לימפומה

האם אם מניקה שחולה בלימפומה עלולה להעביר תאים סרטניים לתינוקת שלה בחלב אם? האם יש צורך לבדוק את התינוקת? בהתחשב בעבודה שאחד מ"יתרונות" ההנקה הוא העברת לימפוציטים בחלב אם אל התינוק. תודה רבה

חלב אם מכיל נוגדנים, לא לימפוציטים. לימפומה לא עוברת בהנקה.

האם התשובה משתנה בהנחה שיש לימפוצייטים? אני מעתיקה לכאן תקציר של מאמר שאומר שיש אם כי סביר להניח שהם מעוכלים במערכת העיכול. האם יתכן שלא כולם מעוכלים? - Leucocytes in human milk AND lymphocyte subsets in cow’s milk-allergic infants Ja ¨rvinen K-M,Suomalainen H.Leucocytes in human milk and lymphocyte subsets in cow’s milk-allergic infants. PediatrAllergyImmunol2002:13:243 –254.#2002BlackwellMunksgaard The breast-fed infant ingests an average of 10 8 leucocytes per day,with breast-feeding often continuing for several months.The precise role of human milk leucocytes is still unresolved.Breast-feeding has been recommended for infants at high risk of allergy to prevent OR delay the development of food allergies AND atopic eczema.However,studies dealing with distinct immunologic factors in the mother’s milk,and their effect on health status OR development of allergies in the infant,are scarce.We evaluated the relationship between the cellular composition of humanmilk and development of cow’s milk allergy (CMA)in the breast-fed infant. Leucocyte subsets in the breast-fed infants were also measured.The study population comprised 61 breast-feeding mothers AND their infants.Thirty-nine mothers each had a cow’s milk-allergic infant,10 had an infant with atopic dermatitis without CMA,and 12 mothers had a healthy infant. Leucocyte subsets in mothers’milk were counted using a light microscope and confirmed by flow cytometry.In infants,peripheral blood lymphocyte subsets were determined by flow cytometry AND were correlated with the health status of the breast-fed infant AND leucocyte composition of the mother’s milk.Human milk was found to be a non-homogenous morphological entity.In the milk of mothers of infants with CMA,the proportion of macrophages was significantly smaller than in the mothers with infants without CMA(p 5 0.036,t-test).Mothers with high proportions of neutrophils in their milk (.20%)had significantly more often infants with CMAthan did those with low proportions of neutrophils (p 5 0.02;Fischer’s exact test).Eosinophils comprising .1%of milk cells wereonlydetectedinthemotherswhohadinfantswithCMA.Furthermore, the proportions of CD4 + T cells were positively correlated with the proportionof milkmacrophagesandnegatively with the percentage of milk neutrophils AND eosinophils.The proportions of total B cells AND those expressing CD23,a low-affinity immunoglobulin E receptor,were positively correlated with the proportions of neutrophils andeosinophils in mother’s milk AND negatively with the percentage of milk macrophages.To conclude,the composition of breast milk in some mothers is abnormal and correlateswithadiagnosisofCMAinabreast-fedinfant.Thismayprovidea new AND interesting insight into the development of food allergies. Kirsi-Marjut Ja¨rvinen and Hanna Suomalainen Helsinki University Central Hospital,Skin and Allergy Hospital,Department of Dermatology, Helsinki,Finland Key words:human milk;leucocytes;oral tolerance;cow’s milk allergy;light microscopy;flow cytometry;infants;breast-feeding Kirsi-Marjut Ja¨rvinen,MD,PhD,Mount Sinai School of Medicine,Div.of Pediatric Allergy and Immunology,Box 1198,One Gustave L-Levy Place,NY10029,USA Tel:+1-212-241-4908 Fax:+1-212-426-1902 E-mail:[email protected] Accepted 18 October 2001 Pediatr Allergy Immunol 2002:13:243–254 Printed in UK.All rights reserved Copyright #2002 Blackwell Munksgaard PEDIATRIC ALLERGY AND IMMUNOLOGY ISSN 0905-6157

אכן, את צודקת, ובחלב האם יש מעט תאים מסוגים שונים, בעיקר מקרופגים וגרנולוציטים, אך גם מעט לימפוציטים. בכל מקרה, באשר ללימפומה - התשובה לא משתנה גם אם יש לימפוציטים בחלב האם. In addition to soluble antigens and anti-infective agents, human milk contains leukocytes; the majority (90%) are neutrophils and macrophages. Lymphocytes account for approximately 10%. The number and type of leukocytes change with duration of lactation. Most of the lymphocytes in milk are T cells. The proportions of CD4 (helper) to CD8 (suppressor/cytotoxic) cells in human milk are similar to those in blood. Cytokines in human milk (eg, TNF-alpha and IL-1-beta) have been shown to enhance the anti-infective function of milk leukocytes. Milk macrophages might participate in the process of immunogenesis in the infant