Detection of secretory
immunoglobulin A (SIgA) in saliva of ventilated and non-ventilated
preterm neonates Julie
A. Hayes, Elvidina N. Adamson-Macedo, Shantha Perera &
Janet Anderson
Key words: Secretory IgA (SIgA), ventilated
preterm, nutrition
Abstract
The very young preterm neonate has multiple immune deficiencies
which may increase his or her vulnerability to infection. Secretory
Immunoglobulin A (SIgA) plays an important role in the protection
of epithelial surfaces exposed to the external environment;
nevertheless controversy exists with regards to the ontogeny
of SIgA in newborns and especially the preterm neonate. The
objective was to investigate if SIgA could be detected in the
saliva of very/extremely low birthweight neonates (V/ELBW).
A total of 707 samples which were collected twice daily (morning
and afternoon) for three consecutive days were obtained from
sixty-eight preterm neonates (mean gestational age 28 weeks;
conceptional age ranged from 25-35 weeks). A repeated measures
design was used. Total concentration of SIgA was determined
from unstimulated saliva by an Enzyme Linked Immunosorbant Assay
technique. Results indicated that SIgA was detectable in the
early postnatal period in the saliva of both ventilated preterms
who were receiving intravenous total parenteral nutrition (TPN)
and non-ventilated preterms.
A 3-way repeated measures Analysis of Variance (ANOVA) showed
no significant effect from ‘before’ and ‘after’
samples during a period of spontaneous activity, time and day
of sampling. A significant effect of mode of nutrition was found;
neonates who were receiving expressed breast milk had significantly
higher concentrations of SIgA than those infants receiving TPN
(df=3, F=14.27, p<0.0001). These results have implications
for the care of the preterm neonate in intensive care.
