1
|
Jandová M, Fišerová M, Paterová P, Cacková L, Měřička P, Malý J, Kacerovský M, Kovaříková E, Strohalm J, Demnerová K, Kadavá J, Sýkorová H, Hyšpler R, Čížková D, Bezrouk A, Houška M. High-Pressure Inactivation of Bacillus cereus in Human Breast Milk. Foods 2023; 12:4245. [PMID: 38231674 DOI: 10.3390/foods12234245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 01/19/2024] Open
Abstract
Although Holder pasteurization is the recommended method for processing breast milk, it does affect some of its nutritional and biological properties and is ineffective at inactivating spores. The aim of this study was to find and validate an alternative methodology for processing breast milk to increase its availability for newborn babies and reduce the financial loss associated with discarding milk that has become microbiologically positive. We prepared two series of breast milk samples inoculated with the Bacillus cereus (B. cereus) strain to verify the effectiveness of two high-pressure treatments: (1) 350 MPa/5 min/38 °C in four cycles and (2) cumulative pressure of 350 MPa/20 min/38 °C. We found that the use of pressure in cycles was statistically more effective than cumulative pressure. It reduced the number of spores by three to four orders of magnitude. We verified that the method was reproducible. The routine use of this method could lead to an increased availability of milk for newborn babies, and at the same time, reduce the amount of wasted milk. In addition, high-pressure treatment preserves the nutritional quality of milk.
Collapse
Affiliation(s)
- Miroslava Jandová
- Tissue Bank, University Hospital Hradec Králové, 500 05 Hradec Králové, Czech Republic
- Department of Histology and Embryology, Faculty of Medicine in Hradec Králové, Charles University, 500 03 Hradec Králové, Czech Republic
| | - Michaela Fišerová
- Tissue Bank, University Hospital Hradec Králové, 500 05 Hradec Králové, Czech Republic
| | - Pavla Paterová
- Department of Clinical Microbiology, University Hospital and Faculty of Medicine in Hradec Králové, Charles University, 500 05 Hradec Králové, Czech Republic
| | - Lucie Cacková
- Department of Clinical Microbiology, University Hospital and Faculty of Medicine in Hradec Králové, Charles University, 500 05 Hradec Králové, Czech Republic
| | - Pavel Měřička
- Tissue Bank, University Hospital Hradec Králové, 500 05 Hradec Králové, Czech Republic
| | - Jan Malý
- Department of Pediatrics, University Hospital Hradec Králové, 500 05 Hradec Králové, Czech Republic
| | - Marian Kacerovský
- Biomedical Research Center, University Hospital Hradec Králové, 500 05 Hradec Králové, Czech Republic
| | | | - Jan Strohalm
- Food Research Institute Prague, 102 00 Prague, Czech Republic
| | - Kateřina Demnerová
- Department of Biochemistry and Microbiology, University of Chemistry and Technology Prague, 166 28 Prague, Czech Republic
| | - Jana Kadavá
- Department of Biochemistry and Microbiology, University of Chemistry and Technology Prague, 166 28 Prague, Czech Republic
| | - Hana Sýkorová
- Department of Biochemistry and Microbiology, University of Chemistry and Technology Prague, 166 28 Prague, Czech Republic
| | - Radomír Hyšpler
- Department of Clinical Biochemistry and Diagnostics, University Hospital Hradec Králové, 500 05 Hradec Králové, Czech Republic
| | - Dana Čížková
- Department of Histology and Embryology, Faculty of Medicine in Hradec Králové, Charles University, 500 03 Hradec Králové, Czech Republic
| | - Aleš Bezrouk
- Department of Medical Biophysics, Faculty of Medicine in Hradec Králové, Charles University, 500 03 Hradec Králové, Czech Republic
| | - Milan Houška
- Food Research Institute Prague, 102 00 Prague, Czech Republic
| |
Collapse
|
2
|
Francese R, Peila C, Donalisio M, Lamberti C, Cirrincione S, Colombi N, Tonetto P, Cavallarin L, Bertino E, Moro GE, Coscia A, Lembo D. Viruses and Human Milk: Transmission or Protection? Adv Nutr 2023; 14:1389-1415. [PMID: 37604306 PMCID: PMC10721544 DOI: 10.1016/j.advnut.2023.08.007] [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: 05/06/2023] [Revised: 07/14/2023] [Accepted: 08/15/2023] [Indexed: 08/23/2023] Open
Abstract
Human milk (HM) is considered the best source of nutrition for infant growth and health. This nourishment is unique and changes constantly during lactation to adapt to the physiological needs of the developing infant. It is also recognized as a potential route of transmission of some viral pathogens although the presence of a virus in HM rarely leads to a disease in an infant. This intriguing paradox can be explained by considering the intrinsic antiviral properties of HM. In this comprehensive and schematically presented review, we have described what viruses have been detected in HM so far and what their potential transmission risk through breastfeeding is. We have provided a description of all the antiviral compounds of HM, along with an analysis of their demonstrated and hypothesized mechanisms of action. Finally, we have also analyzed the impact of HM pasteurization and storage methods on the detection and transmission of viruses, and on the antiviral compounds of HM. We have highlighted that there is currently a deep knowledge on the potential transmission of viral pathogens through breastfeeding and on the antiviral properties of HM. The current evidence suggests that, in most cases, it is unnecessarily to deprive an infant of this high-quality nourishment and that the continuation of breastfeeding is in the best interest of the infant and the mother.
