Influence Of Different Formulas And Maternal Atopy On Th1/Th2/Tr1 Cells In Peripheral Blood Of Preterm Infants

[Objective] To detect the proportion of Th1/Th2/Tr1 cells in peripheral blood of preterm infants fed with extensively hydrolyzed whey formulas(e HF-W) or cow's milk formulas(CMF); And to detect the proportion of Th1/Th2/Tr1 cells in peripheral blood of preterm infants with maternal atopy; To detect the proportion of Th1/Th2/Tr1 cells in peripheral blood of preterm infants with maternal atopy fed with extensively hydrolyzed whey formulas(e HF-W) or cow's milk formulas(CMF).[Method] There was a prospective cohort study, conducted in a cohort of 64 preterm infants admitted to department of Neonatal Intensive Care Unit, Shanghai Children's Medical Center between September 2014 and January 2015. Enrolled infants were fed with e HF-W or CMF. Infants of two groups were matched with gestational age, and maternal atopy in accordance with the principle of 1:1. The proportion of Th1(CD3+CD8-IFN-?+T)cells, Th2(CD3+CD8-IL-4+T)cells, Tr1(CD3+CD8-IL-10+T)cells in CD3+CD8-T cells of peripheral blood were detected by flow cytometry.[Results] 1. At full enteral feeding, the proportion of Th1 cells in peripheral blood of e HF-W group was significantly increased when compared with CMF group(P<0.05), the other two cells' proportion had no significant difference(P>0.05).2. Compared to before enteral feeding, the proportion of Th1 cells in peripheral blood of e HF-W group and CMF group was significantly increased(P<0.05) and of Th2 cells were significantly decreased(P<0.05) at full enteral feeding.3. Compared to CMF group, the preterm infants of e HF-W group had a significantly shorter time when reaching full enteral feeding(P<0.05), and had a significantly lower level of serum total bilirubin(P<0.05).4. Compared to no maternal atopy group, the preterm infants of maternal atopy group had a significant higher level of Th2 cells and Tr1 cells proportion in peripheral blood at the time of before enteral feeding(P<0.05).5. In maternal atopy group, compared to before feeding, the proportion of Th1 cells and Th2 cells in peripheral blood of preterm infants in e HF-W group was significantly decreased when reach full enteral feeding(P<0.05); while the proportion of Tr1 cells was significantly increased(P<0.05).6. In maternal atopy group, compared to before feeding, the proportion of Th1 cells in peripheral blood of preterm infants in CMF group was significantly increased when reach full enteral feeding(P<0.05); the proportion of Th2 cells was significantly decreased(P<0.05); the proportion of Tr1 cells had no significant decreased.[Conclusions] 1. e HF-W induced preterm infant's oral tolerance, and improved Th1 cells immune response; 2. CMF induced preterm infant's oral tolerance, but suppressd Th1/Th2 cells immune response; 3.Compare to CMF, e HF-W could improve feeding toleranc of preterm infants, and decreased the leve of serum total bilirubin; 4. Compared to no maternal atopy group, maternal immune state had influce on neonatal immune system, which led to Th2 cells immune response on neonates; 5. Feeding preterms with e HF-W whose mother suffered atopy would promote T-cells to distinguish into Tr1 cells, and suppressd Th2 cells, than induced oral tolerance; 6. Preterm infants with maternal atopy fed with CMFwere induced an impaired oral tolerance, and Th cells were promoted into Th1 cells and Th2 cells.