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Jiang B, Xia Y, Zhou L, Liang X, Chen X, Chen M, Li X, Lin S, Zhang N, Zheng L, Tao M, Petocz P, Gallier S, Rowan A, Wang B. Safety and tolerance assessment of milk fat globule membrane-enriched infant formulas in healthy term Chinese infants: a randomised multicenter controlled trial. BMC Pediatr 2022; 22:465. [PMID: 35918695 PMCID: PMC9347101 DOI: 10.1186/s12887-022-03507-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 07/19/2022] [Indexed: 11/30/2022] Open
Abstract
Background Milk fat globule membrane (MFGM), natural to breast milk, is essential for neonatal development, but lacking from standard infant formulas. Objectives To evaluate the safety and tolerability of MFGM supplementation in formula for infants 0 to 12 months. Methods In a prospective, multicentre, double-blind, randomized trial, healthy term infants were randomized to a standard formula (SF, n = 104) or an MFGM-enriched formula (MF, n = 108) for 6 months and a corresponding follow-on formula until 12 months. Exclusively breast-fed infants (n = 206) were recruited as the reference group (BFR). Tolerance and safety events were recorded continuously. Anthropometric measurements were assessed at enrolment, 42 days and 4, 6, 8 and 12 months. Results Infants (n = 375) completed the study with average dropout of < 20%. Stool frequency, color, and consistency between SF and MF were not significantly different throughout, except the incidence of loose stools in MF at 6 months being lower than for SF (odds ratio 0.216, P < 0.05) and the frequency of green-colored stools at 12 months being higher in MF (CI 95%, odds ratio 8.92, P < 0.05). The BFR had a higher frequency of golden stools and lower rate of green stools (4–6 months) than the two formula-fed groups (P < 0.05). SF displayed more diarrhoea (4.8%) than MF (1%) and BFR (1%) at the 8-month visit (P < 0.05). BFR (0–1%) had significantly less (P < 0.05) lower respiratory infections than MF (4.6–6.5%) and SF (2.9–5.8%) at 6- and 8-months, respectively. Formula intake, frequency of spit-up/vomiting or poor sleep were similar between SF and MF. Growth rate (g/day) was similar at 4, 6, 8 and 12 months between the 3 groups, but growth rate for BFR was significantly higher than for SF and MF at 42 days (95% CI, P = 0.001). Conclusions MFGM-enriched formula was safe and well-tolerated in healthy term infants between 0 and 12 months, and total incidences of adverse events were similar to that for the SF group. A few differences in formula tolerance were observed, however these differences were not in any way related to poor growth.
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Affiliation(s)
- BoWen Jiang
- Maternal &, Child Health Hospital of Fuzhou, Fuzhou, 350005, China.,School of Medicine, Xiamen University, Xiamen City, 361005, China
| | - Yong Xia
- Maternal &, Child Health Hospital of Fuzhou, Fuzhou, 350005, China.,School of Medicine, Xiamen University, Xiamen City, 361005, China
| | - LiHong Zhou
- School of Medicine, Xiamen University, Xiamen City, 361005, China
| | - XiaoYing Liang
- Maternal &, Child Health Hospital of Fuzhou, Fuzhou, 350005, China
| | - XuHui Chen
- Maternal &, Child Health Hospital of Fuqing, Fuqing, 350300, China
| | | | - XiaoXia Li
- Second Hospital of Fuzhou, Fuzhou, 350007, China
| | - Shan Lin
- Maternal &, Child Health Hospital of Fuzhou, Fuzhou, 350005, China
| | - Nai Zhang
- Maternal &, Child Health Hospital of Fuzhou, Fuzhou, 350005, China
| | - Ling Zheng
- Maternal &, Child Health Hospital of Fuqing, Fuqing, 350300, China
| | - Miao Tao
- Maternal &, Child Health Hospital of Fuzhou, Fuzhou, 350005, China
| | - Peter Petocz
- Macquarie University, Sydney, NSW, 2109, Australia
| | - Sophie Gallier
- Fonterra Co-Operative Group Limited, Wellington, New Zealand
| | - Angela Rowan
- Fonterra Co-Operative Group Limited, Wellington, New Zealand
| | - Bing Wang
- School of Medicine, Xiamen University, Xiamen City, 361005, China.
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Chin PY, Dorian C, Sharkey DJ, Hutchinson MR, Rice KC, Moldenhauer LM, Robertson SA. Toll-Like Receptor-4 Antagonist (+)-Naloxone Confers Sexually Dimorphic Protection From Inflammation-Induced Fetal Programming in Mice. Endocrinology 2019; 160:2646-2662. [PMID: 31504393 PMCID: PMC6936318 DOI: 10.1210/en.2019-00493] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 08/21/2019] [Indexed: 12/21/2022]
Abstract
Inflammation elicited by infection or noninfectious insults during gestation induces proinflammatory cytokines that can shift the trajectory of development to alter offspring phenotype, promote adiposity, and increase susceptibility to metabolic disease in later life. In this study, we use mice to investigate the utility of a small molecule Toll-like receptor (TLR)4 antagonist (+)-naloxone, the nonopioid isomer of the opioid receptor antagonist (-)-naloxone, for mitigating altered fetal metabolic programming induced by a modest systemic inflammatory challenge in late gestation. In adult progeny exposed to lipopolysaccharide (LPS) challenge in utero, male but not female offspring exhibited elevated adipose tissue, reduced muscle mass, and elevated plasma leptin at 20 weeks of age. Effects were largely reversed by coadministration of (+)-naloxone following LPS. When given alone without LPS, (+)-naloxone elicited accelerated postweaning growth and elevated muscle and fat mass in adult male but not female offspring. LPS induced expression of inflammatory cytokines Il1a, Il1b, Il6, Tnf, and Il10 in fetal brain, placental, and uterine tissues, and (+)-naloxone suppressed LPS-induced cytokine expression. Fetal sex-specific regulation of cytokine expression was evident, with higher Il1a, Il1b, Il6, and Il10 induced by LPS in tissues associated with male fetuses, and greater suppression by (+)-naloxone of Il6 in females. These data demonstrate that modulating TLR4 signaling with (+)-naloxone provides protection from inflammatory diversion of fetal developmental programming in utero, associated with attenuation of gestational tissue cytokine expression in a fetal sex-specific manner. The results suggest that pharmacologic interventions targeting TLR4 warrant evaluation for attenuating developmental programming effects of fetal exposure to maternal inflammatory mediators.
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Affiliation(s)
- Peck Yin Chin
- Robinson Research Institute and Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Camilla Dorian
- Robinson Research Institute and Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - David J Sharkey
- Robinson Research Institute and Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Mark R Hutchinson
- Robinson Research Institute and Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
- Australian Research Council Centre of Excellence for Nanoscale BioPhotonics, Adelaide, South Australia, Australia
| | - Kenner C Rice
- Drug Design and Synthesis Section, National Institute on Drug Abuse and National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland
| | - Lachlan M Moldenhauer
- Robinson Research Institute and Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
| | - Sarah A Robertson
- Robinson Research Institute and Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
- Correspondence: Sarah A. Robertson, PhD, Robinson Research Institute and the Adelaide Medical School, University of Adelaide, North Terrace, Adelaide, South Australia 5005, Australia. E-mail:
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