Collapse
Affiliation(s)
- Rachele Francese
- Department of Clinical and Biological Sciences, Laboratory of Molecular Virology and Antiviral Research, University of Turin, Orbassano (TO), Italy
| | - Chiara Peila
- Department of Public Health and Pediatrics, Neonatal Intensive Care Unit, University of Turin, Turin, Italy
| | - Manuela Donalisio
- Department of Clinical and Biological Sciences, Laboratory of Molecular Virology and Antiviral Research, University of Turin, Orbassano (TO), Italy
| | - Cristina Lamberti
- Institute of the Science of Food Production - National Research Council, Grugliasco, TO, Italy
| | - Simona Cirrincione
- Institute of the Science of Food Production - National Research Council, Grugliasco, TO, Italy
| | - Nicoletta Colombi
- Biblioteca Federata di Medicina "Ferdinando Rossi", University of Turin, Turin, Italy
| | - Paola Tonetto
- Department of Public Health and Pediatrics, Neonatal Intensive Care Unit, University of Turin, Turin, Italy
| | - Laura Cavallarin
- Institute of the Science of Food Production - National Research Council, Grugliasco, TO, Italy
| | - Enrico Bertino
- Department of Public Health and Pediatrics, Neonatal Intensive Care Unit, University of Turin, Turin, Italy
| | - Guido E Moro
- Italian Association of Human Milk Banks (AIBLUD), Milan, Italy.
| | - Alessandra Coscia
- Department of Public Health and Pediatrics, Neonatal Intensive Care Unit, University of Turin, Turin, Italy.
| | - David Lembo
- Department of Clinical and Biological Sciences, Laboratory of Molecular Virology and Antiviral Research, University of Turin, Orbassano (TO), Italy.
| |
Collapse
|
3
|
Kothari A, Pitino MA, Unger S, Perreault V, Doyen A, Pouliot Y, McGeer AJ, Stone D, O’Connor DL. Preservation of Anti-cytomegalovirus Activity in Human Milk Following High-Pressure Processing Compared to Holder Pasteurization. Front Nutr 2022; 9:918814. [PMID: 35662924 PMCID: PMC9160983 DOI: 10.3389/fnut.2022.918814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 05/06/2022] [Indexed: 11/13/2022] Open
Abstract
Pasteurized donor human milk is recommended for hospitalized preterm infants when mother’s own milk is unavailable. Our aim was to compare the antiviral activity of human milk processed by Holder pasteurization (HoP) or high-pressure processing (HPP) against representative enveloped and non-enveloped viruses including cytomegalovirus and hepatitis A virus. Expressed milk from 20 donors collected from the Ontario Milk Bank was combined into 10 pools, each from two unique donors. Each pool was processed by HoP (62.5°C, 30 min) or HPP (500 MPa, 8 min, 4°C) and subsequently inoculated with cytomegalovirus or hepatitis A virus to achieve a final concentration of 5-log plaque-forming units/mL. Plaque reduction assays were used to quantify detectable virus after 30 min incubation (room temperature). Post hoc experiments using a 4 h incubation time were conducted if reductions were detected at 30 min. Irrespective of processing, cytomegalovirus concentrations declined in all pools after 30 min incubation (P < 0.0001). Milk processed by HoP exhibited significantly less reduction compared to raw milk (P = 0.0069). In post hoc experiments, anti-cytomegalovirus activity was maintained at 4 h, with high inter-pool variability. Hepatitis A virus concentration remained unchanged after 30 min incubation in raw and processed milk. Anti-cytomegalovirus activity in human milk is preserved following HoP and HPP, persisting up to 4 h post-inoculation; anti-hepatitis A virus activity was not observed in raw or processed milk. Further research is needed to understand how HoP or promising alternative processing methods affect the antiviral activity of donated milk, given its potential importance to recipient infants.
Collapse
Affiliation(s)
- Akash Kothari
- Translational Medicine Program, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Michael A. Pitino
- Translational Medicine Program, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Sharon Unger
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Paediatrics, Sinai Health, Toronto, ON, Canada
- Rogers Hixon Ontario Human Milk Bank, Sinai Health, Toronto, ON, Canada
| | - Véronique Perreault
- Centre de Recherche en Sciences et Technologie du Lait (STELA), Département des Sciences des Aliments et de Nutrition, Institut sur la Nutrition et les Aliments Fonctionnels, Université Laval, Quebec City, QC, Canada
| | - Alain Doyen
- Centre de Recherche en Sciences et Technologie du Lait (STELA), Département des Sciences des Aliments et de Nutrition, Institut sur la Nutrition et les Aliments Fonctionnels, Université Laval, Quebec City, QC, Canada
| | - Yves Pouliot
- Centre de Recherche en Sciences et Technologie du Lait (STELA), Département des Sciences des Aliments et de Nutrition, Institut sur la Nutrition et les Aliments Fonctionnels, Université Laval, Quebec City, QC, Canada
| | - Allison J. McGeer
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Laboratory Medicine and Pathobiology, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Microbiology, Sinai Health, Toronto, ON, Canada
| | - Debbie Stone
- Rogers Hixon Ontario Human Milk Bank, Sinai Health, Toronto, ON, Canada
| | - Deborah L. O’Connor
- Translational Medicine Program, Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Paediatrics, Sinai Health, Toronto, ON, Canada
- Rogers Hixon Ontario Human Milk Bank, Sinai Health, Toronto, ON, Canada
- *Correspondence: Deborah L. O’Connor,
| |
Collapse
|
4
|
Pitino MA, Unger S, Gill A, McGeer AJ, Doyen A, Pouliot Y, Bazinet RP, Kothari A, Mazzulli T, Stone D, O'Connor DL. High pressure processing inactivates human cytomegalovirus and hepatitis A virus while preserving macronutrients and native lactoferrin in human milk. INNOV FOOD SCI EMERG 2022. [DOI: 10.1016/j.ifset.2021.102891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
|
5
|
Medina‐Rivera M, Centeno‐Tablante E, Finkelstein JL, Rayco‐Solon P, Peña‐Rosas JP, Garcia‐Casal MN, Rogers L, Ridwan P, Martinez SS, Andrade J, Layden AJ, Chang J, Zambrano MP, Ghezzi‐Kopel K, Mehta S. Presence of Ebola virus in breast milk and risk of mother-to-child transmission: synthesis of evidence. Ann N Y Acad Sci 2021; 1488:33-43. [PMID: 33113592 PMCID: PMC8048832 DOI: 10.1111/nyas.14519] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/16/2020] [Accepted: 10/08/2020] [Indexed: 12/28/2022]
Abstract
To help inform global guidelines on infant feeding, this systematic review synthesizes evidence related to the presence of the Ebola virus (EBOV) in breast milk and its potential risk of viral transmission to the infant when breastfeeding. We relied on a comprehensive search strategy to identify studies including women with suspected, probable, or confirmed EBOV infection, intending to breastfeed or give breast milk to an infant. Our search identified 10,454 records, and after deduplication and screening, we assessed 148 full texts. We included eight studies reporting on 10 breastfeeding mothers and their children (one mother with twins), who provided breast milk samples for assessment. EBOV was detected via RT-PCR or viral culture in seven out of ten breast milk samples. Four out of the five-breastfed infants with EBOV-positive breast milk were found positive for EBOV infection, and all of these EBOV-positive infants died. Since previous reports have detected EBOV in tears, saliva, sweat, and contaminated surfaces, with the current evidence, it is not possible to conclude with certainty that breast milk was the main route of EBOV transmission.
