Look at:  http://www.pediatrics.org/cgi/content/abstract/101/2/242

*******

PEDIATRICS Vol. 101 No. 2 February 1998, pp. 242-249

Modulation of the Immune System by Human Milk and Infant Formula
Containing Nucleotides


Received Jan 22, 1997; accepted Jul 2, 1997.

Larry K. Pickering*, Dan M. Granoff, Julie Reed Erickson§, Marc L.
Masor,
Christopher T. Cordle, Joseph P.
Schaller, Timothy R. Winship, Charles L. Paule, and Milo D. Hilty

>From the * Center for Pediatric Research, Children's Hospital of The
King's Daughters, Eastern Virginia Medical School,
Norfolk, Virginia; the  Children's Hospital/Oakland Research Institute,
Oakland, California; the § University of Arizona,
Tucson, Arizona; and  Ross Products Division, Abbott Laboratories,
Columbus, Ohio.

Objective.  To determine whether human milk and nucleotides added to
infant formula at levels present in human milk enhance
development of the immune system during infancy.

Methods.  A 12-month, controlled, randomized and blinded, multisite
feeding trial was conducted on two infant formulas:
iron-fortified, milk-based control formula (Control) or the same formula

fortified with nucleotides (Nucleotide). The level
(72 mg/L) and ratio of individual nucleotides selected were patterned
after those available in human milk. A third group fed
human milk exclusively for 2 months and then human milk or Similac with
iron until 12 months of age also was studied.
Response to immunizations was chosen to assess development of the immune

system. Infants followed the immunization
schedule recommended by the American Academy of Pediatrics in 1991.

Outcome Variables.  Antibody responses were determined at 6, 7, and 12
months of age to Haemophilus influenzae type b
polysaccharide (Hib), to diphtheria and tetanus toxoids, and to oral
polio virus (OPV) immunizations.

Results.  Of 370 full-term, healthy infants enrolled, 311 completed the
study (107 Control, 101 Nucleotide, 103 human
milk/Similac with iron). Intake, tolerance, and growth of infants were
similar in all three groups. Compared with the Control
group 1 month after the third immunization (7 months of age), the
Nucleotide group had a significantly higher Hib antibody
concentration (geometric mean concentrations of 7.24 vs 4.05 µg/mL,
respectively), and a significantly higher diphtheria
antibody concentration (geometric mean of 1.77 vs 1.38 U/mL). The
significantly higher Hib antibody response in the
Nucleotide group persisted at 12 months. The antibody responses to
tetanus and OPV were not enhanced by nucleotide
fortification. There also was an effect of breastfeeding on immune
response. Infants who breastfed had significantly higher
neutralizing antibody titers to polio virus than either formula-fed
group
(1:346 vs 1:169 and 1:192 in the Control and Nucleotide
groups, respectively) at 6 months of age.

Conclusion.  Infant formula fortified with nucleotides enhanced H
influenzae type b and diphtheria humoral antibody
responses. Feeding human milk enhanced antibody response to OPV. Dietary

factors play a role in the antibody response of
infants to immunization.
************

--
Andrea Eastman, MA, CCE
Granville, Ohio
mailto:[log in to unmask]

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