@article{08fb7c9305664d5393f2cf2088360358,
title = "Breast milk prefusion F immunoglobulin g as a correlate of protection against respiratory syncytial virus acute respiratory illness",
abstract = "Background Transplacental respiratory syncytial virus (RSV) antibody transfer has been characterized, but little is known about the protective effect of breast milk RSV-specific antibodies. Serum antibodies against the prefusion RSV fusion protein (pre-F) exhibit high neutralizing activity. We investigate protection of breast milk pre-F antibodies against RSV acute respiratory infection (ARI). Methods Breast milk at 1, 3, and 6 months postpartum and midnasal swabs during infant illness episodes were collected in mother-infant pairs in Nepal. One hundred seventy-four infants with and without RSV ARI were matched 1:1 by risk factors for RSV ARI. Pre-F immunoglobulin A (IgA) and immunoglobulin G (IgG) antibody levels were measured in breast milk. Results The median breast milk pre-F IgG antibody concentration before illness was lower in mothers of infants with RSV ARI (1.4 [interquartile range {IQR}, 1.1-1.6] log 10 ng/mL) than without RSV ARI (1.5 [IQR, 1.3-1.8] log 10 ng/mL) (P =.001). There was no difference in median maternal pre-F IgA antibody concentrations in cases vs controls (1.7 [IQR, 0.0-2.2] log 10 ng/mL vs 1.7 [IQR, 1.2-2.2] log 10 ng/mL, respectively; P =.58). Conclusions Low breast milk pre-F IgG antibodies before RSV ARI support a potential role for pre-F IgG as a correlate of protection against RSV ARI. Induction of breast milk pre-F IgG may be a mechanism of protection for maternal RSV vaccines.",
keywords = "IgG and IgA antibodies, acute respiratory infection, breast milk, maternal vaccination, respiratory syncytial virus",
author = "Mazur, {Natalie I.} and Horsley, {Nicole M.} and Englund, {Janet A.} and Maaike Nederend and Amalia Magaret and Azad Kumar and Jacobino, {Shamir R.} and {De Haan}, {Cornelis A.M.} and Khatry, {Subarna K.} and Leclerq, {Steven C.} and Steinhoff, {Mark C.} and Tielsch, {James M.} and Joanne Katz and Graham, {Barney S.} and Bont, {Louis J.} and Leusen, {Jeanette H.W.} and Chu, {Helen Y.}",
note = "Funding Information: Financial support. This work was supported by the Netherlands Royal Academy for Medical Sciences (Academy medical sciences grant 2017, Academy Medical Sciences Fund); the Bill & Melinda Gates Foundation (grant number 50274); and the National Institutes of Health (grant number K23-AI103105). Funding Information: Potential conflicts of interest. H. Y. C.{\textquoteright}s institution receives research support from Novavax and Sanofi-Pasteur. J. A. E. has received research support to her institution from Novavax, MedImmune, GlaxoSmithKline, and Gilead. B. S. G. has a patent pending for an RSV pre-F candidate. J. M. T. and J. K. received grants from the Bill & Melinda Gates Foundation (BMGF) during the conduct of the study. J. K. has received grants from BMGF, the Thrasher Research Fund, the National Institutes of Health, the Whole New World Foundation, and the US Agency for International Development. L. J. B. has regular interaction with pharmaceutical and other industrial partners, but has not received personal fees or other personal benefits; and has received minor funding for consultation and invited lectures by AbbVie, MedImmune, Ablynx, Bavaria Nordic, MabXience, Novavax, and Janssen (total annual estimate <€20000). University Medical Center Utrecht has received major funding (>€100000 per industrial partner) for investigator-initiated studies from AbbVie, MedImmune, Janssen, BMGF, and MeMed Diagnostics, as well as minor funding for participation in trials by Regeneron and Janssen since 2015 (total annual estimate <€20000). All other authors report no potential conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed. Publisher Copyright: {\textcopyright} The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America.",
year = "2019",
month = jan,
day = "1",
doi = "10.1093/infdis/jiy477",
language = "English (US)",
volume = "219",
pages = "59--67",
journal = "Journal of Infectious Diseases",
issn = "0022-1899",
publisher = "Oxford University Press",
number = "1",
}