusively breastfed up to 4 months of age. BM samples were collected from lactating mothers who participated in a 2 × 2 factorial, randomized, nontreatment controlled trial study set in Tokyo, which looked at the efficacy of emollients and synbiotics in preventing AD and food allergy in children during the first year of life. A total of 258 colostrum samples and 269 1-month BM samples were analyzed. We found that one-month BM sCD14 levels in the AD group were significantly lower than in the non-AD group. Levels of sCD14 in 1-month BM were not related to allergen sensitization in the overall analysis, but egg white sensitization correlated inversely with 1-month BM sCD14 in infants without AD. The results suggest that sCD14 in BM may be involved in atopic manifestations in early infancy.

Keywords: allergen sensitization; atopic dermatitis; breast milk; soluble CD14.

Figure 1

(a) Levels of sCD14 in colostrum (n = 258) and in 1-month BM (n = 269). There was a significant difference between colostral sCD14 and 1-month BM sCD14 levels (Wilcoxon rank sum test, p < 0.0001) and (b) Colostral sCD14 and 1-month BM sCD14 levels with or without maternal allergic history. In AD or non-AD infants, sCD14 levels in BM were not significantly different between mothers with allergic history and those without allergic history (Wilcoxon rank sum test, p > 0.05). The levels are shown as median with interquartile ranges.

Figure 2

Dose-dependent trend for sCD14 levels in 1-month BM to EWS at 9 months of age in AD (a) and non-AD (b) infants. EWS decreased significantly with increasing sCD14 levels in 1-month BM in non-AD infants (Cochran–Armitage trend test, p = 0.042).