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Sindi AS, Stinson LF, Lai CT, Gridneva Z, Leghi GE, Netting MJ, Wlodek ME, Muhlhausler BS, Zhou X, Payne MS, Geddes DT. Human milk lactoferrin and lysozyme concentrations vary in response to a dietary intervention. J Nutr Biochem 2025; 135:109760. [PMID: 39251146 DOI: 10.1016/j.jnutbio.2024.109760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 08/08/2024] [Accepted: 09/04/2024] [Indexed: 09/11/2024]
Abstract
It is known that human milk (HM)1 antimicrobial protein composition varies during lactation. However, the impact of maternal diet on these antimicrobial proteins, particularly lactoferrin and lysozyme remains unknown. In addition, it is unclear whether daily, circadian, and between breast variations exist for lactoferrin and lysozyme concentrations. We investigated the impact of a low sugar, low fat, high fibre dietary intervention on HM lysozyme and lactoferrin concentrations. HM was sampled across a 3-week period; daily, at different times of day, and from both breasts to measure the level of intraindividual variation. The intervention significantly reduced maternal sugar, total fat, and saturated fat intake. HM lactoferrin concentration declined significantly over the course of the intervention however the effect size was relatively small. In addition, lactoferrin and lysozyme concentrations were variable over time, and differed significantly within and across the day but not between breasts.
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Affiliation(s)
- Azhar S Sindi
- Division of Obstetrics and Gynaecology, School of Medicine, The University of Western Australia, Subiaco, Western Australia, Australia; College of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia; ABREAST Network, Perth, Western Australia, Australia; UWA Centre for Human Lactation Research and Translation, Crawley, Western Australia, Australia
| | - Lisa F Stinson
- ABREAST Network, Perth, Western Australia, Australia; UWA Centre for Human Lactation Research and Translation, Crawley, Western Australia, Australia; School of Molecular Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Ching Tat Lai
- ABREAST Network, Perth, Western Australia, Australia; UWA Centre for Human Lactation Research and Translation, Crawley, Western Australia, Australia; School of Molecular Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Zoya Gridneva
- ABREAST Network, Perth, Western Australia, Australia; UWA Centre for Human Lactation Research and Translation, Crawley, Western Australia, Australia; School of Molecular Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Gabriela E Leghi
- School of Agriculture, Food and Wine, The University of Adelaide, Urrbrae, South Australia, Australia
| | - Merryn J Netting
- Women and Kids Theme, South Australian Health and Medical Research Institute (SAHMRI), North Terrace, South Australia, Australia; Discipline of Paediatrics, The University of Adelaide, North Adelaide, South Australia, Australia; Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - Mary E Wlodek
- School of Molecular Sciences, The University of Western Australia, Crawley, Western Australia, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia
| | - Beverly S Muhlhausler
- School of Agriculture, Food and Wine, The University of Adelaide, Urrbrae, South Australia, Australia; CSIRO, Adelaide, South Australia, Australia
| | - Xiaojie Zhou
- ABREAST Network, Perth, Western Australia, Australia; UWA Centre for Human Lactation Research and Translation, Crawley, Western Australia, Australia; School of Molecular Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Matthew S Payne
- Division of Obstetrics and Gynaecology, School of Medicine, The University of Western Australia, Subiaco, Western Australia, Australia
| | - Donna T Geddes
- ABREAST Network, Perth, Western Australia, Australia; UWA Centre for Human Lactation Research and Translation, Crawley, Western Australia, Australia; School of Molecular Sciences, The University of Western Australia, Crawley, Western Australia, Australia.
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Quifer-Rada P, Aguilar-Camprubí L, Samino S, Amigó N, Soler O, Padró-Arocas A. Metabolomics Approach to Identify Biomarkers of Acute and Subacute Mastitis in Milk Samples: A Pilot Case-Control Study. Metabolites 2024; 14:566. [PMID: 39452946 PMCID: PMC11509265 DOI: 10.3390/metabo14100566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2024] [Revised: 10/17/2024] [Accepted: 10/18/2024] [Indexed: 10/26/2024] Open
Abstract
Background and aims: Mastitis is one of the main complications during breastfeeding and contributes to the cessation of breastfeeding. However, the etiopathogenesis and diagnosis of mastitis are complex and not yet well defined. We aimed to identify metabolic and lipidic changes in human milk during acute and subacute mastitis in order to detect potential biomarkers of mastitis. Methods: We conducted a pilot case-control study including 14 breastfeeding women with acute mastitis, 32 with subacute mastitis symptoms, and 19 without any mastitis symptoms (control). Milk samples were collected and analyzed by proton nuclear magnetic resonance (H-NMR) for metabolomics analysis. To assess the association between the significant metabolites and lipids and the development of acute and subacute mastitis, multi-adjusted logistic regression models were developed. Results: The NMR-based metabolomics approach was able to identify and quantify a total of 40 metabolites in breast milk samples. After adjusting for confounding variables, acute mastitis was significantly associated with acetate (OR 3.9 IC 1.4-10.8), total cholesterol (OR 14 CI 3.2-62), esterified cholesterol (OR 3.3 CI 1.9-5.8), and sphingomyelin (OR 2.6 CI 1.2-5.8). The other metabolites presented weak association (OR < 2.5). Subacute mastitis was significantly associated with glutamine, lysophosphatidylcholine, phosphatidylcholine, plasmalogen, and total polyunsaturated fatty acids, but only cholesterol showed a strong association (OR > 2.5) with an OR of 2.6 (IC 1.1-6.6). Conclusions: Metabolic alteration in breast milk occurs during a process of both acute and subacute mastitis. Acetate, esterified cholesterol, lysophostidylcholine, and polyunsaturated fatty acids increased in both acute and subacute mastitis. However, according to the multi-adjusted regression logistic models, the candidate biomarkers for acute and subacute mastitis are cholesterol, lysophosphatidylcoholine, phosphatidylcholine, plasmalogen, and polyunsaturated fatty acids.
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Affiliation(s)
- Paola Quifer-Rada
- LactApp Women Health, 08014 Barcelona, Spain; (P.Q.-R.); (L.A.-C.)
- Department of Endocrinology & Nutrition, Biomedical Research Institute Sant Pau, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain
- CIBER of Diabetes and Associated Metabolic Diseases, 28029 Madrid, Spain; (S.S.); (N.A.)
| | | | - Sara Samino
- CIBER of Diabetes and Associated Metabolic Diseases, 28029 Madrid, Spain; (S.S.); (N.A.)
- Biosfer Teslab, 43206 Reus, Spain;
| | - Nuria Amigó
- CIBER of Diabetes and Associated Metabolic Diseases, 28029 Madrid, Spain; (S.S.); (N.A.)
- Biosfer Teslab, 43206 Reus, Spain;
- Department of Basic Medical Sciences, University Rovira I Virgili, IISPV, 43204 Reus, Spain
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Perrella SL, Anderton-May EL, McLoughlin G, Lai CT, Simmer KN, Geddes DT. Human Milk Sodium and Potassium as Markers of Mastitis in Mothers of Preterm Infants. Breastfeed Med 2022; 17:1003-1010. [PMID: 36378839 DOI: 10.1089/bfm.2022.0198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: This prospective longitudinal study examined changes in milk sodium concentration (Na) and sodium:potassium ratio (Na:K), microbiological culture, milk production, and breast health in relation to mastitis after preterm birth. Methods: We studied women who gave birth at 29-34 weeks of gestation in a tertiary obstetric hospital in Perth, Western Australia. Milk samples, 24-hour milk production, and breast health data were collected every second day to day 10 postpartum, then every third day until infant discharge from the neonatal unit. Milk Na and K were measured at point of care (POC) using handheld ion selective meters, and Na:K calculated. Cultures were performed on postnatal days 8, 13, and every 6 days thereafter. For episodes of mastitis, milk was cultured at onset, and Na and Na:K measured daily until resolution. Women were followed up at 4 and 8 weeks postpartum. Results: In a sample of 44 women, 4 mastitis cases were detected in 3 women during their infants' neonatal stay; all had elevated milk Na and Na:K that resolved within 48 hours; 2/4 experienced reduced milk production and 1/4 had heavy growth of Staphylococcus epidermidis. A further 2 mastitis cases were reported in 39 women followed up to 8 weeks postpartum. Four women had elevated milk Na and Na:K without clinical signs of mastitis; three also had reduced milk production. Conclusions: POC testing of milk Na and/or Na:K may offer a useful indicator of breast health. Mastitis may cause an acute reduction in milk production regardless of the presence of culture-positive infection.
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Affiliation(s)
- Sharon Lisa Perrella
- School of Molecular Science, The University of Western Australia, Crawley, Western Australia, Australia
| | - Emma-Lee Anderton-May
- Neonatology Clinical Care Unit, King Edward Memorial Hospital, Subiaco, Western Australia, Australia
| | - Grace McLoughlin
- School of Biomedical Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Ching Tat Lai
- School of Molecular Science, The University of Western Australia, Crawley, Western Australia, Australia
| | - Karen Norrie Simmer
- Neonatology Clinical Care Unit, King Edward Memorial Hospital, Subiaco, Western Australia, Australia.,School of Medicine, The University of Western Australia, Crawley, Western Australia, Australia
| | - Donna Tracy Geddes
- School of Molecular Science, The University of Western Australia, Crawley, Western Australia, Australia
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Huang Q, Zheng XM, Zhang ML, Ning P, Wu MJ. Lactation mastitis: Promising alternative indicators for early diagnosis. World J Clin Cases 2022; 10:11252-11259. [PMID: 36387788 PMCID: PMC9649554 DOI: 10.12998/wjcc.v10.i31.11252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/31/2022] [Accepted: 09/22/2022] [Indexed: 02/05/2023] Open
Abstract
Although lactation mastitis (LM) has been extensively researched, the incidence rate of LM remains a salient clinical problem. To reduce this incidence rate and achieve a better prognosis, early and specific quantitative indicators are particularly important. It has been found that milk electrolyte concentrations (chloride, potassium, and sodium) and electrical conductivity (EC) significantly change in the early stages of LM in an animal model. Several studies have evaluated EC for the detection of subclinical mastitis in cows. EC, chloride, and sodium content of milk were more accurate for predicting infection status than were other variables. In the early stages of LM, lactic sodium, chloride, and EC increase, but potassium decreases. However, these indicators have not been reported in the diagnosis of LM in humans. This review summarizes the pathogenesis and the mechanism of LM in terms of milk electrolyte concentration and EC, and aim to provide new ideas for the detection of sub-clinical mastitis in humans.
