PMID- 9445498 OWN - NLM STAT- MEDLINE DCOM- 19980217 LR - 20190516 IS - 1098-4275 (Electronic) IS - 0031-4005 (Linking) VI - 101 IP - 2 DP - 1998 Feb TI - Modulation of the immune system by human milk and infant formula containing nucleotides. PG - 242-9 AB - 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 micrograms/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 responses to OPV. Dietary factors play a role in the antibody response of infants to immunization. FAU - Pickering, L K AU - Pickering LK AD - Center for Pediatric Research, Children's Hospital of The King's Daughters, Eastern Virginia Medical School, Norfolk, USA. FAU - Granoff, D M AU - Granoff DM FAU - Erickson, J R AU - Erickson JR FAU - Masor, M L AU - Masor ML FAU - Cordle, C T AU - Cordle CT FAU - Schaller, J P AU - Schaller JP FAU - Winship, T R AU - Winship TR FAU - Paule, C L AU - Paule CL FAU - Hilty, M D AU - Hilty MD LA - eng GR - HD 13021/HD/NICHD NIH HHS/United States PT - Clinical Trial PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't PT - Research Support, U.S. Gov't, P.H.S. PL - United States TA - Pediatrics JT - Pediatrics JID - 0376422 RN - 0 (Immunoglobulins) RN - 0 (Nucleotides) RN - 0 (Vaccines) SB - IM MH - Bottle Feeding MH - Breast Feeding MH - *Food, Fortified MH - Humans MH - Immune System/*drug effects MH - Immunoglobulins/analysis MH - Infant MH - *Infant Food MH - Infant, Newborn MH - Milk, Human/*immunology MH - Nucleotides/*immunology MH - Single-Blind Method MH - Vaccines/*immunology EDAT- 1998/01/31 00:00 MHDA- 1998/01/31 00:01 CRDT- 1998/01/31 00:00 PHST- 1998/01/31 00:00 [pubmed] PHST- 1998/01/31 00:01 [medline] PHST- 1998/01/31 00:00 [entrez] AID - 10.1542/peds.101.2.242 [doi] PST - ppublish SO - Pediatrics. 1998 Feb;101(2):242-9. doi: 10.1542/peds.101.2.242.