Collapse
Affiliation(s)
| | | | | | - Pura Rayco‐Solon
- Department of Maternal, Newborn, Child and Adolescent Health and AgeingWorld Health OrganizationGenevaSwitzerland
| | | | | | - Lisa Rogers
- Department of Nutrition and Food SafetyWorld Health OrganizationGenevaSwitzerland
| | - Pratiwi Ridwan
- Division of Nutritional SciencesCornell UniversityIthacaNew York
| | - Sabrina Sales Martinez
- Department of Dietetics and Nutrition, Robert Stempel College of Public Health and Social WorkFlorida International UniversityMiamiFlorida
| | - Joyce Andrade
- Hospital de Niños Roberto Gilbert ElizaldeGuayaquilEcuador
| | | | - Juan Chang
- Hospital de Niños Roberto Gilbert ElizaldeGuayaquilEcuador
| | | | | | - Saurabh Mehta
- Division of Nutritional SciencesCornell UniversityIthacaNew York
| |
Collapse
|
6
|
McGuire MK, Seppo A, Goga A, Buonsenso D, Collado MC, Donovan SM, Müller JA, Ofman G, Monroy-Valle M, O'Connor DL, Pace RM, Van de Perre P. Best Practices for Human Milk Collection for COVID-19 Research. Breastfeed Med 2021; 16:29-38. [PMID: 33393841 PMCID: PMC7826442 DOI: 10.1089/bfm.2020.0296] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
In addition to providing life-giving nutrients and other substances to the breastfed infant, human milk can also represent a vehicle of pathogen transfer. As such, when an infectious disease outbreak, epidemic, or pandemic occurs-particularly when it is associated with a novel pathogen-the question will naturally arise as to whether the pathogen can be transmitted through breastfeeding. Until high-quality data are generated to answer this question, abandonment of breastfeeding due to uncertainty can result. The COVID-19 pandemic, which was in full swing at the time this document was written, is an excellent example of this scenario. During these times of uncertainty, it is critical for investigators conducting research to assess the possible transmission of pathogens through milk, whether by transfer through the mammary gland or contamination from respiratory droplets, skin, breast pumps, and milk containers, and/or close contact between mother and infant. To promote the most rigorous science, it is critical to outline optimal methods for milk collection, handling, storage, and analysis in these situations, and investigators should openly share their methods in published materials. Otherwise, the risks of inconsistent test results from preanalytical and analytical variation, false positives, and false negatives are unacceptably high and the ability to provide public health guidance poor. In this study, we provide "best practices" for collecting human milk samples for COVID-19 research with the intention that this will also be a useful guide for future pandemics.
Collapse
Affiliation(s)
- Michelle K McGuire
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, Idaho, USA
| | - Antti Seppo
- Division of Allergy and Immunology, Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Ameena Goga
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa.,HIV Prevention Research Unit, South African Medical Research Council, Cape Town, South Africa.,Department of Pediatrics and Child Health, University of Pretoria, Pretoria, South Africa
| | - Danilo Buonsenso
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy.,Global Health Research Institute, Università Cattolica del Sacro Cuore, Rome, Italia
| | - María Carmen Collado
- Department of Biotechnology, Institute of Agrochemistry and Food Technology-National Research Council (IATA-CSIC), Valencia, Spain
| | - Sharon M Donovan
- Department of Food Science and Human Nutrition, University of Illinois, Urbana, Illinois, USA
| | - Janis A Müller
- Institute of Molecular Virology, Ulm University Medical Center, Ulm, Germany
| | - Gaston Ofman
- College of Medicine, Section of Neonatal-Perinatal Medicine, Oklahoma City, Oklahoma, USA
| | - Michele Monroy-Valle
- Unidad de Investigación en Seguridad Alimentaria y Nutricional, Facultad de Ciencias Químicas y Farmacia Universidad de San Carlos de Guatemala, Guatemala City, Guatemala.,School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Deborah L O'Connor
- Department of Nutritional Sciences, University of Toronto and Translational Medicine Program, The Hospital for Sick Children, Toronto, Canada
| | - Ryan M Pace
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, Idaho, USA
| | - Philippe Van de Perre
- Pathogenesis and Control of Chronic Infections, INSERM, University of Montpellier, Etablissement Franc¸ais du Sang, CHU Montpellier, Montpellier, France
| |
Collapse
|
7
|
Liang C, Tian L, Liu Y, Hui N, Qiao G, Li H, Shi Z, Tang Y, Zhang D, Xie X, Zhao X. A promising antiviral candidate drug for the COVID-19 pandemic: A mini-review of remdesivir. Eur J Med Chem 2020; 201:112527. [PMID: 32563812 PMCID: PMC7834743 DOI: 10.1016/j.ejmech.2020.112527] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/14/2020] [Accepted: 06/01/2020] [Indexed: 02/08/2023]
Abstract
Remdesivir (GS-5734), a viral RNA-dependent RNA polymerase (RdRP) inhibitor that can be used to treat a variety of RNA virus infections, is expected to be an effective treatment for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. On May 1, 2020, The U.S. Food and Drug Administration (FDA) has granted Emergency Use Authorization (EUA) for remdesivir to treat COVID-19 patients. In light of the COVID-19 pandemic, this review presents comprehensive information on remdesivir, including information regarding the milestones, intellectual properties, anti-coronavirus mechanisms, preclinical research and clinical trials, and in particular, the chemical synthesis, pharmacology, toxicology, pharmacodynamics and pharmacokinetics of remdesivir. Furthermore, perspectives regarding the use of remdesivir for the treatment of COVID-19 are also discussed.
