Don’t cry over spilled milk…. Unless it’s breast milk

Mazur NI,  Horsley N, Englund JA, Nederend M, Magaret A, Kumar A, Jacobino SR, de Haan CAM, Khatry SK, LeClerq SC, Steinhoff MC, Tielsch JM, Katz J, Graham BS, Bont LJ, Leusen JHW, Chu HY

Maternal RSV vaccines are on the verge of establishment. Protection by maternal vaccination is mainly based on transplacental antibody (Ab) transfer. Antibody transfer via breast milk might offer additional protection. The immunological correlate for protection against RSV, by maternal antibodies transferred via breast milk, is unknown. Mazur and colleagues are the first to show that breast milk derived antibodies directed against pre-F RSV play an important role in the protection against RSV infection. 
They conducted a study among 174 infants under the age of 6 months. Infants were stratified by risk factors into a group with and a group without RSV.  While pre-F IgA Ab did not differ between the two groups, pre-F IgG Ab was significantly lower in the group with RSV.  Although the difference between the two groups was small it does suggest the potential role of pre-F IgG antibodies as a correlate of protection against RSV respiratory tract infection.
Induction of pre-F IgG in breast milk by maternal vaccination will probably transfer protection to infants against RSV disease, additional to transplacental antibody transfer. 
This review was written by Sjanna Besteman

Download paper of the month september 2018