Anti-gliadin antibodies in breast milk from celiac mothers on a gluten-free diet
To analyze the presence of total IgA and anti-gliadin antibodies (AGA) in BM from CD mothers who follow a gluten-free diet (GFD) and from mothers on a normal gluten-containing diet (ND).
218 samples of mature milk were obtained at different months of lactation (1–6) from 83 mothers (2 or more samples per mother) from Italy (Naples), The Netherlands (Leiden) and Spain (Madrid, Valencia and Reus): 42 CD mothers on GFD for more than 2 years and 41 non-CD mothers on a ND. Whey samples were analyzed for AGA-IgA by an indirect homemade ELISA and for total IgA (g/L) by a commercial ELISA kit.
AGA-IgA was detected in BM, both in mothers on a GFD and mothers on a ND. AGA-IgA levels in both groups of mothers, CD and non-CD, show the same trend towards decreasing slightly along the months of lactation (p = 0.91). A different trend is observed for total IgA levels, decreasing markedly in CD mothers from the first month of lactation onwards but remaining stable in non-CD mothers (p = 0.048). A statistically significant association was found between the means of total IgA and AGA-IgA (p < 0.001).
AGA-IgA is present in BM from mothers on a ND as well as in BM from mothers who had been on a GFD for years. This reflects the existence of a long-lasting immunological memory independent of the mother’s diet. If the presence of these antibodies has any role in promoting the acquisition of gluten tolerance in the infant, our study shows that children of CD mothers would be on equal conditions as children of non-CD mothers.
KeywordsGliadin antibodies Breast milk Celiac disease Immunoglobulin A
Normal gluten containing diet
We thank all the families who participated in this study. We are very grateful to Dr. Amado Salvador Peña for his critical revision of the manuscript. We are also grateful to Miguel Bolonio (Medical Research Institute La Fe) for his useful discussions. Supported by Grants from the European Commission (FP6-2005-FOOD-4B-36383–PREVENTCD), and a Grant of the Spanish Ministry of Health: FIS PS09/01056 Factores ambientales de riesgo asociados a la Enfermedad Celiaca y otras Enfermedades Autoinmunes en población con susceptibilidad genética, Eurospital, Fondazione Celiachia, Fria Bröd, Instituto de Salud Carlos III, Spanish Society for Pediatric Gastroenterology, Hepatology, and Nutrition, Stichting Coeliakie Onderzoek Nederland, Thermo Fisher Scientific, the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition The funding organizations have no role in the conception, design, or conduct of the study, in the analysis or interpretation of the data, or in the writing of the manuscript or the decision to submit it for publication. Author who received GRANTs: MLM, SLV, IP, CRK.
Ms. Roca had full access to all the data in the study and has taken responsibility for the integrity of the data and the accuracy of the data analysis. MR, MLM and CRK contributed to the study concept and design; MR conducted the research work, SLV, PCE, RA, GC, IP, RT, MCM, MLM and CRK provided samples and clinical data for the study; DH was responsible of the statistical analysis of the data; all authors contributed to writing the paper and provided critical revision and important intellectual content. MR, MLM and CRK had primary responsibility for final content. All authors read and approved the final manuscript.
Complinace with ethical standards
Conflict of interest
None, any author has not potential conflicts of interest to declare.
No Funder/Sponsor has contributed to any aspect of the study.
The study was approved by the Ethical Committee of La Fe University Hospital. The study was approved by the medical ethics committee at each participating center. All mothers were informed of the purpose of the study and voluntary provided the milk samples.
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