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Molecular Virology: Tables of
Antimicrobial Factors and Microbial Contaminants in Human Milk
Table 1: Antibacterial factors found in
human milk
"Many cultures have considered
that human milk has special medicinal and nutritional properties ... it
is also used as a folk remedy for conjuntivitis ... This view is
paralleled in the 18th Century London Pharmacopoeia which says,
'breast milk is an emollient and cool, and cureth Red Eye immediately.'"
- Singh, et al. (1981) J. Trop. Ped. 28: 35
| Factor | Shown in vitro to be active against |
| Secretory IgA |
E. coli (also pili, capsular antigens, CFA1) including
enteropathogenic strains, C. tetani, C. diphtheriae, K. pneumoniae,
S. pyogenes, S. mutans, S. sanguins, S. mitis, S. agalactiae (group B
streptococci), S. salvarius, S. pneumoniae (also capsular
polysaccharides), C. burnetti, H. influenzae.
H. pylori, S. flexneri, S. boydii, S. sonnei, C. jejuni, N. meningitidis,
B. pertussis, S. dysenteriae, C. trachomatis, Salmonella (6 groups),
S. minnesota, P. aeruginosa, L. innocua, Campylobacter flagelin, Y.
enterocolitica, S. flexneri
virulence plasmid antigen, C. diphtheriae toxin, E. coli
enterotoxin, V. cholerae enterotoxin, C. difficile toxins,
H. influenzae capsule, S. aureus enterotoxin F,
Candida albicans*,
Mycoplasma pneumoniae |
| IgG | E. coli, B. pertussis, H. influenzae type b, S. pneumoniae, S. agalactiae, N. meningitidis, 14 pneumoccoccal capsular polysaccharides, V. cholerae lipopolysaccharide, S. flexneri invasion plasmid-coded antigens, major opsonin for S. aureus |
| IgM | V. cholerae lipopolysaccharide, E. coli, S. flexneri |
| IgD | E. coli |
Analogues of epithelial cell
receptors (oligosaccharides and sialylated oligosaccharides***) |
S. pneumoniae, H. influenzae |
Bifidobacterium bifidum
growth factors (oligosaccharides,
glycopeptides)
Other Bifidobacteria growth
factors (alpha-lactoglobulin, lactoferrin, sialyllactose) |
Enteric bacteria. Two infant Bifidobacteria species provide a lipophilic
molecule which kills S. typhimurium. B. bifidum produces Bifidocin
B which kills Listeria. B. longum produces protein BIF, which stops
E. coli. |
| Carbohydrate |
E. coli enterotoxin, E. coli, C. difficile toxin A |
| Cathelicidin (LL-37 peptide) |
S. aureus, group A streptococcus, E. coli |
| Casein |
H. influenzae |
| kappa-Casein** |
H. pylori, S. pneumoniae, H. influenzae |
Complement C1-C9
(mainly C3 and C4) |
Killing of S. aureus in macrophages, E. coli (serum-sensitive) |
ß-defensin-1 or -2 or
neutrophil-α-defensin-1
or α-defensin-5 or -6 |
E. coli, P. aeruginosa, (some Candida albicans
*) |
Factor binding proteins (zinc,
vitamin B12, folate) |
Dependent E. coli |
| Free secretory component** |
E. coli colonization factor antigen 1 (CFA I) and CFA II, C. difficile
toxin A, H. pylori, E. coli |
| Fucosylated oligosaccharides |
E. coli heat stable enterotoxin, C. jejuni, E. coli |
| Ganglioside GM1 |
E. coli enterotoxin, V. cholerae toxin, C. jejuni enterotoxin,
E. coli |
| Ganglioside GM3 |
E. coli |
| Glycolipid Gb3 |
S. dysenterae toxin, shigatoxin of shigella and E. coli |
| Glycoproteins (mannosylated) |
E. coli, E. coli CFA11, fimbrae |
Glycoproteins (receptor-
like)+ oligosaccharides |
V. cholerae |
Glycoproteins (sialic acid
-containing or terminal galactose) |
E. coli (S-fimbrinated) |
