Monday, June 17, 2019

Immunoglobulin A (IgA) antibodies protect against this disease. And preterm infants get IgA from their mother's breast milk during the first weeks of life, researchers from the University of Pittsburgh and UPMC Children's Hospital of Pittsburgh explained.

IgA antibodies bind to bacteria in the gut. The more bacteria that's bound with IgA, the less likely babies are to develop NEC, this study found.
"It's been well-known for a decade that babies who get NEC have particular bacteria -- Enterobacteriaceae -- in their guts, but what we found is that it's not how much Enterobacteriaceae there is, but whether it's bound to IgA that matters. And that's potentially actionable," said study senior author Timothy Hand. He's an assistant professor of pediatric infectious diseases at Pitt's School of Medicine.
The researchers analyzed fecal samples from 30 preterm infants with NEC and 39 without NEC. Breast-fed babies had more IgA-bound gut bacteria -- a good thing -- than formula-fed babies. Infants who developed NEC were more likely to have been formula-fed.
Among babies without NEC, Enterobacteriaceae was largely tied up by IgA, allowing diverse types of bacteria to flourish. But among infants with NEC, IgA-unbound Enterobacteriaceae dominated in the days before the disease was diagnosed, according to the researchers.
The study was published June 17 in the journal Nature Medicine.
As part of their research, the team bred mice that couldn't produce IgA in their breast milk. Pups that received IgA-free milk from their mothers were just as susceptible to NEC as those that were fed formula.
However, preventing NEC may not be as simple as adding IgA to infant formula, Hand said.
He noted that breast milk provides other benefits beyond IgA, so donor milk is the best choice if breastfeeding or pumped breast milk isn't an option.
"What we showed is that IgA is necessary but may not be sufficient to prevent NEC," Hand said in a university news release. "What we're arguing is that you might want to test the antibody content of donor milk and then target the most protective milk to the most at-risk infants."

2 comments:

  1. Postmenopausal women who survive breast cancer may have a higher risk for developing heart disease, a new study says.
    Heart problems can appear more than five years after radiation treatment for breast cancer, and the added risk persists for as much as 30 years, according to Brazilian researchers.
    Heart disease is the leading cause of death in older women.
    "Heart disease appears more commonly in women treated for breast cancer because of the toxicities of chemotherapy, radiation therapy, and use of aromatase inhibitors, which lower estrogen. Heart-healthy lifestyle modifications will decrease both the risk of recurrent breast cancer and the risk of developing heart disease," said Dr. JoAnn Pinkerton, executive director of the North American Menopause Society (NAMS).
    In this study, researchers led by Dr. Daniel de Araujo Brito Buttros, from Botucatu Medical School at Sao Paulo State University, compared and evaluated heart disease risk factors in 96 postmenopausal breast cancer survivors and 192 women without breast cancer.
    The investigators found that cancer survivors were much more likely to have metabolic syndrome, diabetes, atherosclerosis, abdominal obesity and high triglyceride levels in their blood. All are major risk factors for heart disease.
    The risk of heart-related death among breast cancer survivors was similar to the risk of death from breast cancer itself.
    The study was recently published online in Menopause, the journal of NAMS. The findings suggest that women consider including a cardiologist in their cancer treatment decisions.
    "Women should schedule a cardiology consultation when breast cancer is diagnosed and continue with ongoing follow-up after cancer treatments are completed," Pinkerton advised in a journal news release.

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  2. As laws around marijuana relax nationwide and the drug becomes more popular, American women are increasingly using pot during pregnancy, a new study finds.
    The study was based on data from more than 467,000 women collected between 2002 and 2017. The researchers found that the percentage of women who said they'd used cannabis at least once during a pregnancy doubled during that time -- from 3.4% to 7%.
    And the percentage of women who reported "daily or near daily" cannabis use during pregnancy more than tripled -- from 0.9% of respondents in 2002 to 3.4% by 2017, according to a team led by Dr. Beth Han of the U.S. Substance Abuse and Mental Health Services Administration.
    A second study highlighted the potential harm to babies from the trend. Canadian researchers looked at data on pregnancy outcomes for almost 662,000 women averaging 30 years of age.
    The investigators found that a history of having used marijuana while pregnant was tied to a doubling of the preterm birth rate -- from 6% among non-users to 12% among users. Preterm birth was defined as birth before 37 weeks' gestation.
    Cannabis use in pregnancy was also tied to higher odds for low birth weight, certain obstetric complications and the need for newborns to be cared for in the neonatal intensive care unit.
    Of course, the study can't prove cause and effect, and other risk factors -- for example, concurrent drinking or tobacco smoking -- could be at play, said a team led by Daniel Corsi of the Ottawa Hospital Research Institute, in Canada.
    But the study also found that "the risk of preterm birth … was statistically significant in subgroups of women who only used cannabis and no other substances."
    Both studies were published online June 18 in the Journal of the American Medical Association.
    In a related editorial, Drs. Michael Silverstein, Elizabeth Howell and Barry Zuckerman agreed that the findings "send a straightforward message: cannabis use in pregnancy is likely unsafe; with an increasing prevalence of use (presumably related to growing social acceptability and legalization in many states), its potential for harm may represent a public health problem."
    Not everyone is comfortable with the pot-in-pregnancy trend, however. Han's team noted that the American College of Obstetricians and Gynecologists has long recommended "that pregnant women discontinue cannabis consumption."
    Nevertheless, in many U.S. states the drug has actually been approved as a means of easing morning sickness. But Han's team found that in 2017, just 0.5% of women said they used cannabis in pregnancy "for medical-only purposes."
    Dr. Jennifer Wu is an obstetrician-gynecologist at Lenox Hill Hospital in New York City. Reading over the new findings she said that "in light of present information, doctors should warn patients about the risks of cannabis during pregnancy."
    Wu noted that cannabis can pass through the placenta to bring "significant risks to the fetus."
    She believes that, in light of society's new, more laissez-faire attitude to pot use generally, "a public health campaign may be needed to reverse the general opinion of the safety of cannabis during pregnancy."

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