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Affiliation(s)
- Qian Huang
- School of Medicine, University of Electronic Science and Technology of China, Chengdu 610000, Sichuan Province, China
| | - Xue-Mei Zheng
- School of Medicine, University of Electronic Science and Technology of China, Chengdu 610000, Sichuan Province, China
| | - Mao-Lin Zhang
- Department of Anesthesiology, Chongqing Medical University, Chongqing 400016, Sichuan Province, China
| | - Ping Ning
- Department of Breast, Chengdu Women's and Children's Central Hospital, Chengdu 610000, Sichuan Province, China
| | - Meng-Jun Wu
- Department of Anesthesiology, Chengdu Women's and Children's Central Hospital, Chengdu 610000, Sichuan Province, China
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Esquerra-Zwiers A, Vroom A, Geddes D, Lai CT. Use of a Portable Point-of-Care Instrumentation to Measure Human Milk Sodium and Potassium Concentrations. Breastfeed Med 2022; 17:46-51. [PMID: 34319795 DOI: 10.1089/bfm.2021.0046] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objective: Human milk (HM) sodium (Na) and potassium (K) concentrations, as well as the Na and K ratio (Na:K), are associated with stages of lactation and breast health. Portable point-of-care instruments to measure HM biomarkers related to secretory activation or tight junction disturbances would supply clinicians immediate information for individualized lactation care. This study compared HM concentrations of Na and K and Na:K measured by a biochemist with inductively coupled plasma optical emission spectrometry (ICP-OES) and measured by a clinician with ion-selective electrode probes (ISEPs). Design: HM samples (n = 92) were participant collected and donated on day 10 postpartum through a convenience sample of breastfeeding women in West Michigan. Na and K concentrations were determined using ICP-OES and ISEPs. Bland-Altman plots, paired sample t-test, and logistic regressions were completed using R 3.4.4 and R Studio 1.2.1335 with package Lattice. Results: Na concentrations were not significantly different with ICP-OES (13.0 ± 14.8 mM) and ISEPs (12.6 ± 13.7 mM, p = 0.06), whereas K concentrations (ICP-OES 16.1 ± 1.9 mM, ISEPs 14.4 ± 2.4 mM, p < 0.001) and Na:K (ICP-OES 0.81 ± 0.92, ISEPs 1.01 ± 1.62, p = 0.011) were significantly different. Between both methods, the Na, K, and Na: K linear relationships were statistically significant. Conclusion: With additional longitudinal and clinical usefulness research clinicians could use ISEPs to collect and interpret relevant lactation data to support individualized lactation interventions.
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Affiliation(s)
| | - Alexandra Vroom
- School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
| | - Donna Geddes
- School of Molecular Science, The University of Western Australia, Perth, Australia
| | - Ching Tat Lai
- School of Molecular Science, The University of Western Australia, Perth, Australia
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Valls-Bellés V, Abad C, Hernández-Aguilar MT, Nacher A, Guerrero C, Baliño P, Romero FJ, Muriach M. Human Milk Antioxidative Modifications in Mastitis: Further Beneficial Effects of Cranberry Supplementation. Antioxidants (Basel) 2021; 11:antiox11010051. [PMID: 35052555 PMCID: PMC8772773 DOI: 10.3390/antiox11010051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 12/31/2022] Open
Abstract
Mastitis is the inflammation of one or several mammal lobes which can be accompanied by a mammary gland infection, and is the leading cause of undesired early weaning in humans. However, little information exists regarding the changes that this disease may induce in the biochemical composition of human milk, especially in terms of oxidative status. Given that newborns are subject to a significant increase in total ROS burden in their transition to neonatal life and that their antioxidant defense system is not completely developed, the aim of this study was to evaluate antioxidant defense (glutathione peroxidase (GPx), reduced glutathione (GSH), total polyphenol content (TPP), and total antioxidant capacity (TAC)) in milk samples from mothers suffering from mastitis and controls. We also measured the oxidative damage to lipids (malondyaldehyde (MDA)) and proteins (carbonyl group content (CGC)) in these samples. Finally, we tested whether dietary supplementation with cranberries (a product rich in antioxidants) in these breastfeeding mothers during 21 days could improve the oxidative status of milk. GPx activity, TPP, and TAC were increased in milk samples from mastitis-affected women, providing a protective mechanism to the newborn drinking mastitis milk. MDA concentrations were diminished in the mastitis group, confirming this proposal. Some oxidative damage might occur in the mammary gland since the CGC was increased in mastitis milk. Cranberries supplementation seems to strengthen the antioxidant system, further improving the antioxidative state of milk.
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Affiliation(s)
- Victoria Valls-Bellés
- Unitat Predepartamental de Medicina, Facultat de Ciencies de la Salud, Universitat Jaume I, 12071 Castellon de la Plana, Spain; (V.V.-B.); (C.A.); (M.T.H.-A.); (A.N.); (C.G.); (P.B.)
| | - Cristina Abad
- Unitat Predepartamental de Medicina, Facultat de Ciencies de la Salud, Universitat Jaume I, 12071 Castellon de la Plana, Spain; (V.V.-B.); (C.A.); (M.T.H.-A.); (A.N.); (C.G.); (P.B.)
| | - María Teresa Hernández-Aguilar
- Unitat Predepartamental de Medicina, Facultat de Ciencies de la Salud, Universitat Jaume I, 12071 Castellon de la Plana, Spain; (V.V.-B.); (C.A.); (M.T.H.-A.); (A.N.); (C.G.); (P.B.)
| | - Amalia Nacher
- Unitat Predepartamental de Medicina, Facultat de Ciencies de la Salud, Universitat Jaume I, 12071 Castellon de la Plana, Spain; (V.V.-B.); (C.A.); (M.T.H.-A.); (A.N.); (C.G.); (P.B.)
| | - Carlos Guerrero
- Unitat Predepartamental de Medicina, Facultat de Ciencies de la Salud, Universitat Jaume I, 12071 Castellon de la Plana, Spain; (V.V.-B.); (C.A.); (M.T.H.-A.); (A.N.); (C.G.); (P.B.)
| | - Pablo Baliño
- Unitat Predepartamental de Medicina, Facultat de Ciencies de la Salud, Universitat Jaume I, 12071 Castellon de la Plana, Spain; (V.V.-B.); (C.A.); (M.T.H.-A.); (A.N.); (C.G.); (P.B.)
| | - Francisco J. Romero
- Hospital General de Requena, Conselleria de Sanitat, Generalitat Valenciana, 46340 Requena, Spain
- Correspondence: (F.J.R.); (M.M.)
| | - María Muriach
- Unitat Predepartamental de Medicina, Facultat de Ciencies de la Salud, Universitat Jaume I, 12071 Castellon de la Plana, Spain; (V.V.-B.); (C.A.); (M.T.H.-A.); (A.N.); (C.G.); (P.B.)
- Correspondence: (F.J.R.); (M.M.)
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Castro I, Arroyo R, Aparicio M, Martínez MÁ, Rovira J, Ares S, Cunha SC, Casal S, Oliveira Fernandes J, Schuhmacher M, Nadal M, Rodríguez JM, Fernández L. Dietary Habits and Relationship with the Presence of Main and Trace Elements, Bisphenol A, Tetrabromobisphenol A, and the Lipid, Microbiological and Immunological Profiles of Breast Milk. Nutrients 2021; 13:nu13124346. [PMID: 34959899 PMCID: PMC8708081 DOI: 10.3390/nu13124346] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/26/2021] [Accepted: 11/29/2021] [Indexed: 12/11/2022] Open
Abstract
Breastfeeding is the best way to feed an infant, although it can also be a source of abiotic contaminants such as heavy metals or bisphenol A (BPA). The early life exposure to these compounds can lead to serious toxic effects in both the short and long-term. These substances can reach breast milk through the mother’s habits, diet being one of the main routes of exposure. The aim of the present work was to analyse possible associations between the dietary habits of women and the content of major trace elements, BPA, fatty acids and lipids, and the microbiological and immunological profiles of human milk. Possible associations between major trace elements and BPA and the lipid, microbiological and immunological profiles were also analysed. The results of this study support that the microbiological composition of human milk is associated with the dietary habits of the women, and that the consumption of canned drinks is related to the presence of BPA in human milk. Furthermore, some relationships were found between the amount of major trace elements and the microbiological and immunological profile of the milk samples. Finally, the presence of BPA was associated with changes in the immunological profile of human milk.
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Affiliation(s)
- Irma Castro
- Department of Nutrition and Food Science, Complutense University of Madrid, 28040 Madrid, Spain; (I.C.); (R.A.); (M.A.); (J.M.R.)
| | - Rebeca Arroyo
- Department of Nutrition and Food Science, Complutense University of Madrid, 28040 Madrid, Spain; (I.C.); (R.A.); (M.A.); (J.M.R.)
| | - Marina Aparicio
- Department of Nutrition and Food Science, Complutense University of Madrid, 28040 Madrid, Spain; (I.C.); (R.A.); (M.A.); (J.M.R.)
| | - María Ángeles Martínez
- Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, 28029 Madrid, Spain;
- Unitat de Nutrició, Departament de Bioquímica i Biotecnologia, Universitat Rovira i Virgili, 43201 Reus, Spain
- Nutrition Unit, University Hospital of Sant Joan de Reus, 43204 Reus, Spain
- Institut d’Investigació Sanitària Pere Virgili (IISPV), 43007 Reus, Spain
| | - Joaquim Rovira
- Environmental Engineering Laboratory, Departament d’Enginyeria Quimica, Universitat Rovira i Virgili, Av. Països Catalans 26, 43007 Tarragona, Spain; (J.R.); (M.S.)
- Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Spain;
| | - Susana Ares
- Department of Neonatology, Universitary Hospital La Paz, P° de la Castellana, 261, 28046 Madrid, Spain;
| | - Sara Cristina Cunha
- LAQV-REQUIMTE, Laboratory of Bromatology and Hydrology, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal; (S.C.C.); (S.C.); (J.O.F.)
| | - Susana Casal
- LAQV-REQUIMTE, Laboratory of Bromatology and Hydrology, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal; (S.C.C.); (S.C.); (J.O.F.)
| | - Jose Oliveira Fernandes
- LAQV-REQUIMTE, Laboratory of Bromatology and Hydrology, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal; (S.C.C.); (S.C.); (J.O.F.)
| | - Marta Schuhmacher
- Environmental Engineering Laboratory, Departament d’Enginyeria Quimica, Universitat Rovira i Virgili, Av. Països Catalans 26, 43007 Tarragona, Spain; (J.R.); (M.S.)
| | - Martí Nadal
- Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira i Virgili, Sant Llorenç 21, 43201 Reus, Spain;
| | - Juan Miguel Rodríguez
- Department of Nutrition and Food Science, Complutense University of Madrid, 28040 Madrid, Spain; (I.C.); (R.A.); (M.A.); (J.M.R.)
| | - Leónides Fernández
- Department of Galenic Pharmacy and Food Technology, Complutense University of Madrid, 28040 Madrid, Spain
- Correspondence: ; Tel.: +34-913943745
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Geddes DT, Gridneva Z, Perrella SL, Mitoulas LR, Kent JC, Stinson LF, Lai CT, Sakalidis V, Twigger AJ, Hartmann PE. 25 Years of Research in Human Lactation: From Discovery to Translation. Nutrients 2021; 13:3071. [PMID: 34578947 PMCID: PMC8465002 DOI: 10.3390/nu13093071] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 08/26/2021] [Accepted: 08/26/2021] [Indexed: 02/06/2023] Open
Abstract
Researchers have recently called for human lactation research to be conceptualized as a biological framework where maternal and infant factors impacting human milk, in terms of composition, volume and energy content are studied along with relationships to infant growth, development and health. This approach allows for the development of evidence-based interventions that are more likely to support breastfeeding and lactation in pursuit of global breastfeeding goals. Here we summarize the seminal findings of our research programme using a biological systems approach traversing breast anatomy, milk secretion, physiology of milk removal with respect to breastfeeding and expression, milk composition and infant intake, and infant gastric emptying, culminating in the exploration of relationships with infant growth, development of body composition, and health. This approach has allowed the translation of the findings with respect to education, and clinical practice. It also sets a foundation for improved study design for future investigations in human lactation.
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Affiliation(s)
- Donna Tracy Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Zoya Gridneva
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Sharon Lisa Perrella
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Leon Robert Mitoulas
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
- Medela, AG, Lättichstrasse 4b, 6340 Baar, Switzerland
| | - Jacqueline Coral Kent
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Lisa Faye Stinson
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Ching Tat Lai
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | - Vanessa Sakalidis
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
| | | | - Peter Edwin Hartmann
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia; (Z.G.); (S.L.P.); (L.R.M.); (J.C.K.); (L.F.S.); (C.T.L.); (V.S.); (P.E.H.)
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9
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Samuel TM, Zhou Q, Giuffrida F, Munblit D, Verhasselt V, Thakkar SK. Nutritional and Non-nutritional Composition of Human Milk Is Modulated by Maternal, Infant, and Methodological Factors. Front Nutr 2020; 7:576133. [PMID: 33117843 PMCID: PMC7557356 DOI: 10.3389/fnut.2020.576133] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 08/19/2020] [Indexed: 02/06/2023] Open
Abstract
Human milk (HM) is dynamic and shows a high inter- and intra-individual variability. To characterize HM with precision, it is necessary to understand the factors that modulate its composition. The objective of this narrative review is to summarize the maternal, infant and methodological factors that affect HM composition. We searched SCOPUS and PubMed databases for articles related to factors that are known to or could potentially influence HM composition and volume across lactation periods. Our comprehensive review encompasses various maternal-, infant-related, and methodological factors that modulate aspects of HM composition including macro- and micronutrients, vitamins and minerals, as well as volume. The most profound changes were observed in HM lipids and lipophiles. Evidence exists for many of the infant-related factors known to affect the nutritive and non-nutritive components of HM (e.g., birth weight, gestational age, infant age/stage of lactation). In contrast, less is known with respect to maternal factors; where there is either limited research or conflicting evidence (e.g., maternal lifestyle, obstetric history, medical conditions), except for the mother's diet, for which there is a relatively well-established understanding. Equally, although many of the methodological factors (e.g., HM sampling, handling and analytics) are known to impact HM composition, few studies have investigated this as a primary outcome, making it an important area of future research in HM. Here we propose a systematic capture of numerous maternal- and infant-related characteristics to facilitate associative comparisons of HM data within and across studies. Additionally, it would be prudent to standardize the methodological aspects known to affect HM composition in analytics, not only for HM lipids and lipophiles, but also for those nutrients whose variability is yet less well-understood. Defining the factors determining HM composition with accuracy will open perspectives for maternal intervention to optimize milk composition for specific needs of infants.
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Affiliation(s)
| | | | | | - Daniel Munblit
- Department of Paediatrics and Paediatric Infectious Diseases, Institute of Child's Health, Sechenov First Moscow State Medical University, Moscow, Russia.,Inflammation, Repair and Development Section, National Heart and Lung Institute, Faculty of Medicine, Imperial College London, London, United Kingdom
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10
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Pevzner M, Dahan A. Mastitis While Breastfeeding: Prevention, the Importance of Proper Treatment, and Potential Complications. J Clin Med 2020; 9:jcm9082328. [PMID: 32707832 PMCID: PMC7465810 DOI: 10.3390/jcm9082328] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 07/18/2020] [Indexed: 12/04/2022] Open
Abstract
Mastitis is an inflammation in the breast, which may involve a bacterial infection. Breast infection during breastfeeding is a common phenomenon that requires immediate and appropriate treatment. Without proper treatment, inflammation may lead to the cessation of breastfeeding. Another potential complication is the development of an abscess. Based on the nutritional and immunological value of breast milk, the recommendations of the American Academy of Pediatrics (AAP) and the World Health Organization (WHO) is exclusive breastfeeding up to 6 months of age, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infanRecent meta-analyses indicate breastfeeding protects against childhood infections, allows for a possible increase in intelligence, and for a reduction in overweight and diabetes. Breastfeeding is beneficial for nursing women as well. It is therefore important to help the mother overcome difficulties such as mastitis and to continue breastfeeding. The choice of a proper treatment and the provision of therapeutic instructions to the patient are crucial for a cure, for a successful duration of breastfeeding, and for preventing complications for mother and baby. In this article, we provide the latest clinical guidelines regarding drug treatment and supportive therapy in mastitis. We also discuss the latest guidelines of candida treatment, as candida infection may develop as a result of antibiotic therapy. Overall, improperly treated mastitis may cause the premature cessation of breastfeeding, and will cause suffering to both mother and baby; giving proper treatment and instructions to the mother are hence of the utmost importance.
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Affiliation(s)
| | - Arik Dahan
- Correspondence: ; Tel.: +972-8-6479483; Fax: +972-8-6479303
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11
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Samuel TM, De Castro CA, Dubascoux S, Affolter M, Giuffrida F, Billeaud C, Picaud JC, Agosti M, Al-Jashi I, Pereira AB, Costeira MJ, Silva MG, Marchini G, Rakza T, Haaland K, Stiris T, Stoicescu SM, Martínez-Costa C, Vanpee M, Domellöf M, Castañeda-Gutiérrez E, Thakkar SK, Silva-Zolezzi I. Subclinical Mastitis in a European Multicenter Cohort: Prevalence, Impact on Human Milk (HM) Composition, and Association with Infant HM Intake and Growth. Nutrients 2019; 12:nu12010105. [PMID: 31905959 PMCID: PMC7019749 DOI: 10.3390/nu12010105] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 12/19/2019] [Accepted: 12/23/2019] [Indexed: 02/01/2023] Open
Abstract
Background: Subclinical mastitis (SCM) is an inflammatory condition of the mammary gland. We examined the effects of SCM on human milk (HM) composition, infant growth, and HM intake in a mother–infant cohort from seven European countries. Methods: HM samples were obtained from 305 mothers at 2, 17, 30, 60, 90, and 120 days postpartum. SCM status was assessed using HM Sodium (Na): Potassium (K) ratio >0.6. Levels of different macro- and micronutrients were analyzed in HM. Results: SCM prevalence in the first month of lactation was 35.4%. Mean gestational age at delivery was lower and birth by C-section higher in SCM mothers (p ≤ 0.001). HM concentrations of lactose, DHA, linolenic acid, calcium, and phosphorous (p < 0.05 for all) was lower, while total protein, alpha-lactalbumin, lactoferrin, albumin, arachidonic acid to DHA ratio, n-6 to n-3 ratio and minerals (iron, selenium, manganese, zinc, and copper) were higher (p < 0.001 for all) in mothers with SCM. There were no differences in infant growth and HM intake between non-SCM and SCM groups. Conclusion: We document, for the first time, in a large European standardized and longitudinal study, a high prevalence of SCM in early lactation and demonstrate that SCM is associated with significant changes in the macro- and micronutrient composition of HM. Future studies exploring the relation of SCM with breastfeeding behaviors and developmental outcomes are warranted.
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Affiliation(s)
- Tinu Mary Samuel
- Nestlé Research, Société des Produits Nestlé SA, Route du Jorat 57, 1000 Lausanne, Switzerland; (S.D.); (M.A.); (F.G.); (E.C.-G.)
