2023 Fiscal Year Final Research Report
Strategy for prevention of Cytomegalovirus infection via breast milk in very low birth weight infants
| Project/Area Number |
20K08217
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 52050:Embryonic medicine and pediatrics-related
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| Research Institution | Showa University |
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Principal Investigator |
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| Co-Investigator(Kenkyū-buntansha) |
幸田 力 昭和大学, 医学部, 准教授 (10365752)
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| Project Period (FY) |
2020-04-01 – 2024-03-31
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| Keywords | サイトメガロウイルス / 電子レンジ / 低温殺菌 / 分泌型IgA抗体 / ラクトフェリン / 超早産児 |
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| Outline of Final Research Achievements |
In preterm infants, human milk(HM) is the best, but if the mother is CMVIgG(+), CMV infection can occur via HM, leading to hepatic dysfunction. Consequently, preventive measures have been considered for HM from CMVIgG(+) mothers. Holder pasteurization(HP) is standard method, but uncommon in Japan, therefore we considered microwave treatment(MT) as a candidate.CMV added into formula resulted in no cell infection after MT at 500W, 40s. Additionally, HM components in 100ml HM was not changed after MT 500W, 40s, thus posing no disadvantage to infants. Clinical studies were supposed to conduct, but due to COVID-19 pandemic, hindering the realization of these studies. Therefore, we kept in vitro experiment. In order to achieve a consistent temperature change(TC) regardless HM volume, we put HM in a 25ml bag and immersing it in 75ml of water provided a equivalent TC to 100ml HM. MT at 200W/500W 60s resulted in prevention of cell infection by HM from CMVIgG(+) mothers significantly.
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| Free Research Field |
新生児医学
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| Academic Significance and Societal Importance of the Research Achievements |
超早産児において母乳は、単なる栄養ではなく薬としての効果もあるため、母乳育児が推奨される。一方、母親がCMV IgG陽性の場合、超早産児の6-37％で経母乳CMV感染が成立し、敗血症性ショックや肝機能障害を起こしうる。そのため、CMV IgG陽性母体の母乳に対して感染対策が検討されてきた。代表は62.5℃30分の低温殺菌であるが、日本で低温殺菌器は一般的ではない。どのNICUでも利用できる電子レンジを今回用いた。児の母乳量に関わらず一定の温度変化を得る方法が確立されたこと、500W20秒であれば母乳成分のロスはなく、かつ、有意に細胞感染を抑制できることから、広く臨床応用できる方法と考えられる。
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