Diabetologia ( IF 8.4 ) Pub Date : 2021-11-27 , DOI: 10.1007/s00125-021-05612-2 Maija E Miettinen 1 , Jarno Honkanen 2 , Sari Niinistö 1 , Outi Vaarala 2 , Suvi M Virtanen 1, 3, 4, 5 , Mikael Knip 6, 7, 8, 9 ,
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Aims/hypothesis
Our aim was to study the association between duration of breastfeeding and circulating immunological markers during the first 3 years of life in children with HLA-conferred susceptibility to type 1 diabetes.
Methods
We performed a longitudinal analysis of 38 circulating immunological markers (cytokines, chemokines and growth factors) in serum samples from Finnish (56 individuals, 147 samples), Estonian (56 individuals 148 samples) and Russian Karelian children (62 individuals, 149 samples) at 3, 6, 12, 18, 24 and 36 months of age. We also analysed gut inflammation markers (calprotectin and human β defensin-2) at 3 (n = 96) and 6 months (n = 153) of age. Comparisons of immunological marker medians were performed between children who were breastfed for 6 months or longer vs children who were breastfed for less than 6 months.
Results
Breastfeeding for 6 months or longer vs less than 6 months was associated with lower median of serum immunological markers at 6 months (granulocyte-macrophage colony-stimulating factor [GMCSF], macrophage inflammatory protein [MIP-3α]), 12 months (IFN-α2, vascular endothelial growth factor, GMCSF, IFN-γ, IL-21), 18 months (FGF-2, IFN-α2) and 24 months of age (CCL11 [eotaxin], monocyte chemoattractant protein-1, TGFα, soluble CD40 ligand, IL-13, IL-21, IL-5, MIP-1α) (all p < 0.01) but not at 36 months of age. Breastfeeding was not associated with gut inflammation markers at 3 and 6 months of age.
Conclusions/interpretation
Children who were breastfed for 6 months or longer had lower medians for 14 immunological markers at one or more age points during the first 2 years of life compared with children who were breastfed for less than 6 months. The clinical meaning of the findings is not clear. However, the present study contributes to the understanding of immunological differences in children that have been breastfed longer, and thus provides a mechanistic suggestion for the previously observed associations between breastfeeding and risk of type 1 diabetes.
Graphical abstract
中文翻译：
生命前 3 年的母乳喂养和循环免疫标志物：DIABIMMUNE 研究
目标/假设
我们的目的是研究 HLA 赋予 1 型糖尿病易感性的儿童出生后头 3 年母乳喂养时间与循环免疫标志物之间的关联。
方法
我们对芬兰人（56 人，147 份样本）、爱沙尼亚人（56 人，148 份样本）和俄罗斯卡累利阿儿童（62 人，149 份样本）的血清样本中的 38 种循环免疫标记物（细胞因子、趋化因子和生长因子）进行了纵向分析。 3、6、12、18、24 和 36 个月大。我们还分析了 3 个月（ n = 96）和 6 个月（n = 153）时的肠道炎症标志物（钙卫蛋白和人类 β 防御素-2） 。在母乳喂养 6 个月或更长时间的儿童与母乳喂养不到 6 个月的儿童之间进行免疫标记中位数的比较。
结果
母乳喂养 6 个月或更长时间与少于 6 个月与 6 个月时血清免疫学标志物（粒细胞-巨噬细胞集落刺激因子 [GMCSF]、巨噬细胞炎症蛋白 [MIP-3α]）、12 个月（IFN- α2、血管内皮生长因子、GMCSF、IFN-γ、IL-21）、18 个月（FGF-2、IFN-α2）和 24 个月（CCL11 [eotaxin]、单核细胞趋化蛋白 1、TGFα、可溶性 CD40配体、IL-13、IL-21、IL-5、MIP-1α）（所有p < 0.01），但在 36 个月大时没有。母乳喂养与 3 个月和 6 个月大的肠道炎症标志物无关。
结论/解释
与母乳喂养不到 6 个月的儿童相比，母乳喂养 6 个月或更长时间的儿童在出生后头 2 年的一个或多个年龄点的 14 种免疫标志物的中位数较低。研究结果的临床意义尚不清楚。然而，本研究有助于了解母乳喂养时间较长的儿童的免疫学差异，从而为先前观察到的母乳喂养与 1 型糖尿病风险之间的关联提供了机制建议。
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