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Background: A few studies have reported that the quantity of selected cytokines/chemokines in breast milk might be associated with atopic dermatitis (AD). Using the multiplex cytokine assay system, we examined cytokines/chemokines in human milk in order to identify new biomarkers related to AD. Methods: We recruited 49 infants with or without AD who participated in a birth cohort and measured the concentrations of cytokines/chemokines in the colostrum (collected within 4–5 days after birth) and mature milk (collected at 1 month postpartum) received by the infants. Results: There were significant differences in the concentrations of interleukin (IL)-1β and IL-12p40 in the colostrum, and in those of IL-4, eotaxin, granulocyte colony-stimulating factor (G-CSF), granulocyte macrophage colony-stimulating factor (GM-CSF), interferon (IFN)-α2 and MIP-1α in the mature milk between the milk received by infants who developed AD at the age of 6 months and that received by the control infants. There was weak to moderate correlation between those 6 cytokines/chemokines in mature milk. Atopic history and IgE levels of mothers were not related to cytokine/chemokine concentrations in breast milk. Logistic regression analyses showed that high levels of eotaxin in the mature milk were a risk for the development of AD at 6 months of age. Conclusion: These results suggest that several cytokines/chemokines, especially eotaxin, are potential biomarkers for development of AD in early infancy.

T(h)2 adjuvant activity can be qualitatively and quantitatively evaluated using a mixed lymphocyte reaction and by changes in the intracellular cyclic adenosine 3',5'-monophosphate concentration, using human dendritic cells in vitro. The current study shows that mothers, whose children (n = 55) developed atopic dermatitis (AD) within 6 months after birth, often demonstrate a higher T(h)2 adjuvant activity in their milk, in comparison to those whose children did not develop such symptoms. Such an activity was recovered in a liquid phase of mothers' milk and was eluted as a single fraction by reversed-phase HPLC. Further analysis of this fraction by mass spectrometry showed that signals originating from a factor with a molecular weight of 767.53 are observed, exclusively in milk with a high T(h)2 adjuvant activity. The mass is exactly that of Coenzyme A (CoA), and indeed, a low concentration of CoA exhibited T(h)2 adjuvant activity both in vitro and in vivo. Moreover, mesenteric lymph node non-T cells obtained from mice that were orally treated with CoA led allogeneic naive CD4(+) T cells to differentiate into T(h)2. Furthermore, the oral administration of CoA induced rough skin, hyperplasia of the epidermis, hypergranulosis in the spinous layer and the thickening of the stratum in mice. These data collectively indicate that some of the patients with AD were exposed to mothers' milk carrying high T(h)2 adjuvant activity right after birth, which may be attributable to presence of CoA contained in the milk.

Abstract 1097 Dendritic cells (DCs) are antigen-presenting cells specialized to activate naïve T lymphocytes and initiate primary immune responses. The different classes of specific immune responses are driven by the biased development of pathogen-specific effector CD4+ T-cell subsets — that is, T helper 1 (Th1), Th2 and Th17 cells, that activate different components of cellular and humoral immunity. Th cell differentiation is critical for achieving proper immune responses, and imbalances in either the function or activity of these cell types are responsible for many immune diseases, including autoimmunity, cancer and allergy. DCs reside in an immature state in many nonlymphoid tissues such as the skin, the intestine or airway mucosa which are under high exposure of pathogens and chemicals. DCs, which take up pathogens, develop their maturation processes, migrate to the T-cell areas of secondary lymphoid organs and interact with naïve T cells. TCR stimulation and co-stimulation allow naïve Th cells to develop into protective effector cells, normally accompanied by the high-level expression of selective sets of cytokines. The balance of these cytokines and the resulting class of immune response strongly depend on the conditions under which DCs are primed for the expression of the T-cell-polarizing molecules. The ligands for many isoforms of toll-like receptors (TLRs), including certain nucleic acids, lipopolysaccharides (LPS) and fungus-derived glycoprotein molecules, alter the DC function, and induce Th1 differentiation in an antigen non-specific manner. In this process, IL-12 produced by DCs is clearly correlated with sensitization of Th1 lymphocytes in vitro and in vivo among the factors that have been shown to influence the Th1-Th2 balance. On the other hand, DCs matured in the presence of prostaglandin E2 (PGE2), histamine, or forskolin induce the differentiation of naïve CD4+ T cells toward Th2 via the cyclic adenosine 3',5'-monophosphate (cAMP) cascade. In vitro assay systems have been established to evaluate Th1/Th2 adjuvant activities, using MLR and intracellular cAMP concentration of antigen-presenting cells. The current study shows that mothers, whose children (n = 55) developed atopic dermatitis (AD) within 6 months after birth, often demonstrate a higher Th2 adjuvant activity in their milk, in comparison to those whose children did not develop such symptoms (figure). Such an activity was recovered in a liquid phase of mothers' milk and was eluted as a single fraction by reversed-phase HPLC. Further analysis of this fraction by mass spectrometry showed that signals originating from a factor with a molecular weight of 767.53 are observed, exclusively in milk with a high Th2 adjuvant activity. The mass is exactly that of Coenzyme A (CoA), and indeed, a low concentration of CoA exhibited Th2 adjuvant activity in vitro. Moreover, mesenteric lymph node non-T cells obtained from mice that were orally treated with CoA, led allogeneic naïve CD4+ T cells to differentiate into Th2. Furthermore, the oral administration of CoA induced rough skin, hyperplasia of the epidermis, hypergranulosis in the spinous layer and the thickening of the stratum in mice. These data collectively indicate that some of the patients with AD were exposed to mothers' milk carrying high Th2 adjuvant activity right after birth, which may be attributable to presence of CoA contained in the milk. Disclosures: No relevant conflicts of interest to declare.