Urine NMR metabolomics analysis of breastfeeding biomarkers during and after pregnancy in a large prospective cohort study

Metabolomics can provide new insights into perinatal nutrition

Perinatal nutrition is a key factor related to the Developmental Origin of Health and Disease hypothesis, which states that each and every event that happens during the periconceptional period and pregnancy can affect the health status of an individual. Metabolomics can be a very useful tool for gathering information about the effect of perinatal nutrition on both mothers and newborn infants. This non-systematic review focuses on the main metabolites detected by this technique, with regard to gestational diabetes, intrauterine growth restriction and breast milk. Conclusion. Nutrition, metabolome and microbiome interactions are gaining interest in the scientific community.

Metabolomic Insights into the Effects of Breast Milk Versus Formula Milk Feeding in Infants

PURPOSE OF REVIEW

This review summarizes the latest scientific evidence for the presence of metabolomic differences between infants fed breast milk (I-BM) and infants fed formula milk (I-FM).

RECENT FINDINGS

Across the studies included in this review, a total of 261 metabolites were analyzed, of which 151 metabolites were reported as significantly associated with infant feeding modality (BM versus FM). However, taken as a whole, the relevant literature was notable both for methodological limitations, such as small sample sizes, and heterogeneity between the studies. This may be why many associations between infant metabolite profile and feeding modality have not replicated across studies. To our knowledge, this is the first review to integrate the available literature on metabolomic differences between I-BM versus I-FM. This narrative review synthesized the data across studies and identified those metabolites which show the most robust associations with infant feeding modality. Methodological limitations of the current studies are identified, followed by recommendations for how to address these in future studies.

Measures of Secretory Activation for Research and Practice: An Integrative Review

Background: Maternal concern about inadequate milk volume commonly emerges in the first 2 weeks postpartum, a critical lactation period that includes secretory activation. This review summarizes the biology of secretory activation and evaluates the accuracy and feasibility of published measures of secretory activation. Materials and Methods: A systematic search of measures of secretory activation for mothers of healthy term and preterm infants yielded 62 abstracts. Following additional screening, 15 publications qualified for quantitative synthesis review and were evaluated with respect to accuracy (validated with another measure of secretory activation in the same mother) and feasibility (accessibility, cost, and ease of use). Results:Maternal perception of milk coming in (MP) is the most feasible measure, but its accuracy has not been established. Patterns of increase in maternal milk volume have been validated with maternal milk-borne biomarkers in breastfeeding, and breast pump-dependent mothers and normal values have been published. Accuracy of serial maternal urinary lactose concentrations has not been established for secretory activation and lacks feasibility. Maternal milk biomarkers are the accurate standard to which other measures are compared but currently lack feasibility for routine use. Conclusions: Use of secretory activation measures can personalize lactation care by matching maternal risk with appropriate diagnostics. Priorities for research and practice include validation of MP as a population-based screening tool, implementation of techniques that measure patterns of increase in milk volume for moderate risk populations, and the development of milk biomarker science for point-of-care use in the most complicated lactation scenarios.

Early Human-Milk Metabolome in Cases of Intrauterine Growth-Restricted and Macrosomic Infants

BACKGROUND

Abnormal fetal growth is associated with short-term and long-term metabolic dysregulation and susceptibility to obesity-related disorders. Maternal milk, the ideal source of infantile nutrition, protects from metabolic diseases in adulthood. By applying nuclear magnetic resonance (NMR) metabolomics, this study investigated the metabolic profile of early human milk/colostrum (EHM/C) at the extremes of fetal-growth conditions, which could affect its nutritional value.

METHODS

From 98 mothers delivering 60 appropriate-for-gestational-age (AGA), 19 large-for-gestational-age (LGA), and 19 intrauterine growth-restricted (IUGR) full-term neonates, milk samples collected on the third to fourth day post partum were examined by NMR spectroscopy. Multivariate data analysis elicited information from NMR spectra and probed to metabolic signatures of EHM/C.

RESULTS

LGA and IUGR EHM/C samples depicted increased content in lactose, citric acid, choline, phosphocholine, and N-acetylglutamine. AGA samples exhibited increased isoleucine and valine. Metabolic pathways involved were valine, leucine/isoleucine biosynthesis and degradation, glycerophospholipid metabolism, aminoacyl-transfer RNA biosynthesis, and citrate cycle. Orthogonal projections to latent structures discriminant analysis models were validated.

CONCLUSION

This holistic metabolomics study framed an increased content of certain essential nutrients in EHM/C samples following the birth of LGA and IUGR infants prone to short- and long-term metabolic disorders, thus stressing additional benefits of early breastfeeding. Assessing the metabolic profile of EHΜ/C enables evaluation of its nutrition value, adjusted to fetal growth, and introduction of appropriate dietary interventions.

