Dextran-Reactive Antibodies in Healthy Infants and Toddlers – Relation to Type of Feeding

Abstract

The appearance of dextran-reactive antibodies (DRA) during the first 2 years of life was studied in 88 healthy newborn babies in an effort to provide information about the origin of DRA in normal persons. The results were related to type of feeding, immunizations and to blood group of infants and their mothers. No DRA were detected in cord sera by passive hemagglutination. At 3 months of age 42% had DRA, at 8 months 95 % and at 27 months 84%. The latter figure corresponds to previous reports of DRA in healthy adults. Peak titers were also seen at 8 months (mean 2 log titers at 3, 8 and 27 months; 2.1, 6.2 and 4.9, respectively). Breastfeeding influenced the time of appearance of DRA and the magnitude of the titers. Babies breast-fed at 3 months more often were DRA negative than those that had received cow’s milk-based formula at that time (p <0.005). However, in those breast-fed babies that were DRA positive the titers were higher than in the formula-fed infants (p <0.001). Other types of feeding e.g. juices did not influence the DRA levels. The appearance of DRA could not be explained by polyclonal stimulation of antibody production since changes of DRA titers in 11 tested patients could not be clearly related to similar changes of levels of antibodies to an unrelated hapten, trinitrophenyl. The study demonstrates that DRA appear during the first year of life, and that the appearance is influenced by exogenous factors. The most likely source of the antigen stimulation is the gastrointestinal flora which is altered by introduction of cow’s milk into the diet.

DEXTRAN‐REACTIVE ANTIBODIES IN CHILDREN Appearance during the First 4 years of Life and Relation to E. coli Infections in the Urinary Tract

“…In our previous investigation we showed that the levels of DRA were significantly higher at 8 months than at 2 years of age, which was the point of time for the last sampling in the study (2). The present follow-up study shows a further decrease in DRA titres from that age.…”

“…Such high titres may rarely be associated with anaphylactoid reactions after infusion of clinical dextran (1). In a previous study we showed that DRA appeared early during infancy, with peak titres at approximately 8 months of age (2). The appearance of DRA was not influenced by immunization against diphtheria, tetanus and pertussis or by the maternal blood group.…”

“…The precise nature of the stimulus for DRA synthesis is not known, though the gastrointestinal flora may be a likely source of the antigen (2,4). Adults with urinary tract infections have higher DRA titres than healthy persons (5).…”

Adult respiratory distress syndrome complicating intravenous infusion of low‐molecular weight dextran

“…However, it is possible that these macromolecules could trigger the release of several vasoactive mediators including histamine, kinins, and products of the lipoxygenase pathway [17]. As dextran is a component of toothpaste, sucrose-containing foods, and some prescribed medications, many individuals can be shown to carry dextranreactive antibodies [ 18,191. Hedin and associates showed that patients who react to dextran have higher levels of dextran-reactive antibodies of the IgG class than do non-reactors, and that the severity of of DIARs correlated directly with the pre-exposure antibody level [16,20].…”