Collapse
Affiliation(s)
- Chengyuan Liang
- School of Food and Bioengineering, Shaanxi University of Science & Technology, Xi'an, 710021, PR China.
| | - Lei Tian
- School of Food and Bioengineering, Shaanxi University of Science & Technology, Xi'an, 710021, PR China
| | - Yuzhi Liu
- School of Food and Bioengineering, Shaanxi University of Science & Technology, Xi'an, 710021, PR China
| | - Nan Hui
- School of Food and Bioengineering, Shaanxi University of Science & Technology, Xi'an, 710021, PR China
| | - Guaiping Qiao
- School of Food and Bioengineering, Shaanxi University of Science & Technology, Xi'an, 710021, PR China
| | - Han Li
- School of Food and Bioengineering, Shaanxi University of Science & Technology, Xi'an, 710021, PR China
| | - Zhenfeng Shi
- Department of Urology Surgery Center, The People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi, 830002, PR China
| | - Yonghong Tang
- Xi'an Taikomed Pharmaceutical Technology Co., Ltd., Xi'an, 710077, PR China
| | - Dezhu Zhang
- Shaanxi Panlong Pharmaceutical Group Co., Ltd., Xi'an, 710025, PR China
| | - Xiaolin Xie
- Shaanxi Panlong Pharmaceutical Group Co., Ltd., Xi'an, 710025, PR China
| | - Xu Zhao
- Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, 200040, PR China.
| |
Collapse
|
8
|
Paul AA, Hoffman KL, Hagan JL, Sampath V, Petrosino JF, Pammi M. Fungal cutaneous microbiome and host determinants in preterm and term neonates. Pediatr Res 2020; 88:225-233. [PMID: 31816621 DOI: 10.1038/s41390-019-0719-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 11/22/2019] [Accepted: 11/26/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND The neonatal cutaneous mycobiome has not been characterized in preterm infants. Invasive fungal infections in preterm neonates are associated with high mortality. The immaturity of the preterm skin predisposes neonates to invasive infection by skin colonizers. We report the clinical and host determinants that influence the skin mycobiome. METHODS Skin swabs from the antecubital fossa, forehead, and gluteal region of 15 preterm and 15 term neonates were obtained during the first 5 weeks of life. The mycobiome was sequenced using the conserved pan-fungal ITS2 region. Blood samples were used to genotype immune modulating genes. Clinical metadata was collected to determine the clinical predictors of the abundance and diversity of the skin mycobiome. RESULTS The neonatal mycobiome is characterized by few taxa. Alpha diversity of the mycobiome is influenced by antibiotic exposure, the forehead body site, and the neonatal intensive care unit (NICU) environment. Beta diversity varies with mode of delivery, diet, and body site. The host determinants of the cutaneous microbiome include single-nucleotide polymorphisms in TLR4, NLRP3,CARD8, and NOD2. CONCLUSION The neonatal cutaneous mycobiome is composed of few genera and is influenced by clinical factors and host genetics, the understanding of which will inform preventive strategies against invasive fungal infections.
Collapse
Affiliation(s)
- Anshu A Paul
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Kristi L Hoffman
- Alkek Center for Microbiome and Metagenomics Research, Baylor College of Medicine, Houston, TX, USA
| | - Joseph L Hagan
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Venkatesh Sampath
- Department of Pediatrics, Section: Neonatology, Children's Mercy Hospital, University of Missouri, Kansas City, MO, USA
| | - Joseph F Petrosino
- Alkek Center for Microbiome and Metagenomics Research, Baylor College of Medicine, Houston, TX, USA
| | - Mohan Pammi
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.
| |
Collapse
|
9
|
Pitino MA, O'Connor DL, McGeer AJ, Unger S. The impact of thermal pasteurization on viral load and detectable live viruses in human milk and other matrices: a rapid review. Appl Physiol Nutr Metab 2020; 46:10-26. [PMID: 32650645 DOI: 10.1139/apnm-2020-0388] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Holder pasteurization (62.5 °C, 30 min) of human milk is thought to reduce the risk of transmitting viruses to an infant. Some viruses may be secreted into milk - others may be contaminants. The effect of thermal pasteurization on viruses in human milk has yet to be rigorously reviewed. The objective of this study is to characterize the effect of common pasteurization techniques on viruses in human milk and non-human milk matrices. Databases (MEDLINE, Embase, Web of Science) were searched from inception to April 20th, 2020, for primary research articles assessing the impact of pasteurization on viral load or detection of live virus. Reviews were excluded, as were studies lacking quantitative measurements or those assessing pasteurization as a component of a larger process. Overall, of 65 131 reports identified, 109 studies were included. Pasteurization of human milk at a minimum temperature of 56-60 °C is effective at reducing detectable live virus. In cell culture media or plasma, coronaviruses (e.g., SARS-CoV, SARS-CoV-2, MERS-CoV) are highly susceptible to heating at ≥56 °C. Although pasteurization parameters and matrices reported vary, all viruses studied, except parvoviruses, were susceptible to thermal killing. Future research important for the study of novel viruses should standardize pasteurization protocols and should test inactivation in human milk. Novelty In all matrices, including human milk, pasteurization at 62.5 °C was generally sufficient to reduce surviving viral load by several logs or to below the limit of detection. Holder pasteurization (62.5 °C, 30 min) of human milk should be sufficient to inactivate nonheat resistant viruses, including coronaviruses, if present.