- Correspondence:
| | | | - Stephane Dubascoux
- Nestlé Research, Société des Produits Nestlé SA, Route du Jorat 57, 1000 Lausanne, Switzerland; (S.D.); (M.A.); (F.G.); (E.C.-G.)
| | - Michael Affolter
- Nestlé Research, Société des Produits Nestlé SA, Route du Jorat 57, 1000 Lausanne, Switzerland; (S.D.); (M.A.); (F.G.); (E.C.-G.)
| | - Francesca Giuffrida
- Nestlé Research, Société des Produits Nestlé SA, Route du Jorat 57, 1000 Lausanne, Switzerland; (S.D.); (M.A.); (F.G.); (E.C.-G.)
| | | | - Jean-Charles Picaud
- Hospices Civils de Lyon, Neonatal intensive care unit, Hôpital Croix Rousse, 69004 Lyon, France;
- Univ. Lyon, CarMeN Laboratory, INSERM U1060, INRA U1397, INSA Lyon, Universite Claude Bernard, 69221 Lyon 1, France
| | | | - Isam Al-Jashi
- Medical School, Department of Obstetrics and Gynecology, Titu Maiorescu Medicine University, 031593 Bucharest, Romania;
| | | | - Maria Jose Costeira
- Instituto de Investigação em Ciências da Vida e Saúde, 4720-011 Braga, Portugal;
| | | | - Giovanna Marchini
- Karolinska University Hospital, 141 86 Stockholm, Sweden; (G.M.); (M.V.)
| | - Thameur Rakza
- Centre d’Investigation Clinique de Lille, Hôpital Jeanne de Flandre, 59777 Lille, France;
| | - Kirsti Haaland
- Oslo University Hospital, 0372 Oslo, Norway; (K.H.); (T.S.)
| | - Tom Stiris
- Oslo University Hospital, 0372 Oslo, Norway; (K.H.); (T.S.)
| | | | | | - Mireilla Vanpee
- Karolinska University Hospital, 141 86 Stockholm, Sweden; (G.M.); (M.V.)
| | - Magnus Domellöf
- Department of Clinical Sciences, Pediatrics, Umea University, 901 87 Umeå, Sweden;
| | - Eurídice Castañeda-Gutiérrez
- Nestlé Research, Société des Produits Nestlé SA, Route du Jorat 57, 1000 Lausanne, Switzerland; (S.D.); (M.A.); (F.G.); (E.C.-G.)
| | - Sagar Kiran Thakkar
- Nestle Research, Singapore 618802, Singapore; (C.A.D.C.); (S.K.T.); (I.S.-Z.)
| | - Irma Silva-Zolezzi
- Nestle Research, Singapore 618802, Singapore; (C.A.D.C.); (S.K.T.); (I.S.-Z.)
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12
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Katsafadou AI, Tsangaris GT, Anagnostopoulos AK, Billinis C, Barbagianni MS, Vasileiou NGC, Spanos SA, Mavrogianni VS, Fthenakis GC. Differential quantitative proteomics study of experimental Mannheimia haemolytica mastitis in sheep. J Proteomics 2019; 205:103393. [PMID: 31154024 DOI: 10.1016/j.jprot.2019.103393] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 05/12/2019] [Accepted: 05/14/2019] [Indexed: 02/08/2023]
Abstract
Objective was the differential quantitative proteomics study of ovine mastitis induced by Mannheimia haemolytica; clinical, microbiological, cytological and histopathological methods were employed for confirmation and monitoring. Proteins were separated by two-dimensional gel electrophoresis (2-DE) for all samples and differentially abundant proteins were identified by mass spectrometry; comparisons were performed with pre- (blood, milk) and post- (milk of contralateral gland) inoculation findings. Animals developed mastitis, confirmed by isolation of challenge strain and increase of neutrophils in milk and by histopathological evidence. In blood plasma, 33 differentially abundant proteins (compared to findings before challenge) were identified: 6 with decrease, 13 with new appearance and 14 with varying abundance. In a post-challenge milk whey protein reference map, 65 proteins were identified; actin cytoplasmic-1, beta-lactoglobulin-1/B, cathelicidin-1 predominated. Further, 89 differentially abundant proteins (compared to findings before challenge) were identified: 18 with decrease, 53 with new appearance, 3 with increase and 15 with varying abundance; 15 proteins showed status changes in blood plasma and milk whey. Differential abundance from inoculated and contralateral glands revealed 74 proteins only from the inoculated gland. Most differentially abundant proteins in milk whey were involved in cell organisation and biogenesis (n = 17) or in inflammatory and defence response (n = 13). SIGNIFICANCE: The proteomes of blood and milk from ewes with experimental mastitis caused by Mannheimia haemolytica and the differential proteomics in sequential samples after challenge are presented for the first time. This is the first detailed proteomics study in M. haemolytica-associated mastitis in ewes. An experimental model fully simulating natural mastitis has been used. Use of experimentally induced mastitis minimised potential variations and allowed consistency of results. The study included evaluation of changes in blood plasma and milk whey. Protein patterns have been studied, indicating with great accuracy changes that had occurred as part of the disease process and development, during the acute phase of infection. Relevant protein-protein interactions were studied. The entirety of proteomics findings has suggested that affected ewes had mounted a defence response that had been regulated by many proteins (e.g., cathelicidins, haptoglobin, serum amyloid A) and through various pathways (e.g., acute phase response, binding and transporting significant ions and molecules); these were interdependent at various points. Potential biomarkers have been indicated for use in diagnostic assays of mastitis.
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Affiliation(s)
- Angeliki I Katsafadou
- Veterinary Faculty, University of Thessaly, 43100 Karditsa, Greece; Proteomics Research Unit, Biomedical Research Foundation of Academy of Athens, 11527 Athens, Greece
| | - George Th Tsangaris
- Proteomics Research Unit, Biomedical Research Foundation of Academy of Athens, 11527 Athens, Greece
| | | | | | | | | | - Stavros A Spanos
- Veterinary Faculty, University of Thessaly, 43100 Karditsa, Greece
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13
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Wren-Atilola HM, Solomons NW, Scott ME, Koski KG. Infant growth faltering linked to subclinical mastitis, maternal faecal-oral contamination, and breastfeeding. MATERNAL AND CHILD NUTRITION 2019; 15:e12756. [PMID: 30472802 DOI: 10.1111/mcn.12756] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 11/17/2018] [Accepted: 11/20/2018] [Indexed: 12/26/2022]
Abstract
Infant growth faltering occurs in breastfed infants <6 months of age. The possibility that maternal health status contributes to this growth faltering is underexplored. We investigated whether (a) subclinical mastitis (SCM), an asymptomatic inflammation of the breast, (b) maternal intestinal nematode and protozoan infections, indicators of faecal-oral contamination, or (c) poor breastfeeding practices increased the odds of stunting (length-for-age z-score < -2SD), underweight (weight-for-age z-score < -2SD), or low head circumference (head circumference-for-age z-score < -2SD) in breastfed infants in rural indigenous communities in Guatemala. Mother-infant dyads (n = 105) were subdivided into those with and without SCM (milk Na:K ratio > 0.6). Maternal and infant anthropometry were measured at the time of breast milk collection. Maternal stool samples were examined for the presence of intestinal nematodes and protozoa. Questionnaires were used to characterize breastfeeding practices (exclusivity and frequency) and support, hygiene (latrine use and household faucet), and infant diarrhoea. SCM occurred in 14% of women and was associated with increased odds of infant stunting (odds ratio [OR] = 4.3; confidence interval [CI] [1.1, 15.8]), underweight (OR = 9.2; CI [1.8, 48.0]), and low head circumference (OR = 15.9; CI [2.6, 96.9]). Maternal pathogenic protozoa and nematodes were uncommon (<4%), but nonpathogenic protozoa were common (e.g., Entamoeba coli [39%]). Entamoeba coli increased the likelihood (OR = 3.3; CI [1.02, 10.6]) of low head circumference, whereas higher breastfeeding frequency lowered its odds (OR = 0.74, CI [0.56, 0.97]). Prevention of SCM may improve early infant growth, but public health measures that increase breastfeeding frequency and reduce faecal-oral contamination may be required to minimize low head circumference.
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Affiliation(s)
| | - Noel W Solomons
- Center for Studies of Sensory Impairment, Aging and Metabolism (CeSSIAM), Guatemala City, Guatemala
| | - Marilyn E Scott
- Institute of Parasitology, McGill University, Montreal, Quebec, Canada
| | - Kristine G Koski
- School of Human Nutrition, McGill University, Montreal, Quebec, Canada
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14
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Schaub R, Badiou S, Viljoen J, Dujols P, Bolloré K, Van de Perre P, Newell ML, Bland R, Nagot N, Tuaillon E. The immune response to sub-clinical mastitis is impaired in HIV-infected women. J Transl Med 2018; 16:296. [PMID: 30359283 PMCID: PMC6202806 DOI: 10.1186/s12967-018-1667-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 10/17/2018] [Indexed: 11/23/2022] Open
Abstract
Background Subclinical mastitis (SCM) is relatively common in lactating women and may be associated with HIV shedding in breast milk. The potential association between HIV infection and breast milk immunologic factors and immune response to SCM needs to be addressed. Methods In this cross-sectional study, SCM (Na/K ratio > 1) was tested in 165 mature breast milk samples collected from 40 HIV-infected women who didn’t transmit HIV to their child by breastfeeding and 43 HIV-uninfected women enrolled in an interventional cohort in South-Africa (Vertical Transmission Study). The level of 33 immune markers related to Th1/Th2 related response, inflammation and bacterial exposure were compared in ART-naive HIV-infected versus HIV-uninfected women. The associations between HIV infection and SCM on the concentration of immune factors were tested separately by Wilcoxon rank-sum test and corrected for false discovery rate. To control for potential confounder effects and take into account the clustering of breast milk samples from a single woman, multivariate mixed linear models adjusted on child age at the time of sampling were performed for each immune factor. Results Subclinical mastitis was detected in 15 (37.5%) HIV-infected women and 10 (23.3%) HIV-uninfected women. In the absence of SCM, the breast milk levels of IP-10 and MIG were higher and IL1-RA lower in HIV-infected women than in HIV-uninfected women (respectively p < 0.001, p = 0.001, p = 0.045). In HIV-uninfected women, SCM was characterized by a robust immune response with higher concentrations of a broad panel of Th1 and inflammatory related immune markers than in samples without SCM. By contrast, in HIV-infected women a limited number of immune markers were increased and lower increases were observed in samples with SCM than without SCM. Conclusion HIV infection in ART-naïve women was associated with elevated breast milk levels of IP-10 and MIG, which areTh1-related cytokines induced by IFN-γ. During SCM, a lower and narrower immune response was observed in HIV-infected than HIV-uninfected women, suggesting that HIV infection affects the capacity of the mammary gland to respond to SCM. Electronic supplementary material The online version of this article (10.1186/s12967-018-1667-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Roxane Schaub
- Pathogenesis and Control of Chronic Infections, INSERM, EFS, Université Montpellier 1, Montpellier, France. .,Département d'Information Médicale, CHU de Montpellier, Montpellier, France. .,CIC AG/Inserm 1424, Centre Hospitalier de Cayenne, Av. des flamboyants, BP 6006, 97 306, Cayenne CEDEX, French Guiana, France.
