Maternal IgA protects against the development of necrotizing enterocolitis in preterm infants.
Gopalakrishna KP, Macadangdang BR, Rogers MB, Tometich JT, Firek BA, Baker R, Ji J, Burr AHP, Ma C, Good M, Morowitz MJ, Hand TW
Nat Med. Jul 2019. doi: 10.1038/s41591-019-0480-9
COMMENT: This work demonstrates that maternal immunoglobulin A (IgA) is an important factor for protection against Necrotizing enterocolitis (NEC), a neonatal disease with high morbidity and mortality associated with intestinal inflammation driven by the microbiome. The authors also show that this IgA bound to bacteria able to provide protection for NEC in newborn comes from maternal milk:
Analysis of IgA binding to fecal bacteria from preterm infants indicated that maternal milk was the predominant source of IgA in the first month of life and that a relative decrease in IgA-bound bacteria is associated with the development of NEC. Sequencing of IgA-bound and unbound bacteria revealed that before the onset of disease, NEC was associated with increasing domination by Enterobacteriaceae in the IgA-unbound fraction of the microbiota.
Our findings show that maternal IgA shapes the host-microbiota relationship of preterm neonates and that IgA in maternal milk is a critical and necessary factor for the prevention of NEC.