Collapse
Affiliation(s)
- Michael A Pitino
- Department of Nutritional Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada.,Translational Medicine Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Deborah L O'Connor
- Department of Nutritional Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada.,Translational Medicine Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Allison J McGeer
- Department of Microbiology, Sinai Health, Toronto, ON M5G 1X5, Canada.,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A1, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
| | - Sharon Unger
- Department of Nutritional Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada.,Division of Neonatology, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada.,Department of Pediatrics, Sinai Health, Toronto, ON M5G 1X5, Canada.,Department of Pediatrics, University of Toronto, Toronto, ON M5G 1X8, Canada
| |
Collapse
|
10
|
Unger S, Christie-Holmes N, Guvenc F, Budylowski P, Mubareka S, Gray-Owen SD, O'Connor DL. Holder pasteurization of donated human milk is effective in inactivating SARS-CoV-2. CMAJ 2020; 192:E871-E874. [PMID: 32646870 DOI: 10.1503/cmaj.201309] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Provision of pasteurized donor human milk, as a bridge to mother's own milk, is the standard of care for very low-birth-weight infants in hospital. The aim of this research was to confirm that Holder pasteurization (62.5°C for 30 min) would be sufficient to inactivate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in donated human milk samples. METHODS We spiked frozen milk samples from 10 donors to the Rogers Hixon Ontario Human Milk Bank with SARS-CoV-2 to achieve a final concentration of 1 × 107 TCID50/mL (50% of the tissue culture infectivity dose per mL). We pasteurized samples using the Holder method or held them at room temperature for 30 minutes and plated serial dilutions on Vero E6 cells for 5 days. We included comparative controls in the study using milk samples from the same donors without addition of virus (pasteurized and unpasteurized) as well as replicates of Vero E6 cells directly inoculated with SARS-CoV-2. We reported cytopathic effects as TCID50/mL. RESULTS We detected no cytopathic activity in any of the SARS-CoV-2-spiked milk samples that had been pasteurized using the Holder method. In the SARS-CoV-2-spiked milk samples that were not pasteurized but were kept at room temperature for 30 minutes, we observed a reduction in infectious viral titre of about 1 log. INTERPRETATION Pasteurization of human milk by the Holder method (62.5°C for 30 min) inactivates SARS-CoV-2. Thus, in the event that donated human milk contains SARS-CoV-2 by transmission through the mammary gland or by contamination, this method of pasteurization renders milk safe for consumption and handling by care providers.
Collapse
Affiliation(s)
- Sharon Unger
- Rogers Hixon Ontario Human Milk Bank (Unger, O'Connor); Department of Paediatrics, Sinai Health (Unger); Combined Containment Level 3 Unit (Christie-Holmes, Guvenc, Budylowski, Gray-Owen), Departments of Molecular Genetics (Guvenc, Gray-Owen), Laboratory Medicine and Pathobiology (Mubareka), and Nutritional Sciences (O'Connor), and the Institute of Medical Sciences (Budylowski), University of Toronto; Sunnybrook Research Institute (Mubareka), Toronto, Ont.
| | - Natasha Christie-Holmes
- Rogers Hixon Ontario Human Milk Bank (Unger, O'Connor); Department of Paediatrics, Sinai Health (Unger); Combined Containment Level 3 Unit (Christie-Holmes, Guvenc, Budylowski, Gray-Owen), Departments of Molecular Genetics (Guvenc, Gray-Owen), Laboratory Medicine and Pathobiology (Mubareka), and Nutritional Sciences (O'Connor), and the Institute of Medical Sciences (Budylowski), University of Toronto; Sunnybrook Research Institute (Mubareka), Toronto, Ont
| | - Furkan Guvenc
- Rogers Hixon Ontario Human Milk Bank (Unger, O'Connor); Department of Paediatrics, Sinai Health (Unger); Combined Containment Level 3 Unit (Christie-Holmes, Guvenc, Budylowski, Gray-Owen), Departments of Molecular Genetics (Guvenc, Gray-Owen), Laboratory Medicine and Pathobiology (Mubareka), and Nutritional Sciences (O'Connor), and the Institute of Medical Sciences (Budylowski), University of Toronto; Sunnybrook Research Institute (Mubareka), Toronto, Ont
| | - Patrick Budylowski
- Rogers Hixon Ontario Human Milk Bank (Unger, O'Connor); Department of Paediatrics, Sinai Health (Unger); Combined Containment Level 3 Unit (Christie-Holmes, Guvenc, Budylowski, Gray-Owen), Departments of Molecular Genetics (Guvenc, Gray-Owen), Laboratory Medicine and Pathobiology (Mubareka), and Nutritional Sciences (O'Connor), and the Institute of Medical Sciences (Budylowski), University of Toronto; Sunnybrook Research Institute (Mubareka), Toronto, Ont
| | - Samira Mubareka
- Rogers Hixon Ontario Human Milk Bank (Unger, O'Connor); Department of Paediatrics, Sinai Health (Unger); Combined Containment Level 3 Unit (Christie-Holmes, Guvenc, Budylowski, Gray-Owen), Departments of Molecular Genetics (Guvenc, Gray-Owen), Laboratory Medicine and Pathobiology (Mubareka), and Nutritional Sciences (O'Connor), and the Institute of Medical Sciences (Budylowski), University of Toronto; Sunnybrook Research Institute (Mubareka), Toronto, Ont
| | - Scott D Gray-Owen
- Rogers Hixon Ontario Human Milk Bank (Unger, O'Connor); Department of Paediatrics, Sinai Health (Unger); Combined Containment Level 3 Unit (Christie-Holmes, Guvenc, Budylowski, Gray-Owen), Departments of Molecular Genetics (Guvenc, Gray-Owen), Laboratory Medicine and Pathobiology (Mubareka), and Nutritional Sciences (O'Connor), and the Institute of Medical Sciences (Budylowski), University of Toronto; Sunnybrook Research Institute (Mubareka), Toronto, Ont
| | - Deborah L O'Connor
- Rogers Hixon Ontario Human Milk Bank (Unger, O'Connor); Department of Paediatrics, Sinai Health (Unger); Combined Containment Level 3 Unit (Christie-Holmes, Guvenc, Budylowski, Gray-Owen), Departments of Molecular Genetics (Guvenc, Gray-Owen), Laboratory Medicine and Pathobiology (Mubareka), and Nutritional Sciences (O'Connor), and the Institute of Medical Sciences (Budylowski), University of Toronto; Sunnybrook Research Institute (Mubareka), Toronto, Ont
| |
Collapse
|
11
|
Kapourchali FR, Cresci GAM. Early-Life Gut Microbiome-The Importance of Maternal and Infant Factors in Its Establishment. Nutr Clin Pract 2020; 35:386-405. [PMID: 32329544 DOI: 10.1002/ncp.10490] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 03/10/2020] [Indexed: 12/17/2022] Open
Abstract
The early-life microbiome is gaining appreciation as a major influencer in human development and long-term health. Multiple factors are known to influence the initial colonization, development, and function of the neonatal gut microbiome. In addition, alterations in early-life gut microbial composition is associated with several chronic health conditions such as obesity, asthma, and allergies. In this review, we focus on both maternal and infant factors known to influence early-life gut colonization. Also reviewed is the important role of infant feeding, including evidence-based strategies for maternal and infant supplementation with the goal to protect and/or restore the infant gut microbiome.