| | - Stéphanie Badiou
- Département de Biochimie, CHU de Montpellier, Montpellier, France
| | - Johannes Viljoen
- Department of Medical Virology, University of Pretoria and NHLS, Pretoria, South Africa
| | - Pierre Dujols
- Pathogenesis and Control of Chronic Infections, INSERM, EFS, Université Montpellier 1, Montpellier, France.,Département d'Information Médicale, CHU de Montpellier, Montpellier, France
| | - Karine Bolloré
- Pathogenesis and Control of Chronic Infections, INSERM, EFS, Université Montpellier 1, Montpellier, France
| | - Philippe Van de Perre
- Pathogenesis and Control of Chronic Infections, INSERM, EFS, Université Montpellier 1, Montpellier, France.,Département de Bactériologie-Virologie, CHU de Montpellier, Montpellier, France
| | - Marie-Louise Newell
- Institute for Developmental Science, Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.,School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Ruth Bland
- Africa Centre for Health and Population studies, University of KwaZulu-Natal, Durban, South Africa.,School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.,Royal Hospital for Children, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Nicolas Nagot
- Pathogenesis and Control of Chronic Infections, INSERM, EFS, Université Montpellier 1, Montpellier, France.,Département d'Information Médicale, CHU de Montpellier, Montpellier, France
| | - Edouard Tuaillon
- Pathogenesis and Control of Chronic Infections, INSERM, EFS, Université Montpellier 1, Montpellier, France.,Département de Bactériologie-Virologie, CHU de Montpellier, Montpellier, France
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15
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Lai CT, Gardner H, Geddes D. Comparison of Inductively Coupled Plasma Optical Emission Spectrometry with an Ion Selective Electrode to Determine Sodium and Potassium Levels in Human Milk. Nutrients 2018; 10:E1218. [PMID: 30177589 PMCID: PMC6164336 DOI: 10.3390/nu10091218] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 08/24/2018] [Accepted: 08/27/2018] [Indexed: 11/16/2022] Open
Abstract
Sodium (Na), potassium (K), and the ratio Na:K in human milk (HM) may be useful biomarkers to indicate secretory activation or inflammation in the breast. Previously, these elements have been measured in a laboratory setting requiring expensive equipment and relatively large amounts of HM. The aim of this study was to compare measurements of Na and K in HM using inductively coupled plasma optical emission spectrometry (ICP-OES) with small portable ion selective electrode probes for Na and K. Sixty-five lactating women donated 5 mL samples of HM. Samples were analyzed with two ion selective probes (Na and K) and also ICP-OES. The data were analyzed using paired t-test and Bland⁻Altman plots. Na concentrations were not significantly different when measured with ion selective electrode (6.18 ± 2.47mM; range: 3.59⁻19.8) and ICP-OES (5.91 ± 3.37 mM; range: 2.59⁻21.5) (p = 0.20). K concentrations measured using the ion selective electrode (11.7 ± 2.21 mM: range: 7.69⁻18.1) and ICP-OES (11.1 ± 1.55 mM: range: 7.91⁻15.2) were significantly different (p = 0.01). However, the mean differences of 0.65 mM would not be clinically relevant when testing at point of care. Compared to ICP-OES, ion selective electrode is sufficiently accurate to detect changes in concentrations of Na and K in HM associated with secretory activation and inflammation in the mammary gland.
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Affiliation(s)
- Ching Tat Lai
- School of Molecular Sciences, University of Western Australia, 35 Stirling Highway, Crawley, 6009 WA, Australia.
| | - Hazel Gardner
- School of Molecular Sciences, University of Western Australia, 35 Stirling Highway, Crawley, 6009 WA, Australia.
| | - Donna Geddes
- School of Molecular Sciences, University of Western Australia, 35 Stirling Highway, Crawley, 6009 WA, Australia.
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16
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Murase M, Wagner EA, Chantry CJ, Dewey KG, Nommsen-Rivers LA. The Relation between Breast Milk Sodium to Potassium Ratio and Maternal Report of a Milk Supply Concern. J Pediatr 2017; 181:294-297.e3. [PMID: 27871690 PMCID: PMC5274566 DOI: 10.1016/j.jpeds.2016.10.044] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 08/26/2016] [Accepted: 10/11/2016] [Indexed: 12/23/2022]
Abstract
We report that, among exclusively breastfeeding mothers at day 7 postpartum, those with milk supply concerns were significantly more likely to exhibit biochemical evidence of less progress toward mature lactation (elevated ratio of breast milk sodium to potassium concentration). Furthermore, an elevated ratio of breast milk sodium to potassium concentration was predictive of early weaning.
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Affiliation(s)
- Masahiko Murase
- Showa University School of Medicine, Tokyo, Japan,Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Erin A. Wagner
- Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
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17
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Mastitis Modifies the Biogenic Amines Profile in Human Milk, with Significant Changes in the Presence of Histamine, Putrescine and Spermine. PLoS One 2016; 11:e0162426. [PMID: 27584695 PMCID: PMC5008837 DOI: 10.1371/journal.pone.0162426] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 08/22/2016] [Indexed: 11/19/2022] Open
Abstract
Biogenic amines (BAs) are low molecular weight nitrogenous organic compounds with different biological activities. Putrescine, spermidine and spermine are essential for the development of the gut and immune system of newborns, and are all found in human milk. Little is known, however, about the role of histamine, tyramine or cadaverine in breast milk. Nor is it known whether mastitis alters the BA composition of milk. The BA profile of human milk, and the influence of mastitis on BA concentrations, were therefore investigated. Putrescine, spermidine and spermine were the main BAs detected. In mastitis-affected milk, the concentrations of putrescine, spermine and histamine were higher.
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18
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Villavicencio A, Rueda MS, Turin CG, Ochoa TJ. Factors affecting lactoferrin concentration in human milk: how much do we know? Biochem Cell Biol 2016; 95:12-21. [PMID: 28075610 DOI: 10.1139/bcb-2016-0060] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Lactoferrin (LF) is a breast milk glycoprotein with antimicrobial and anti-inflammatory effects. Its beneficial properties in infants, especially in those born preterm, are currently being studied in clinical trials. However, the maternal and nursing infant factors that may affect LF concentration in breast milk are still not clear. We conducted a systematic review to investigate the factors that may affect the concentration of LF in breast milk. We used a 2-step approach to identify the eligible studies according to inclusion/exclusion criteria, and to determine which studies would be considered. We included 70 qualified articles from 29 countries with publication dates ranging from 1976 to 2015. We described the correlation between LF concentration in breast milk and lactation stage; 10 maternal factors, such as race, parity, among others; and 2 infant factors: infections and prematurity. Colostrum has the highest LF levels, but they decrease with days postpartum. No other factor has been consistently associated with LF concentration. A major limitation of the majority of the published studies is the small sample size and the different methods used to measure LF concentration. Therefore, there is a need for large, multicenter studies with standardized study design, sample collection, and LF measurement methods to identify clinically significant factors associated with LF expression in breast milk, which will help promote exclusive breastfeeding in preterm infants.
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Affiliation(s)
- Aasith Villavicencio
- a Instituto de Medicina Tropical "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima 31, Peru
| | - Maria S Rueda
- a Instituto de Medicina Tropical "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima 31, Peru
| | - Christie G Turin
- a Instituto de Medicina Tropical "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima 31, Peru
| | - Theresa J Ochoa
- b Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru.,c University of Texas School of Public Health, Houston, TX 77030, USA
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19
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Say B, Dizdar EA, Degirmencioglu H, Uras N, Sari FN, Oguz S, Canpolat FE. The effect of lactational mastitis on the macronutrient content of breast milk. Early Hum Dev 2016; 98:7-9. [PMID: 27341630 DOI: 10.1016/j.earlhumdev.2016.03.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Revised: 03/15/2016] [Accepted: 03/15/2016] [Indexed: 01/12/2023]
Abstract
AIMS Mastitis in lactating mothers reduces milk production and alters the cellular composition of milk. Changes occurring in the mammary gland during the inflammatory response are believed to increase the permeability of the blood-milk barrier. This study examined the effect of mastitis during lactation on the macronutrient content of breast milk. METHODS The study was conducted at Zekai Tahir Burak Maternity Teaching Hospital. Transitional breast milk samples were obtained from term lactating mothers with or without mastitis. Milk protein, fat, carbohydrate, and energy levels were measured using a mid-infrared human milk analyzer. RESULTS The study recruited 30 term lactating mothers: 15 mothers diagnosed with mastitis and 15 healthy mothers. The characteristics of the mothers in both groups were similar. Fat, carbohydrate, and energy levels were statistically lower in the milk samples of mothers with mastitis compared with the mothers without mastitis. CONCLUSION Lactational mastitis was associated with lower breast milk fat, carbohydrate, and energy levels. The local inflammatory response induced by cytokines and increased blood-milk barrier permeability might account for the changes in the fat, carbohydrate, and energy levels of human milk.
