title: Maternal serum but not breast milk IL-5, IL-6, and IL-13 immune markers are associated with scratching among infants.
abstract: BACKGROUND
  Scratching in infants is considered to be related to early development of eczema. Little is known about the effects of maternal immune markers on scratching among infants. The objective is to compare the risks related to maternal serum immune markers (IMs) during pregnancy and IMs in breast milk for the occurrence of scratching in infants at 6 and 12 months of age.
  
  
  METHODS
  Pregnant women were recruited in Columbia and Charleston, South Carolina. Blood (median 3 weeks prepartum) and breast milk (3 weeks postpartum) samples were collected. The concentrations of interferon (IFN)-γ, IFN gamma-induced protein 10 (IP-10) (or CXCL10), CCL11, interleukin (IL) 1β, IL-4, IL-5, IL-6, IL-8 (CXCL8), IL-10, IL-12 (p70), IL-13, transforming growth factor (TGF)-β1, and immunoglobulin (Ig) A in both maternal serum and whey were assayed using optimized immunoassays. Scratching and skin manifestations were ascertained at 6 and 12 months. Generalized estimating equations were used to estimate relative risks (RRs) of IMs for repeated measurements of scratching, considering intra-individual correlations and adjusting for confounders.
  
  
  RESULTS
  Of 178 women, 161 provided blood and 115 breast milk samples. IL-1β, IL-4, IL-10, IL-12, and CCL11 in maternal serum and whey were not analyzed due to a large proportion of non-detectable values. Infants in the highest tertile of IL-6 and IL-13 in maternal serum were at higher risk of scratching (RR 1.73 and 1.84, respectively; p ≤ 0.002) compared to infants in the first tertile; similarly, infants born to mothers with high (versus low) levels of serum IL-5 were also at increased risk (RR 1.60, p = 0.002). None of the breast milk IMs studied were associated with scratching.
  
  
  CONCLUSIONS
  Scratching but not doctors diagnosed eczema was associated with higher levels of maternal IL-5, IL-6, and IL-13 during pregnancy. Further investigations are necessary to determine how maternal serum IMs influence infants scratching.
authors.affiliation: Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, 236A Robison Hall, Memphis, TN 38152 USA.
authors.forename: Nelís
authors.initials: N
authors.lastname: Soto-Ramírez
authors.affiliation: Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC USA.
authors.forename: Keith
authors.initials: K
authors.lastname: Boyd
authors.affiliation: Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, 236A Robison Hall, Memphis, TN 38152 USA.
authors.forename: Hongmei
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Food Allergy and Immunology Laboratory, Michigan State University, East Lansing, MI USA.
authors.forename: Venugopal
authors.initials: V
authors.lastname: Gangur
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, Temple University, Philadelphia, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Goetzl
authors.affiliation: Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Memphis, 236A Robison Hall, Memphis, TN 38152 USA.
authors.forename: Wilfried
authors.initials: W
authors.lastname: Karmaus
keywords: Breast milk; IL-13; IL-5; IL-6; Immune markers; Maternal serum; Scratching episodes