Collapse
Affiliation(s)
| | - Gail A M Cresci
- Department of Inflammation and Immunity, Cleveland Clinic, Cleveland, Ohio, USA.,Department of Pediatric Gastroenterology, Cleveland Clinic, Cleveland, Ohio, USA.,Center for Human Nutrition, Cleveland Clinic, Cleveland, Ohio, USA
| |
Collapse
|
12
|
Wesolowska A, Sinkiewicz-Darol E, Barbarska O, Bernatowicz-Lojko U, Borszewska-Kornacka MK, van Goudoever JB. Innovative Techniques of Processing Human Milk to Preserve Key Components. Nutrients 2019; 11:E1169. [PMID: 31137691 PMCID: PMC6566440 DOI: 10.3390/nu11051169] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 05/15/2019] [Accepted: 05/20/2019] [Indexed: 12/25/2022] Open
Abstract
Human milk not only contains all nutritional elements that an infant requires, but is also the source of components whose regulatory role was confirmed by demonstrating health-related deficiencies in formula-fed children. A human milk diet is especially important for premature babies in the neonatal intensive care unit (NICU). In cases where breastfeeding is not possible and the mother's own milk is insufficient in volume, the most preferred food is pasteurized donor milk. The number of human milk banks has increased recently but their technical infrastructure is continuously developing. Heat treatment at a low temperature and long time, also known as holder pasteurization (62.5 °C, 30 min), is the most widespread method of human milk processing, whose effects on the quality of donor milk is well documented. Holder pasteurization destroys vegetative forms of bacteria and most viruses including human immunodeficiency virus (HIV) herpes and cytomegalovirus (CMV). The macronutrients remain relatively intact but various beneficial components are destroyed completely or compromised. Enzymes and immune cells are the most heat sensitive elements. The bactericidal capacity of heat-pasteurized milk is lower than that of untreated milk. The aim of the study was for a comprehensive comparison of currently tested methods of improving the preservation stage. Innovative techniques of milk processing should minimize the risk of milk-borne infections and preserve the bioactivity of this complex biological fluid better than the holder method. In the present paper, the most promising thermal pasteurization condition (72 °C-75 °C,) and a few non-thermal processes were discussed (high pressure processing, microwave irradiation). This narrative review presents an overview of methods of human milk preservation that have been explored to improve the safety and quality of donor milk.
Collapse
Affiliation(s)
- Aleksandra Wesolowska
- Laboratory of Human Milk and Lactation Research at Regional Human Milk Bank in Holy Hospital, Medical University of Warsaw, Department of Neonatology, 63A Zwirki i Wigury St., 02-091 Warsaw, Poland.
| | - Elena Sinkiewicz-Darol
- Human Milk Bank, Ludwik Rydygier' Provincial Polyclinical Hospital in Torun, Torun, 53-59 St. Jozef St., 87-100 Torun, Poland.
| | - Olga Barbarska
- Laboratory of Human Milk and Lactation Research at Regional Human Milk Bank in Holy Hospital, Medical University of Warsaw, Department of Neonatology, 63A Zwirki i Wigury St., 02-091 Warsaw, Poland.
| | - Urszula Bernatowicz-Lojko
- Human Milk Bank, Ludwik Rydygier' Provincial Polyclinical Hospital in Torun, Torun, 53-59 St. Jozef St., 87-100 Torun, Poland.
| | | | - Johannes B van Goudoever
- Department of Pediatrics, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands.
| |
Collapse
|
13
|
Moro GE, Billeaud C, Rachel B, Calvo J, Cavallarin L, Christen L, Escuder-Vieco D, Gaya A, Lembo D, Wesolowska A, Arslanoglu S, Barnett D, Bertino E, Boquien CY, Gebauer C, Grovslien A, Weaver GA, Picaud JC. Processing of Donor Human Milk: Update and Recommendations From the European Milk Bank Association (EMBA). Front Pediatr 2019; 7:49. [PMID: 30873395 PMCID: PMC6403467 DOI: 10.3389/fped.2019.00049] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 02/06/2019] [Indexed: 11/18/2022] Open
Abstract
Background: A mother's own milk (MOM) is the gold standard for the feeding and nutrition of preterm and full term infants. When MOM is not available or there is not enough, donor human milk (DHM) should be used. Milk delivered to Human Milk Banks (HMBs) should be pasteurized to inactivate viral and bacterial agents. Currently, a pasteurization process at 62.5°C for 30 min (Holder pasteurization, HoP) is recommended in all international HMBs guidelines. State of the art: It is known that HoP affects some of the nutritional and biological components of human milk. Studies have demonstrated that temperature cycle in HoP is not always controlled or calibrated. A better check of these parameters in the pasteurizers on the market today may contribute to an improvement of the quality of HM, still maintaining some of the negative effects of the heat treatment of human milk. So, food industry, and dairy industry in particular, are evaluating innovative methodologies alternative to HoP to better preserve the nutritional and biological properties of fresh human milk, while assuring at least the same microbiological safety of HoP. The most studied processing techniques include High-Temperature-Short-Time (HTST) pasteurization, High Pressure Processing (HPP), and Ultraviolet-C (UV-C) irradiation. HTST is a thermal process in which milk is forced between plates or pipes that are heated on the outside by hot water at a temperature of 72°C for 5-15 s. HPP is a non-thermal processing method that can be applied to solid and liquid foods. This technology inactivates pathogenic microorganisms by applying a high hydrostatic pressure (usually 300-800 MPa) during short-term treatments (<5-10 min). UV irradiation utilizes short-wavelength ultraviolet radiation in the UV-C region (200-280 nm), which is harmful to microorganisms. It is effective in destroying the nucleic acids in these organisms, so that their DNA is disrupted by UV radiation. Aim: The aim of this paper is to present the EMBA recommendations on processing of HM, based on the most recent results obtained with these new technologies. Conclusions: Although research on the most promising technologies that will represent an alternative to HoP (HTST, HPP, UV-C) in the future is progressing, it is now important to recognize that the consistency and quality assurance of the pasteurizers on the market today represent a fundamental component that was previously lacking in the Holder approach.