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Affiliation(s)
- Birgul Say
- Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey.
| | - Evrim Alyamaç Dizdar
- Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey
| | - Halil Degirmencioglu
- Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey
| | - Nurdan Uras
- Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey
| | - Fatma Nur Sari
- Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey
| | - Suna Oguz
- Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey
| | - Fuat Emre Canpolat
- Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, Turkey
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Zhang L, de Waard M, Verheijen H, Boeren S, Hageman JA, van Hooijdonk T, Vervoort J, van Goudoever JB, Hettinga K. Changes over lactation in breast milk serum proteins involved in the maturation of immune and digestive system of the infant. J Proteomics 2016; 147:40-47. [PMID: 26877185 DOI: 10.1016/j.jprot.2016.02.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 02/01/2016] [Accepted: 02/10/2016] [Indexed: 12/18/2022]
Abstract
UNLABELLED To objective of this study was to better understand the biological functions of breast milk proteins in relation to the growth and development of infants over the first six months of life. Breast milk samples from four individual women collected at seven time points in the first six months after delivery were analyzed by filter aided sample preparation and dimethyl labeling combined with liquid chromatography tandem mass spectrometry. A total of 247 and 200 milk serum proteins were identified and quantified, respectively. The milk serum proteome showed a high similarity (80% overlap) on the qualitative level between women and over lactation. The quantitative changes in milk serum proteins were mainly caused by three groups of proteins, enzymes, and transport and immunity proteins. Of these 21 significantly changed proteins, 30% were transport proteins, such as serum albumin and fatty acid binding protein, which are both involved in transporting nutrients to the infant. The decrease of the enzyme bile salt-activated lipase as well as the immunity proteins immunoglobulins and lactoferrin coincide with the gradual maturation of the digestive and immune system of infants. The human milk serum proteome didn't differ qualitatively but it did quantitatively, both between mothers and as lactation advanced. The changes of the breast milk serum proteome over lactation corresponded with the development of the digestive and immune system of infants. BIOLOGICAL SIGNIFICANCE Breast milk proteins provide nutrition, but also contribute to healthy development of infants. Despite the previously reported large number of identified breast milk proteins and their changes over lactation, less is known on the changes of these proteins in individual mothers. This study is the first to determine the qualitative and quantitative changes of milk proteome over lactation between individual mothers. The results indicate that the differences in the milk proteome between individual mothers are more related to the quantitative level than qualitative level. The correlation between the changes of milk proteins and the gradual maturation of the gastrointestinal tract and immune system in infants, contributes to a better understanding of the biological functions of human milk proteins for the growth and development of infants.
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Affiliation(s)
- Lina Zhang
- Dairy Science and Technology, Food Quality and Design Group, Wageningen University, The Netherlands.
| | - Marita de Waard
- Department of Paediatrics, VU University Medical Center, Amsterdam, The Netherlands
| | - Hester Verheijen
- Department of Paediatrics, VU University Medical Center, Amsterdam, The Netherlands
| | - Sjef Boeren
- Laboratory of Biochemistry, Wageningen University, The Netherlands
| | - Jos A Hageman
- Biometris-Applied Statistics, Wageningen University, The Netherlands; Centre for BioSystems Genomics, Wageningen University, The Netherlands
| | - Toon van Hooijdonk
- Dairy Science and Technology, Food Quality and Design Group, Wageningen University, The Netherlands
| | - Jacques Vervoort
- Laboratory of Biochemistry, Wageningen University, The Netherlands
| | - Johannes B van Goudoever
- Department of Paediatrics, VU University Medical Center, Amsterdam, The Netherlands; Academic Medical Center, Emma Children's Hospital, Amsterdam, The Netherlands
| | - Kasper Hettinga
- Dairy Science and Technology, Food Quality and Design Group, Wageningen University, The Netherlands.
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Ingman WV, Glynn DJ, Hutchinson MR. Mouse models of mastitis - how physiological are they? Int Breastfeed J 2015; 10:12. [PMID: 25848399 PMCID: PMC4386103 DOI: 10.1186/s13006-015-0038-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 03/04/2015] [Indexed: 11/10/2022] Open
Abstract
Lactation mastitis is a common, but poorly understood, inflammatory breast disease that is a significant health burden. A better understanding of the aetiology of mastitis is urgently required, and will assist in the development of improved prevention and treatment strategies in both human and animal species. Studies in mice have the potential to greatly assist in identifying new drug candidates for clinical trials, and in developing a better understanding of the disease. Mouse models of mastitis involve administration of a mastitis-inducing agent to the mammary gland usually during lactation to examine the host immune response, and progression through to resolution of the disease. There are important variations in the protocols of these mouse models that critically affect the conclusions that can be drawn from the research. Some protocols involve weaning of offspring at the time of mastitis induction, and there are variations in the mastitis-inducing agent and its carrier. Induction of mammary gland involution through weaning of offspring limits the capacity to study the disease in the context of a lactating mammary gland. Administration of live bacteria in an aqueous carrier can cause sepsis, restricting the physiological relevance of the model. Mouse model research should employ appropriately designed controls and closely monitor the health of the mice. In this commentary, we discuss the advantages and study design limitations of each mouse model, and highlight the potential for further development of physiologically relevant mouse models of mastitis.
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Affiliation(s)
- Wendy V Ingman
- Discipline of Surgery, School of Medicine, The Queen Elizabeth Hospital, University of Adelaide, Woodville, Australia ; Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | - Danielle J Glynn
- Discipline of Surgery, School of Medicine, The Queen Elizabeth Hospital, University of Adelaide, Woodville, Australia ; Robinson Research Institute, University of Adelaide, Adelaide, Australia
| | - Mark R Hutchinson
- Discipline Physiology, School of Medical Sciences, University of Adelaide, Adelaide, Australia
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Broadhurst M, Beddis K, Black J, Henderson H, Nair A, Wheeler T. Effect of gestation length on the levels of five innate defence proteins in human milk. Early Hum Dev 2015; 91:7-11. [PMID: 25460250 DOI: 10.1016/j.earlhumdev.2014.11.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 11/03/2014] [Accepted: 11/06/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Human milk contains a range of host defence proteins that appear to contribute to health and wellbeing, but their variability in abundance among individuals has not been very well characterised. Milk from mothers of premature infants has altered composition, but the effect of gestation length on the host-defence properties of milk is not known. A study was therefore undertaken to determine the variability and effect of gestation length on the abundance of five host-defence proteins in milk; lactoferrin, secretory IgA, IgG, secretory component, and complement C3. METHODS Milk was obtained from 30 mothers at their second and fifth week of lactation. These were from three groups of ten mothers having had very premature (V; 28-32 weeks gestation), premature (P; 33-36 weeks) or full term deliveries (T; 37-41 weeks). The concentration of each of the five proteins was measured in each milk sample by either ELISA or quantitative western blotting. RESULTS The concentration of IgG, and complement C3 ranged 22- and 17-fold respectively between mothers, while lactoferrin, secretory IgA, and secretory component ranged 7-, 9-, and 4-fold, respectively. The V group had significantly lower concentrations of four of the five proteins, the exception being IgG. Levels of these four proteins also decreased between weeks 2 and 5 of lactation in the P and T groups. Significant correlation was found between the concentrations of the host defence proteins within individual mothers, indicating some degree of co-ordinate regulation. CONCLUSIONS Mothers vary widely in the levels of host defence proteins in milk. Very short gestation length results in decreased abundance of host-defence proteins in milk. This may have functional implications for very premature infants.
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Affiliation(s)
| | - Keryn Beddis
- AgResearch, Ruakura Research Centre, Hamilton, New Zealand
| | - Janet Black
- Neonatal Unit, Waikato Hospital, Private Bag 3200, Hamilton, New Zealand
| | | | - Arun Nair
- Neonatal Unit, Waikato Hospital, Private Bag 3200, Hamilton, New Zealand
| | - Thomas Wheeler
- AgResearch, Ruakura Research Centre, Hamilton, New Zealand.
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Kawano A, Emori Y. The relationship between maternal postpartum psychological state and breast milk secretory immunoglobulin A level. J Am Psychiatr Nurses Assoc 2015; 21:23-30. [PMID: 25589451 DOI: 10.1177/1078390314566882] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Maternal psychological state may influence the passive transfer of immune factors (e.g., immunoglobulin) via the mother's breast milk. OBJECTIVE The aim of this study was to determine whether a correlation exists between mothers' postpartum psychological state and their breast milk secretory immunoglobulin A (SIgA) levels. STUDY DESIGN Eighty-one mothers who delivered at an urban general hospital were included in our analysis. Two weeks after delivery, we measured their breast milk SIgA levels and simultaneously documented their psychological state using the Profile of Mood States (POMS), General Health Questionnaire (GHQ), and State-Trait Anxiety Inventory (STAI) scales. RESULTS Breast milk SIgA levels were negatively correlated with negative POMS states (tension-anxiety, depression-dejection, anger-hostility, fatigue, and confusion). A negative correlation was also observed between SIgA levels and GHQ mental health (r = -.625, P = .000), and a similar negative correlation was observed with STAI trait and state anxieties. However, no correlation existed between breast milk SIgA levels and the positive POMS state (vigor). CONCLUSIONS These results indicate that the maternal psychological state may affect the immune properties of breast milk.
