title: Maternal cytomegalovirus-specific immune responses and symptomatic postnatal cytomegalovirus transmission in very low-birth-weight preterm infants.
abstract: BACKGROUND
  Transmission of cytomegalovirus (CMV) via breast milk can lead to severe acute illness in very low-birth-weight (VLBW) preterm infants. Although the majority of CMV-seropositive women shed CMV in milk, symptomatic postnatal infection of VLBW infants occurs infrequently, suggesting that virologic or immunologic factors in milk may be associated with the risk and severity of postnatal CMV infection.
  
  
  METHODS
  We investigated the magnitude of CMV-specific cellular and humoral immune responses in milk of 30 seropositive mothers of VLWB preterm infants and assessed their relationship to milk CMV load and symptomatic CMV transmission.
  
  
  RESULTS
  Milk immunoglobulin G (IgG) avidity was inversely correlated to milk CMV load (r = -0.47; P = .009). However, milk CMV load and CMV-specific cellular and humoral immune responses were similar in mothers of VLBW infants with and those without symptomatic postnatal CMV infection.
  
  
  CONCLUSIONS
  Similar immunologic parameters in milk of CMV-seropositive mothers of VLBW infants with and without symptomatic postnatal CMV infection indicate that screening milk by these parameters may not predict disease risk. However, the inverse correlation between milk CMV IgG avidity and CMV load may suggest that enhancement of maternal CMV-specific IgG responses could aid in reduction of CMV shedding into breast milk.
authors: Division of Viral Pathogenesis, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
authors: Elizabeth P
authors: EP
authors: Ehlinger
authors: Emily M
authors: EM
authors: Webster
authors: Helen H
authors: HH
authors: Kang
authors: Aislyn
authors: A
authors: Cangialose
authors: Adam C
authors: AC
authors: Simmons
authors: Kimberly H
authors: KH
authors: Barbas
authors: Sandra K
authors: SK
authors: Burchett
authors: Mary L
authors: ML
authors: Gregory
authors: Karen M
authors: KM
authors: Puopolo
authors: Karen P
authors: KP
authors: Puopolo
authors: Sallie R
authors: SR
authors: Permar
mesh_terms: D000293:Adolescent; D000328:Adult; D000915:Antibody Affinity / Q000276:immunology; D001942:Breast Feeding / Q000009:adverse effects; D003587:Cytomegalovirus / Q000276:immunology* / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000276:immunology* / Q000635:transmission*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007111:Immunity, Cellular; D056724:Immunity, Humoral; D007070:Immunoglobulin A / Q000276:immunology; D007074:Immunoglobulin G / Q000276:immunology; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis / Q000276:immunology*; D019102:Infant, Very Low Birth Weight / Q000276:immunology*; D018445:Infectious Disease Transmission, Vertical; D007958:Leukocyte Count; D008895:Milk, Human / Q000276:immunology* / Q000821:virology; D019562:Viral Load / Q000276:immunology; D055815:Young Adult
chemical_list: D007070:Immunoglobulin A; D007074:Immunoglobulin G