Collapse
Affiliation(s)
- Guido E. Moro
- Associazione Italiana delle Banche del Latte Umano Donato, Milan, Italy
| | - Claude Billeaud
- Neonatology Nutrition, Lactarium Bordeaux-Marmande, CIC Pédiatrique 1401 Children's Hospital, Bordeaux, France
| | - Buffin Rachel
- Lactarium Auvergne Rhone Alpes, Hospices Civils de Lyon, Lyon, France
| | - Javier Calvo
- Fundació Banc Sang i Teixits de les Illes Balears, Palma de Mallorca, Spain
| | - Laura Cavallarin
- Institute of Sciences of Food Production, National Research Council, Turin, Italy
| | | | - Diana Escuder-Vieco
- Banco Regional de Leche Materna, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Antoni Gaya
- Fundació Banc Sang i Teixits de les Illes Balears, Palma de Mallorca, Spain
| | - David Lembo
- Laboratory of Molecular Virology, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Aleksandra Wesolowska
- Department of Neonatology, Faculty of Health Science, Medical University of Warsaw, Warsaw, Poland
| | - Sertac Arslanoglu
- Division of Neonatology, Department of Pediatrics, Istanbul Medeniyet University, Istanbul, Turkey
| | - Debbie Barnett
- Greater Glasgow and Cycle Donor Milk Bank, Royal Hospital for Sick Children, Glasgow, United Kingdom
| | - Enrico Bertino
- Neonatal Unit of Turin University, City of Health and Science, Turin, Italy
| | - Clair-Yves Boquien
- PhAN, Institut National de la Recherche Agronomique, Université de Nantes, CRNH-Ouest, Nantes, France
| | - Corinna Gebauer
- Abteilung Neonatologie Klinik und Poliklinik für Kinder und Jugendliche, Leipzig, Germany
| | - Anne Grovslien
- Breast Milk Bank, Oslo University Hospital, Oslo, Norway
| | - Gillian A. Weaver
- The Milk Bank, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Jean-Charles Picaud
- Lactarium Auvergne Rhone Alpes, Hospices Civils de Lyon, Lyon, France
- CarMeN Unit, INSERM U1397, Claude Bernard University Lyon 1, Lyon, France
| |
Collapse
|
14
|
Fernández L, Ruiz L, Jara J, Orgaz B, Rodríguez JM. Strategies for the Preservation, Restoration and Modulation of the Human Milk Microbiota. Implications for Human Milk Banks and Neonatal Intensive Care Units. Front Microbiol 2018; 9:2676. [PMID: 30473683 PMCID: PMC6237971 DOI: 10.3389/fmicb.2018.02676] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 10/19/2018] [Indexed: 12/11/2022] Open
Abstract
Studies carried in the last years have revealed that human milk contains a site-specific microbiota and constitutes a source of potentially beneficial bacteria to the infant gut. Once in the infant gut, these bacteria contribute to the assembly of a physiological gut microbiota and may play several functions, contributing to infant metabolism, protection against infections, immunomodulation or neuromodulation. Many preterm neonates are fed with pasteurized donor's human milk (DHM) or formula and, therefore, are devoid of contact with human milk microbes. As a consequence, new strategies are required to allow the exposition of a higher number of preterm infants to the human milk microbiota early in life. The first strategy would be to promote and to increase the use of own mother's milk (OMM) in Neonatal Intensive Care Units (NICUs). Even small quantities of OMM can be very valuable since they would be added to DHM in order to microbiologically "customize" it. When OMM is not available, a better screening of donor women, including routine cytomegalovirus (CMV) screening of milk, may help to avoid the pasteurization of the milk provided by, at least, a relevant proportion of donors. Finally, when pasteurized DHM or formula are the only feeding option, their supplementation with probiotic bacteria isolated from human milk, such as lactic acid bacteria or bifidobacteria, may be an alternative to try to restore a human milk-like microbiota before feeding the babies. In the future, the design of human milk bacterial consortia (minimal human milk microbiotas), including well characterized strains representative of a healthy human milk microbiota, may be an attractive strategy to provide a complex mix of strains specifically tailored to this target population.
Collapse
Affiliation(s)
- Leónides Fernández
- Department of Galenic Pharmacy and Food Technology, Complutense University of Madrid, Madrid, Spain
| | - Lorena Ruiz
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias – Consejo Superior de Investigaciones Científicas, Villaviciosa, Spain
| | - Josué Jara
- Department of Galenic Pharmacy and Food Technology, Complutense University of Madrid, Madrid, Spain
| | - Belén Orgaz
- Department of Microbiology and Biochemistry of Dairy Products, Instituto de Productos Lácteos de Asturias – Consejo Superior de Investigaciones Científicas, Villaviciosa, Spain
| | - Juan M. Rodríguez
- Department of Nutrition and Food Science, Complutense University of Madrid, Madrid, Spain
| |
Collapse
|
15
|
Gayà A, Calvo J. Improving Pasteurization to Preserve the Biological Components of Donated Human Milk. Front Pediatr 2018; 6:288. [PMID: 30356694 PMCID: PMC6189300 DOI: 10.3389/fped.2018.00288] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 09/18/2018] [Indexed: 02/04/2023] Open
Abstract
Donor human milk (DHM) in human milk banks (HMB) is routinely subjected to heat treatment to ensure microbiological security, most guidelines recommending a temperature of 62. 5°C for 30 min. However, this procedure negatively impacts on milk quality, due to the destruction of biological components. Different studies have called for a more respectful treatment of DHM to preserve its properties, and have explored the use of alternative technologies. There is also clear evidence that bacterial and viral contamination in human milk can be effectively destroyed by temperatures lower than that currently recommended (62.5°C). Thus, a simple option would be to optimize the conventional pasteurization technique so the treated milk is free of infectious elements yet retains a maximum amount of biological components. An advantage of this approach is that it would be unnecessary to replace the pasteurization equipment currently available in most HMB. On the basis of a literature review, we here analyze and discuss evidence that pasteurization of human milk at a temperature below 62.5°C results in an improved preservation of its properties without compromising safety regarding the transmission of infectious agents.