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Affiliation(s)
- Atsuko Kawano
- Atsuko Kawano, RN, NMW, PhD, Yoko Emori, RN, NMW, PhD, University of Tsukuba, Ibaraki, Japan
| | - Yoko Emori
- Atsuko Kawano, RN, NMW, PhD, Yoko Emori, RN, NMW, PhD, University of Tsukuba, Ibaraki, Japan
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Urinary metabolomic fingerprinting after consumption of a probiotic strain in women with mastitis. Pharmacol Res 2014; 87:160-5. [DOI: 10.1016/j.phrs.2014.05.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 05/18/2014] [Accepted: 05/19/2014] [Indexed: 01/08/2023]
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Ingman WV, Glynn DJ, Hutchinson MR. Inflammatory mediators in mastitis and lactation insufficiency. J Mammary Gland Biol Neoplasia 2014; 19:161-7. [PMID: 24961655 DOI: 10.1007/s10911-014-9325-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 06/18/2014] [Indexed: 12/15/2022] Open
Abstract
Mastitis is a common inflammatory disease during lactation that causes reduced milk supply. A growing body of evidence challenges the central role of pathogenic bacteria in mastitis, with disease severity associated with markers of inflammation rather than infection. Inflammation in the mammary gland may be triggered by microbe-associated molecular patterns (MAMPs) as well as danger-associated molecular patterns (DAMPs) binding to pattern recognition receptors such as the toll-like receptors (TLRs) on the surface of mammary epithelial cells and local immune cell populations. Activation of the TLR4 signalling pathway and downstream nuclear factor kappa B (NFkB) is critical to mediating local mammary gland inflammation and systemic immune responses in mouse models of mastitis. However, activation of NFkB also induces epithelial cell apoptosis and reduced milk protein synthesis, suggesting that inflammatory mediators activated during mastitis promote partial involution. Perturbed milk flow, maternal stress and genetic predisposition are significant risk factors for mastitis, and could lead to a heightened TLR4-mediated inflammatory response, resulting in increased susceptibility and severity of mastitis disease in the context of low MAMP abundance. Therefore, heightened host inflammatory signalling may act in concert with pathogenic or commensal bacterial species to cause both the inflammation associated with mastitis and lactation insufficiency. Here, we present an alternate paradigm to the widely held notion that breast inflammation is driven principally by infectious bacterial pathogens, and suggest there may be other therapeutic strategies, apart from the currently utilised antimicrobial agents, that could be employed to prevent and treat mastitis in women.
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Affiliation(s)
- Wendy V Ingman
- Discipline of Surgery, School of Medicine, The Queen Elizabeth Hospital, University of Adelaide, Woodville, Australia
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Glynn DJ, Hutchinson MR, Ingman WV. Toll-like receptor 4 regulates lipopolysaccharide-induced inflammation and lactation insufficiency in a mouse model of mastitis. Biol Reprod 2014; 90:91. [PMID: 24671877 DOI: 10.1095/biolreprod.114.117663] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Lactation mastitis is a debilitating inflammatory breast disease in postpartum women. Disease severity is associated with markers of inflammation rather than bacterial load, suggesting that immune-signaling pathways activated in the host are important in the disease pathology. The role of the innate pattern recognition receptor toll-like receptor 4 (TLR4) in progression and resolution of mastitislike disease was investigated in a mouse model. Lipopolysaccharide in Matrigel (10 μg/10 μl) was administered into the teat canal of lactating Tlr4 null mutant and wild-type mice to induce a localized area of inflammation. Mastitis induction resulted in a marked influx of RB6-positive neutrophils and F4/80-positive macrophages, which was higher in Tlr4(-/-) mice compared to wild-type mice. Tlr4 null mutation resulted in an altered immune-signaling fingerprint following induction of mastitis, with attenuated serum cytokines, including CXCL1, CCL2, interleukin 1 beta, and tumor necrosis factor alpha compared to wild-type mice. In both genotypes, the localized area of inflammation had resolved after 7 days, and milk protein was evident. However, the mammary glands of wild-type mice exhibited reduced capacity for milk production, with decreased percent area populated with glandular epithelium and decreased abundance of nuclear phosphorylated signal transducer and activator of transcription 5 compared to Tlr4 null mice. This study demonstrates that inflammatory pathways activated in the host are critically important in mastitis disease progression and suggests that lactation insufficiency associated with mastitis may be a consequence of TLR4-mediated inflammation, rather than the bacterial infection itself.
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Affiliation(s)
- Danielle J Glynn
- School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, South Australia, Australia
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Yoshida M, Shinohara H, Sugiyama T, Kumagai M, Muto H, Kodama H. Taste of milk from inflamed breasts of breastfeeding mothers with mastitis evaluated using a taste sensor. Breastfeed Med 2014; 9:92-7. [PMID: 24350703 PMCID: PMC3934511 DOI: 10.1089/bfm.2013.0084] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND The refusal of infants to suckle from a breast that is inflamed with mastitis suggests that the taste of the milk has changed. However, the taste of milk from a breast with mastitis has never been empirically determined. The present study compares the taste of milk from breastfeeding mothers with or without mastitis and identifies specific changes in the taste of milk from mothers with mastitis. SUBJECTS AND METHODS The intensity of four basic tastes (sourness, saltiness, bitterness, and umami) of breastmilk from 24 healthy mothers at 3-5 days and at 2-3, 4-5, and 8-10 weeks postpartum and from 14 mothers with mastitis was determined objectively using a taste sensor. The intensity of each basic taste and the concentrations of main taste substances in milk were compared between the inflamed breasts and the normal breasts of control mothers or the contralateral asymptomatic breast of mothers with unilateral mastitis. RESULTS The transition from colostrum to mature milk was accompanied by changes in the taste of the milk, such as decreased saltiness and umami and increased bitterness and sourness. Umami and saltiness increased in milk from inflamed breasts. Contents of sodium, glutamate, and guanosine monophosphate increased in milk from inflamed breasts. CONCLUSIONS Tastes that were specifically associated with inflamed breasts appeared to include an increase in umami and saltiness, which might have resulted from an increased content in factors associated with umami and sodium.
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Affiliation(s)
- Michiko Yoshida
- 1 Department of Maternity Child Nursing, Akita University Graduate School of Health Sciences , Akita, Japan
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Abstract
BACKGROUND Mastitis and abscess in HIV-infected women increase the risk of breastfeeding transmission of HIV. Guidelines encourage women to stop breastfeeding on the affected breast and feed on the contralateral breast. However, impact of breast pathology on breast milk HIV dynamics is unknown. METHODS HIV RNA was quantified in 211 breast milk samples collected before, during, and after a clinical mastitis or an abscess diagnosis from 38 HIV-infected women participating in a Zambian breastfeeding study. HIV RNA quantity was compared between affected and unaffected breasts over time using generalized estimating equation models. A sample of 115 women without breast pathology was selected as a control group. RESULTS In the affected breast, breast milk HIV RNA quantity increased from the pre- to during-pathology period by log(10) 0.45 copies per milliliter [95% confidence interval (CI): 0.16 to 0.74], and after symptom resolution, HIV RNA levels were no different from prepathology levels (log10 -0.04 copies per milliliter 95% CI: -0.33 to 0.25). In the contralateral, unaffected breast, HIV RNA quantity did not significantly increase (log(10) 0.15 copies per milliliter, 95% CI: -0.41 to 0.10). Increase was more marked in women with abscess or with a greater number of mastitis symptoms. HIV RNA was not significantly different between affected and unaffected women, except at the time of diagnosis. CONCLUSIONS Breast milk HIV RNA increased modestly in the affected breast with unilateral mastitis or abscess and returned to prepathology levels with symptom resolution. Contralateral HIV RNA was not affected. Results support guidelines encouraging feeding from the contralateral breast to minimize the risk of HIV transmission associated with unilateral breast pathology.
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Maternal and infant infections stimulate a rapid leukocyte response in breastmilk. Clin Transl Immunology 2013; 2:e3. [PMID: 25505951 PMCID: PMC4232055 DOI: 10.1038/cti.2013.1] [Citation(s) in RCA: 156] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Revised: 01/24/2013] [Accepted: 03/04/2013] [Indexed: 01/22/2023] Open
Abstract
Breastmilk protects infants against infections; however, specific responses of breastmilk immune factors to different infections of either the mother or the infant are not well understood. Here, we examined the baseline range of breastmilk leukocytes and immunomodulatory biomolecules in healthy mother/infant dyads and how they are influenced by infections of the dyad. Consistent with a greater immunological need in the early postpartum period, colostrum contained considerable numbers of leukocytes (13–70% out of total cells) and high levels of immunoglobulins and lactoferrin. Within the first 1–2 weeks postpartum, leukocyte numbers decreased significantly to a low baseline level in mature breastmilk (0–2%) (P<0.001). This baseline level was maintained throughout lactation unless the mother and/or her infant became infected, when leukocyte numbers significantly increased up to 94% leukocytes out of total cells (P<0.001). Upon recovery from the infection, baseline values were restored. The strong leukocyte response to infection was accompanied by a more variable humoral immune response. Exclusive breastfeeding was associated with a greater baseline level of leukocytes in mature breastmilk. Collectively, our results suggest a strong association between the health status of the mother/infant dyad and breastmilk leukocyte levels. This could be used as a diagnostic tool for assessment of the health status of the lactating breast as well as the breastfeeding mother and infant.
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Hunt KM, Williams JE, Shafii B, Hunt MK, Behre R, Ting R, McGuire MK, McGuire MA. Mastitis is associated with increased free fatty acids, somatic cell count, and interleukin-8 concentrations in human milk. Breastfeed Med 2013; 8:105-10. [PMID: 22283504 PMCID: PMC3568962 DOI: 10.1089/bfm.2011.0141] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Research in bovine lactation has demonstrated that milk produced by a mammary gland displaying inflammation-based symptoms of mastitis has increased levels of free fatty acids (FFAs) compared with milk produced by a contralateral asymptomatic gland. However, the effects of mastitis on lipid classes in milk have not been investigated in humans. METHODS The study described here compared milk collected from the symptomatic breast of women with mastitis (n=14) with that collected from the contralateral asymptomatic breast to determine if mastitis caused alterations in the quantity of total lipids, FFAs, and phospholipids (PLs), as well as the fatty acid profiles of these lipid classes. To assess their efficacy as biomarkers of mastitis, samples were also analyzed for selected markers of local inflammation: sodium, somatic cell count (SCC), and interleukin-8 (IL-8). RESULTS FFAs were higher in milk from the mastitic breast compared with that from the healthy breast (1.31 vs. 1.07 ± 0.10 g/100 g of lipid, p<0.05). Similarly, SCC and IL-8 were elevated roughly 10-fold in milk from mastitic breasts, compared with milk from healthy breasts, and sodium tended to be higher in milk from mastitic breasts (p<0.10). However, there were no differences in total lipid, PLs, or fatty acid profiles within each lipid class. CONCLUSIONS In summary, mastitis is associated with increased lipolysis in the human breast but not alterations in milk fat synthesis, as evidenced by a lack of alteration in total milk lipids. Additionally, these results indicate that SCC and IL-8 may be better indicators of mammary inflammation than sodium content.
