Prevention of sudden infant death

Chemistry: analytical and immunological testing – Biological cellular material tested

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436513, 436900, 435 792, 600300, 600532, 600543, 422 83, 422 84, G01N 3348, A61B 508

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06083756&

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BRIEF SUMMARY
FIELD OF THE INVENTION

The present invention relates to the identification of infants with increased risk of sudden death (sudden death syndrome; SIDS), and to methods and means for SIDS prevention.


BACKGROUND OF THE INVENTION

Sudden infant death syndrome (SIDS) occurs in young infants during a narrow time range that peaks at 3 months and extends over about two years from birth. It is relatively common (7,000 deaths in the United States per year). Usually it is defined in the negative: "The sudden death of any infant or young child which is unexpected in history and in which a thorough post-mortem examination fails to demonstrate an adequate cause for death".
SIDS is believed to have multiple causal mechanisms for which various theories have been forwarded. One potential cause of SIDS is the sudden cessation of ventilation (apnea; for a survey, see Thach B T, Apnea and the Sudden Infant Death Syndrome, Saunders N & Sullivan C, Eds., Lung Biology in: Health and Disease, Vol. 7/I, Marcel Dekker, New York 1994, p. 649-671. In most cases, life-threatening episodes of apnea in infants can be managed by stimulation or by artificial respiration provided apnea is detected at once and appropriate measures are taken immediately upon detection. Close surveillance of infants at risk thus is indicated.
Several factors identified in epidemiological studies of SIDS are associated with increased susceptibility of infants to infectious diseases, particularly upper respiratory tract infections. The period in which infants are at highest risk roughly corresponds to the period when maternal antibodies in the infant are decreasing while its immature immune system is not able to provide full compensation. The vast majority of SIDS-related deaths occur below the age of two years. Not only are breast-fed infants less vulnerable to infections but also less susceptible to SIDS. Many babies who died from SIDS had mild gastrointestinal tract infection shortly before death; IgA response of their duodenal mucosa was found to be significantly increased (Stoltenberg L et al., Pediatr. Res. 32 (1992) 372-375).
In the apnea hypothesis for SIDS, the cause of death is thought to be suffocation. The infant suddenly stops breathing. This might be caused, for instance, by acute upper airway obstruction, gastroesophageal reflux or abnormal cardiopulmonary control.
Means for identifying SIDS-prone infants are lacking. Close monitoring of infants identified being at SIDS risk can be expected to substantially reduce mortality. Pharmaceutical means for preventing SIDS in infants are lacking. Their possible use would require identification of infants at risk.


OBJECTS OF THE INVENTION

It is an object of the invention to provide a means for identification of infants susceptible to SIDS.
It is another object of the invention to provide pharmaceutical means and methods for their use for the prevention of SIDS.


SUMMARY OF THE INVENTION

The present invention is based on the insight that the incidence of SIDS is substantially increased in infants whose mothers test positive for IgG antibodies to Helicobacter pylori (H. pylori) and that the mothers may transfer infection with H. pylori to their children. It is also based on the insight that, to a lesser extent, H. pylori transmission may be caused by other members of the family or persons in frequent and bodily close contact with the infant. Furthermore, the present invention is based on the insight that, as a preventive measure against SIDS in infants, mothers infected by H. pylori should be treated rather than their children; the same concept holds true for said other members of the family or persons in close contact with the infant. However, there is no reason for not treating infants once they have been infected with H. pylori. Once these insights have been gained, it is evident that preventive measures should be taken as early as possible, preferably ante partum. In this context, it should be noted that only a small proportion of infected persons, perhaps 15 to 20 percent, will have an ulcer d

REFERENCES:
patent: 5848975 (1998-12-01), Phillips
Blecker et al., Journal of Clinical Microbiology, vol. 31, No. 7, Jul. (1993), pp. 1770-1773.
Dialog Information Service, File 155, Medline, Dialog Accession No. 08367085, G. Oderda, et al., "Eighteen Month Follow Up of Helicobacter Pylori Positive Children Treated With Amoxycillin and Tinidazole", & Gut (England), Oct. 1992, vol. 33, No. 10, pp. 1328-1330.
Dialog Information Service, File 155, Medline, Dialog Accession No. 09124837, Medline Accession No. 95054837, U. Blecker, et al., "Evolution of Helicobacter Pylori Positivity in Infants Born From Positive Mothers", J. Pediatr. Gastroenterol. Nutr. (United States), Jul. 1994, vol. 19, No. 1, pp. 87-90.
Dialog Information Service, File 155, Medline, Dialog Accession No. 08918853, Medline Accession No. 94233853, T.G. Murrell, et al., "Sudden Infant Death Syndrome (SIDS): Are Common Bacterial Toxins Responsible, and Do They Have a Vaccine Potential?", Vaccine (England), Mar. 1994, vol. 12, No. 4, pp. 365-368.
Dialog Information Service, File 155, Medline, Dialog Accessiion No. 09172550, Medline Accession No. 95102550, C.C. Blackwell, et al., "The Role of Infectious Agents in Sudden Infant Death Syndrome", FEMS Immunol. Med. Microbiol (Netherlands), Aug. 1994, vol. 9, No. 2, pp. 91-100.

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