Collapse
Affiliation(s)
- Antoni Gayà
- Banc de Llet Materna, Fundació Banc de Sang i Teixits de les Illes Balears, Palma de Mallorca, Spain
- Terapia Celular e Ingeniería Tisular, Institut d'Investigació Sanitària Illes Balears, Palma de Mallorca, Spain
| | - Javier Calvo
- Banc de Llet Materna, Fundació Banc de Sang i Teixits de les Illes Balears, Palma de Mallorca, Spain
- Terapia Celular e Ingeniería Tisular, Institut d'Investigació Sanitària Illes Balears, Palma de Mallorca, Spain
| |
Collapse
|
16
|
Escuder-Vieco D, Espinosa-Martos I, Rodríguez JM, Corzo N, Montilla A, Siegfried P, Pallás-Alonso CR, Fernández L. High-Temperature Short-Time Pasteurization System for Donor Milk in a Human Milk Bank Setting. Front Microbiol 2018; 9:926. [PMID: 29867837 PMCID: PMC5958646 DOI: 10.3389/fmicb.2018.00926] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 04/20/2018] [Indexed: 12/05/2022] Open
Abstract
Donor milk is the best alternative for the feeding of preterm newborns when mother's own milk is unavailable. For safety reasons, it is usually pasteurized by the Holder method (62.5°C for 30 min). Holder pasteurization results in a microbiological safe product but impairs the activity of many biologically active compounds such as immunoglobulins, enzymes, cytokines, growth factors, hormones or oxidative stress markers. High-temperature short-time (HTST) pasteurization has been proposed as an alternative for a better preservation of some of the biological components of human milk although, at present, there is no equipment available to perform this treatment under the current conditions of a human milk bank. In this work, the specific needs of a human milk bank setting were considered to design an HTST equipment for the continuous and adaptable (time-temperature combination) processing of donor milk. Microbiological quality, activity of indicator enzymes and indices for thermal damage of milk were evaluated before and after HTST treatment of 14 batches of donor milk using different temperature and time combinations and compared to the results obtained after Holder pasteurization. The HTST system has accurate and simple operation, allows the pasteurization of variable amounts of donor milk and reduces processing time and labor force. HTST processing at 72°C for, at least, 10 s efficiently destroyed all vegetative forms of microorganisms present initially in raw donor milk although sporulated Bacillus sp. survived this treatment. Alkaline phosphatase was completely destroyed after HTST processing at 72 and 75°C, but γ-glutamil transpeptidase showed higher thermoresistance. Furosine concentrations in HTST-treated donor milk were lower than after Holder pasteurization and lactulose content for HTST-treated donor milk was below the detection limit of analytical method (10 mg/L). In conclusion, processing of donor milk at 72°C for at least 10 s in this HTST system allows to achieve the microbiological safety objectives established in the milk bank while having a lower impact regarding the heat damage of the milk.
Collapse
Affiliation(s)
- Diana Escuder-Vieco
- Banco Regional de Leche Materna, Hospital Universitario 12 de Octubre, Instituto de Investigación i+12, Madrid, Spain
| | | | - Juan M Rodríguez
- Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, Madrid, Spain
| | - Nieves Corzo
- Departamento de Bioactividad y Análisis de Alimentos, Instituto de Investigación en Ciencias de la Alimentación, CIAL (CSIC-UAM), Madrid, Spain
| | - Antonia Montilla
- Departamento de Bioactividad y Análisis de Alimentos, Instituto de Investigación en Ciencias de la Alimentación, CIAL (CSIC-UAM), Madrid, Spain
| | | | - Carmen R Pallás-Alonso
- Banco Regional de Leche Materna, Hospital Universitario 12 de Octubre, Instituto de Investigación i+12, Madrid, Spain.,Servicio de Neonatología, Hospital Universitario 12 de Octubre, Instituto de Investigación i+12, Universidad Complutense de Madrid, Madrid, Spain
| | - Leónides Fernández
- Departamento de Nutrición, Bromatología y Tecnología de los Alimentos, Universidad Complutense de Madrid, Madrid, Spain
| |
Collapse
|
17
|
Olgun NS. Viral Infections in Pregnancy: A Focus on Ebola Virus. Curr Pharm Des 2018; 24:993-998. [PMID: 29384053 PMCID: PMC6419752 DOI: 10.2174/1381612824666180130121946] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Revised: 01/21/2018] [Accepted: 01/25/2018] [Indexed: 11/22/2022]
Abstract
During gestation, the immune response of the placenta to viruses and other pathogens plays an important role in determining a pregnant woman's vulnerability toward infectious diseases. Located at the maternalfetal interface, trophoblast cells serve to minimize the spread of viruses between the host and developing fetus through an intricate system of innate antiviral immune signaling. Adverse pregnancy outcomes, ranging from learning disabilities to preterm birth and fetal death, are all documented results of a viral breach in the placental barrier. Viral infections during pregnancy can also be spread through blood and vaginal secretions, and during the post-natal period, via breast milk. Thus, even in the absence of vertical transmission of viral infection to the fetus, maternal health can still be compromised and threaten the pregnancy. The most common viral DNA isolates found in gestation are adenovirus, cytomegalovirus, and enterovirus. However, with the recent pandemic of Ebola virus, and the first documented case of a neonate to survive due to experimental therapies in 2017, it is becoming increasingly apparent that the changing roles and impacts of viral infection during pregnancy needs to be better understood, while strategies to minimize adverse pregnancy outcomes need to be identified. This review focuses on the adverse impacts of viral infection during gestation, with an emphasis on Ebola virus.
Collapse
Affiliation(s)
- Nicole S. Olgun
- Centers for Disease Control and Prevention-National Institute for Occupational Safety and Health, Morgantown, West Virginia
| |
Collapse
|