美国匹兹堡儿童医院Timothy W. Hand团队取得进展。他们的研究显示，母体免疫球蛋白A（IgA）可预防早产儿坏死性小肠结肠炎(NEC)的发生。 2019年7月，国际知名学术期刊《自然—医学》发表了这一成果。

研究团队证明，母体免疫球蛋白A (IgA)是防止坏死性小肠结肠炎(NEC)发生的一个重要因素。研究者通过分析早产儿粪便中IgA结合的细菌，证明婴儿出生后的第一个月，母乳是IgA的主要来源，而且IgA结合细菌的相对减少与NEC的发生有关。通过对IgA结合菌和未结合菌的测序发现，在发病前，NEC与肠杆菌科在IgAa结合菌群中占主导地位的增加有关。此外，研究还证实IgA在小鼠模型中对预防NEC至关重要，在小鼠模型中，由缺乏IgA的母亲喂养的幼鼠尽管暴露于母乳中，但仍容易患病。研究结果表明，母体IgA形成早产儿的宿主菌群关系，母体母乳中的IgA是预防NEC的关键和必要因素。

据了解，母乳中分泌的抗体可以保护新生儿免受细菌的侵袭。坏死性小肠结肠炎(NEC)与肠道菌群引起的炎症有关，是一种高发病率和高死亡率的早产儿疾病。在母乳喂养的婴儿中，NEC的发病率要低得多，目前这种益处背后的机制尚不清楚。

附：英文原文

Title: Maternal IgA protects against the development of necrotizing enterocolitis in preterm infants

Author: Kathyayini P. Gopalakrishna, Benjamin R. Macadangdang, Matthew B. Rogers, Justin T. Tometich, Brian A. Firek, Robyn Baker, Junyi Ji, Ansen H. P. Burr, Congrong Ma, Misty Good, Michael J. Morowitz, Timothy W. Hand

Issue&Volume: Volume 25 Issue 7, July 2019

Abstract: Neonates are protected from colonizing bacteria by antibodies secreted into maternal milk. Necrotizing enterocolitis (NEC) is a disease of neonatal preterm infants with high morbidity and mortality that is associated with intestinal inflammation driven by the microbiota. The incidence of NEC is substantially lower in infants fed with maternal milk, although the mechanisms that underlie this benefit are not clear. Here we show that maternal immunoglobulin A (IgA) is an important factor for protection against NEC. Analysis of IgA binding to fecal bacteria from preterm infants indicated that maternal milk was the predominant source of IgA in the first month of life and that a relative decrease in IgA-bound bacteria is associated with the development of NEC. Sequencing of IgA-bound and unbound bacteria revealed that before the onset of disease, NEC was associated with increasing domination by Enterobacteriaceae in the IgA-unbound fraction of the microbiota. Furthermore, we confirmed that IgA is critical for preventing NEC in a mouse model, in which pups that are reared by IgA-deficient mothers are susceptible to disease despite exposure to maternal milk. Our findings show that maternal IgA shapes the hostmicrobiota relationship of preterm neonates and that IgA in maternal milk is a critical and necessary factor for the prevention of NEC.

DOI: 10.1038/s41591-019-0480-9

Source:https://www.nature.com/articles/s41591-019-0480-9