| alpha-Lactalbumin (variant) |
S. pneumoniae |
| Lactoferrin** |
E. coli, E. coli/CFA1 or S-fimbriae, Candida albicans
*,
Candida krusei*,
Rhodotorula rubra*, H. influenzae, S. flexneri,
Actinobacillus actinomycetemcomitans |
| Lactoperoxidase |
Streptococcus, Pseudomonas, E. coli, S. typhimurium |
| Lewis antigens |
S. aureus, C. perfringens |
| Lipids |
S. aureus, E. coli, S. epidermis, H. influenzae, S. agalactiae, L. monocytogenes,
N. gonorrhoeae, C. trachomatis, B. parapertusis heat-labile toxin, binds Shigella-like
toxin-1 |
| Lysozyme |
E. coli, Salmonella, M. lysodeikticus, S. aureus, P. fragi, growing Candida
albicans* and Aspergillus
fumigatus* |
Milk cells (80% macrophages,
15% neutrophils,
0.3% B and 4% T lymphocytes) |
By phagocytosis and killing: E. coli, S. aureus, S. enteritidis
By sensitised lymphocytes: E. coli
By phagocytosis: Candida albicans*, E. coli
Lymphocyte stimulation: E. coli K antigen, tuberculin
Spontaneous monokines: simulated by lipopolysaccaride
Induced cytokines: PHA, PMA + ionomycin
Fibronectin helps in uptake by phagocytic cells. |
Mucin (muc-1; milk fat
globulin membrane) |
E. coli (S-fimbrinated) |
Nonimmunoglobulin
(milk fat, proteins) |
C. trachomatis, Y. enterocolitica |
| Phosphatidylethanolamine |
H. pylori |
| (Tri to penta) phosphorylated beta-casein |
H. influenzae |
| Sialyllactose |
V. cholerae toxin, H. pylori |
Sialyloligosaccharides
on sIgA(Fc) |
E. coli (S-fimbrinated) adhesion |
| Soluble bacterial pattern recognition receptor CD14 |
Bacteria (or LPS) activate this to induce immune response molecules from intestinal
cells |
| Sulphatide (sulphogalactosylceramide) |
S. typhimurium |
| Unidentified factors |
S. aureus, B. pertussis, C. jejuni, E. coli, S. typhimurium, S. flexneri, S. sonnei,
V. cholerae, L. pomona, L. hyos, L. icterohaemorrhagiae, C. difficile toxin B,
H. pylori, C. trachomatis |
Xanthine oxidase
(with added hypoxanthine) |
E. coli, S. enteritidis |
| Factors found at low level in human milk | Shown in vitro to
be active against |
| CCL28 (CC-chemokine) | Candida albicans*, P. aeruginosa, S.
mutans, S. pyogenes, S. aureus, K. pneumonidae |
| Heparin | Chlamydia pneumoniae |
| RANTES (CC-chemokine) |
E. coli, S. aureus, Candida albicans*, Cryptococcus
neoformans* |
| Secretory leukocyte protease inhibitor (antileukocyte protease; SLPI) | E. coli, S. aureus, growing C. albicans* and A. fumigatus* |
* Fungi
** Contain fucosylated oligosaccharides. Stomach pepsin releases potent antibacterial peptides.
*** One sialylated pentasaccharide (3'-sialyllactose-N-neotetraose; NE-1530) had no beneficial effect on otitis media in phase-2 clinical trials
- Human milk contains nearly a thousand different oligosaccharides (determined by MALDI-mass spectrometry). Many have the potential to act as receptors for bacteria not listed in the table.
- Concentration of milk components in Breastfeeding: unravelling the mysteries of mother's milk (requires completion of free registration to Medscape)
- Various combinations of lysozyme, lactoferrin and SLPI have synergistic effect against E. coli.
Based on a table from the Proceedings of Breast Milk and Special Care Nurseries: Problems and
Opportunities Conference. August 1995. Melbourne.
NB: A bibliography for this table is currently available.
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