Baumgartel, Kelley
(2015)
THE IMPACT OF PROMOTER POLYMORPHISMS ON CYTOKINE CONCENTRATION IN PRETERM BREAST MILK AND SUBSEQUENT INFANT OUTCOMES.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
Abstract
The immune protection offered through breast milk is especially important for premature infants. Interleukins (ILs), found in breast milk but in varying concentrations, may provide preterm infants with protection against prematurity-related complications. Promoter polymorphisms have been associated with variable IL levels, though this relationship has never been investigated in breast milk. The aims of this study were to: 1) examine the relationship between maternal IL genotypes and weekly milk concentrations of IL4, IL6, and IL10, 2) describe the trajectories of milk IL change over the first three weeks postpartum, 3) examine whether maternal IL genotypes predict milk IL trajectories, 4) examine if weekly IL levels and/or IL trajectories predict infant outcomes, and 5) explore a relationship between maternal IL genotypes and infant outcomes. An ancillary study was conducted that extracted maternal DNA from breast milk for genotyping using TaqMan. Trajectory modeling was used to identify IL subgroups. After controlling for gestational age and prepregnancy BMI, there was an inverse association between rs1800796 minor allele absence (MAA) and milk IL6 among African Americans (p=0.0722). Subsequently, higher milk IL6 was also associated with decreased risk of IVH in African Americans (OR=0.32, p=0.1059). Additionally, among African Americans, there was a positive association between IL6 milk levels and calprotectin (week one p=0.0794, week two p=0.0978). Caucasians had an inverse relationship between rs1800795 MAA and milk IL6 (p=0.0966). Subsequently, there is a relationship between milk IL6 and infant calprotectin in Caucasians (p=0.0290). MAA of rs1800896 was associated with milk IL10 levels among African Americans (p=0.0705), though there was no relationship between milk IL10 levels and outcomes. There were no associations between maternal SNP and IL trajectory groups. Trajectory analysis resulted in linear group shapes, with two distinct subgroups in IL6, and three subgroups in both IL4 and IL10. Infants who received milk from IL4 group 2 were more likely to receive a blood transfusion than infants who received milk from group 3 (OR=4.16, p=0.0712). There was an association between IL6 group 1 membership and both IVH (OR=6.275, p=0.0412) and fecal calprotectin (p=0.0822). Traditionally significant findings (p≤0.05) included relationships between maternal IL genotypes and NICU outcomes.
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Details
| Item Type: |
University of Pittsburgh ETD
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| Status: |
Unpublished |
| Creators/Authors: |
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| ETD Committee: |
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| Date: |
11 June 2015 |
| Date Type: |
Publication |
| Defense Date: |
27 May 2015 |
| Approval Date: |
11 June 2015 |
| Submission Date: |
10 June 2015 |
| Access Restriction: |
1 year -- Restrict access to University of Pittsburgh for a period of 1 year. |
| Number of Pages: |
261 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Nursing > Nursing |
| Degree: |
PhD - Doctor of Philosophy |
| Thesis Type: |
Doctoral Dissertation |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
Breast milk, interleukin, promoter polymorphism, genetics, single nucleotide polymorphism, infant outcomes, prematurity |
| Date Deposited: |
11 Jun 2015 18:58 |
| Last Modified: |
15 Nov 2016 14:28 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/25370 |
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