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Alonso-Fauste I, Andrés M, Iturralde M, Lampreave F, Gallart J, Alava MA. Proteomic characterization by 2-DE in bovine serum and whey from healthy and mastitis affected farm animals. J Proteomics 2011; 75:3015-30. [PMID: 22193514 DOI: 10.1016/j.jprot.2011.11.035] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Revised: 11/25/2011] [Accepted: 11/29/2011] [Indexed: 10/14/2022]
Abstract
Acute phase proteins (APP) have been identified in whey and sera from healthy and mastitis cows through the proteomic analysis using two-dimensional electrophoresis (2-DE) coupled with Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (MALDI-TOF MS). Although normal and mastitis serum samples show relatively similar protein composition, marked differences in expression levels and patterns can be observed. Conversely, normal and mastitis whey showed a very different composition, likely due to extravasation of blood proteins to the mammary gland. Different isoforms from the most abundant protein in milk, casein, were detected in both normal and mastitis whey. Other proteins, such as lactotransferrin, were only detected in the inflamed animal samples. Immunoglobulins showed different patterns but not increased levels in the inflamed whey. Also, many cellular proteins in mastitis cow's whey, that were absent from healthy cow's milk. They are responsible for the great change in composition between normal and mastitis whey, especially those which exert a biological function related to immune defense. Data collected in this work are of interest for gaining information about physiological changes in protein patterns in different fluids and, the correspondent modifications as result of an acute phase process in farm. This article is part of a Special Issue entitled: Proteomics: The clinical link.
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Affiliation(s)
- Idoia Alonso-Fauste
- Departamento de Bioquímica y Biología Molecular y Celular, Facultad de Ciencias, Universidad de Zaragoza, Pedro Cerbuna, 12, 50009-Zaragoza, Spain
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Betzold CM. An Update on the Recognition and Management of Lactational Breast Inflammation. J Midwifery Womens Health 2010; 52:595-605. [DOI: 10.1016/j.jmwh.2007.08.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Identifying and treating plugged ducts, mastitis, and abscess.Editor's note: AJN has revised this column to provide you with the latest evidence-based interventions to manage your patients' symptoms. If there's a topic you'd like us to address, please e-mail us and let us know.
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Letters to the Editor. Public Health Nutr 2009; 12:1588. [DOI: 10.1017/s1368980009990887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Fetherston CM, Lai CT, Hartmann PE. Recurrent blocked duct(s) in a mother with immunoglobulin A deficiency. Breastfeed Med 2008; 3:261-5. [PMID: 19086829 DOI: 10.1089/bfm.2008.0115] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract Secretory immunoglobulin A (sIgA) is the dominant immunoglobulin in human milk, and apart from the obvious contribution it makes towards the protection of the infant, sIgA may also form an important part of the defense of the mammary gland. This report involves a mother (M8) who participated in a research study investigating the relationships between symptoms and changes in the physiology of the lactating breast during mastitis. Breastmilk samples were collected on Days 14, 30, 60, and 90 postpartum, to establish the normal reference range of biochemical markers, and during periods of breast inflammation. M8 experienced seven episodes of blocked duct(s) during the first 19 weeks, five of which occurred within the 90-day reference sample collection period. On analysis, it was found there was no detectable sIgA present in her milk samples. Medical referral and further testing resulted in a diagnosis of selective IgA deficiency, of which the mother had not been previously aware. M8 showed little variation in her milk composition even when suffering with blocked duct(s), although there was an increase in the concentration of lactoferrin in both breasts at reference collection days 14-90. Lactoferrin concentration was also unusually high at Day 14 (15 g/L) in the left breast and continued to be increased in this breast until Day 60. The absence of sIgA in this mother's breastmilk may have been a contributing factor in her experiencing recurrent blocked ducts.
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Affiliation(s)
- C M Fetherston
- School of Nursing, Murdoch University, Mandurah, WA, Australia.
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Abstract
Meeting mothers' personal breast-feeding goals depends on a number of factors, including the timely resolution of any problems she encounters. Nurses are often the first providers who interact with the mother during the perinatal period and are positioned to guide mothers through the prevention and solving of breast-feeding problems. Although many problems may be "common," failure to remedy conditions that cause pain, frustration, and anxiety can lead to premature weaning and avoidance of breast-feeding subsequent children. This article describes strategies and interventions to alleviate common problems that breast-feeding mothers frequently encounter.
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Pang WW, Hartmann PE. Initiation of human lactation: secretory differentiation and secretory activation. J Mammary Gland Biol Neoplasia 2007; 12:211-21. [PMID: 18027076 DOI: 10.1007/s10911-007-9054-4] [Citation(s) in RCA: 179] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2007] [Accepted: 10/25/2007] [Indexed: 12/21/2022] Open
Abstract
Theories for the origin of milk have been recorded since the time of Ancient Greeks. In those times it was believed that milk was derived from special vessels that connected the uterus to the breasts. The "chyle theory" on the origin of milk was another prominent theory which persisted well into the nineteenth century before the realisation that milk components were derived from blood and some milk constituents were actually synthesized within the breasts. The demonstration that milk ejection was the expulsion of milk that had already been secreted and that milk secretion was a separate continuous process, set the background for the development for the current understanding of milk synthesis and secretion. Today we know that there are two stages in the initiation of lactation- secretory differentiation and secretory activation. Secretory differentiation represents the stage of pregnancy when the mammary epithelial cells differentiate into lactocytes with the capacity to synthesize unique milk constituents such as lactose. This process requires the presence of a 'lactogenic hormone complex' of the reproductive hormones, estrogen, progesterone, prolactin and some metabolic hormones. Secretory activation on the other hand, is the initiation of copious milk secretion and is associated with major changes in the concentrations of many milk constituents. The withdrawal of progesterone triggers the onset of secretory activation but prolactin, insulin and cortisol must also be present. This review describes the works of pioneers that have led to our current understanding of the biochemical and endocrinological processes involved in the initiation of human lactation.
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Affiliation(s)
- Wei Wei Pang
- School of Biomedical, Biomolecular and Chemical Sciences, M310, Faculty of Life and Physical Sciences, The University of Western Australia, 35 Stirling Highway, Crawley, 6009, WA, Australia
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Engstrom JL, Meier PP, Jegier B, Motykowski JE, Zuleger JL. Comparison of milk output from the right and left breasts during simultaneous pumping in mothers of very low birthweight infants. Breastfeed Med 2007; 2:83-91. [PMID: 17661579 DOI: 10.1089/bfm.2006.0019] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Milk output from the right and left breasts was compared in mothers who were pumping exclusively and had not yet fed their infants at breast. METHODS Thirty-five mothers of very low birthweight infants established lactation with a hospital grade, electric, dual pump, and recorded milk output separately for each breast during every pumping session from enrollment until completion of the study (mean = 19.8 days) using a standardized milk log. Milk output from each breast was also weighed during six observed milk expressions over a 2-week period during the study. RESULTS For the observed pumping sessions (n = 210), milk output was greater from the right breast in 65.7% of the sessions. For the milk log data (n = 3099 pumping sessions) milk output was greater from the right breast in 47.6% of the sessions, greater from the left breast in 28.0%, and equal from both breasts in 24.4% of the sessions. The mean difference in milk output between the right and left breasts was 6.6 mL (SD = 12.1) for the observed sessions, and 5.0 mL for the milk log data (SD = 10.9). The mean right-to-left breastmilk output ratio was 1.20 for the observed sessions and 1.17 for the milk log data. The right-to-left breastmilk ratios were not associated with time of day, day of pumping, total milk output, maternal handedness or the breast pump suction pattern. The right-to-left breast differences were associated with parity and breastfeeding experience, with primiparous women and first-time breastfeeders demonstrating the greatest differences. CONCLUSIONS These findings suggest that differences in the milk output from the right and left breasts are common, and that milk output is often greater from the right breast. The differences appear early in lactation, are not related to total milk output, and are relatively consistent throughout the day and over the first weeks of lactation.
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Affiliation(s)
- Janet L Engstrom
- Rush University College of Nursing, Armour Academic Facility, Chicago, IL 60612, USA.
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Abstract
My research into the physiology of lactation began at the University of Sydney in the early 1960s with funding from the Australian Dairy Industry. In 1972 I moved to The University of Western Australia to teach medical students and initiated a research program in human lactation. Coincidentally this was a very significant time for human lactation because 1972 was the nadir for breastfeeding in many Western countries, including Australia. In Western Australia the proportion of women choosing to breastfeed increased from <50% to the current rate of approximately 95%. Because the invasive conventional techniques used to study lactation in laboratory and domestic animals could not be applied to investigation of the regulation of milk synthesis in lactating women, it was necessary to develop new approaches to the study of mammary gland metabolism in women. These methods have included measuring breast volume using a computerized breast measurement system, measuring milk macro- and micro-components on small volumes of breast milk, bioluminescent metabolomic assays, and ultrasound analysis of breast function. Currently, my research is directed toward understanding the control of synthesis, secretion, and removal of milk in women with the aim of developing clinical protocols for the assessment of the normal and abnormal function of the lactating breast.
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Affiliation(s)
- Peter E Hartmann
- School of Biomedical, Biomolecular, and Chemical Sciences, The University of Western Australia, Crawley, Western Australia, Australia.
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