Clinical insights gained through metabolomic analysis of human breast milk

Introduction: Among the OMICS technologies, that have emerged in recent years, metabolomics has allowed relevant step forwards in clinical research. Several improvements in disease diagnosis and clinical management have been permitted, even in neonatology. Among potentially evaluable biofluids, breast milk (BM) results are highly interesting, representing a fluid of conjunction between mothers newborns, describing their interaction.Areas covered: in this review, updating a previous review article, we discuss research articles and reviews on BM metabolomics and found in MEDLINE using metabolomics, breast milk, neonatal nutrition, breastfeeding, human milk composition, and preterm neonates as keywords.Expert opinion: Our research group has a profound interest in metabolomics research. In 2012, we published the first metabolomic analysis on BM samples, reporting interesting data on its composition and relevant differences with formula milk (FM), useful to improve FM composition. As confirmed by successive studies, such technology can detect the specific BM composition and its dependence on several variables, including lactation stage, gestational age, maternal or environmental conditions. Moreover, since BM contaminants or drug levels can be detected, metabolomics also results useful to determine BM safety. These are only a few practical applications of BM analysis, which will be reviewed in this paper.

Worldwide Variation in Human Milk Metabolome: Indicators of Breast Physiology and Maternal Lifestyle?

Human milk provides essential substrates for the optimal growth and development of a breastfed infant. Besides providing nutrients to the infant, human milk also contains metabolites which form an intricate system between maternal lifestyle, such as the mother's diet and the gut microbiome, and infant outcomes. This study investigates the variation of these human milk metabolites from five different countries. Human milk samples (n = 109) were collected one month postpartum from Australia, Japan, the USA, Norway, and South Africa and were analyzed by nuclear magnetic resonance. The partial least squares discriminant analysis (PLS-DA) showed separation between either maternal countries of origin or ethnicities. Variation between countries in concentration of metabolites, such as 2-oxoglutarate, creatine, and glutamine, in human milk, between countries, could provide insights into problems, such as mastitis and/or impaired functions of the mammary glands. Several important markers of milk production, such as lactose, betaine, creatine, glutamate, and glutamine, showed good correlation between each metabolite. This work highlights the importance of milk metabolites with respect to maternal lifestyle and the environment, and also provides the framework for future breastfeeding and microbiome studies in a global context.

Human Breast Milk: Exploring the Linking Ring Among Emerging Components

Maternal breast milk (BM) is a complex and unique fluid that evolution adapted to satisfy neonatal needs; in addition to classical nutrients, it contains several bioactive components. BM characteristically shows inter-individual variability, modifying its composition during different phases of lactation. BM composition, determining important consequences on neonatal gut colonization, influences both short and long-term development. Maternal milk can also shape neonatal microbiota, through its glycobiome rich in Lactobacilli spp. and Bifidobacteria spp. Therefore, neonatal nourishment during the first months of life seems the most important determinant of individual's outcomes. Our manuscript aims to provide new evidence in the characterization of BM metabolome and microbiome, and its comparison to formula milk, allowing the evaluation of each nutrient's influence on neonatal metabolism. This result very interesting since potentially offers an innovative approach to investigate the complex relationship between BM components and infant's health, also providing the chance to intervene in a sartorial way on diet composition, according to the nutritional requests. Future research, integrating metabolomics, microbiomics and stem cells knowledge, could make significant steps forward in understanding BM extraordinary properties and functions.

Urinary metabolomics of pregnant women at term: a combined GC/MS and NMR approach

BACKGROUND

Physiological changes leading to parturition are not completely understood while clinical diagnosis of labour is still retrospective. Gas chromatography mass spectrometry (GC/MS) and nuclear magnetic resonance spectroscopy (NMR) represent two of the main analytical platforms used in clinical metabolomics. Metabolomics might help us to improve our knowledge about the biochemical mechanisms underlying labour.

METHODS

Urine samples (n = 59), collected from pregnant women at term of gestation before and/or after the onset of labour, were analysed by GC/MS and NMR techniques in order to identify the metabolic profile. Both GC/MS and NMR data matrices containing the identified metabolites were analysed by multivariate statistical techniques in order to characterise the discriminant variables between labour (L) and not labour (NL) status.

RESULTS

18 potential metabolites (11 with (1)H-NMR, eight with GC-MS: glycine was relevant in both) were found discriminant in urine of women during labour. Taken together, the identified metabolites produced a composite biomarker pattern, a sort of barcode, capable of differentiating between labour and not labour conditions. Major discriminant metabolites for NMR and GC/MS analysis were: alanine, glycine, acetone, 3-hydroxybutiyric acid, 2,3,4-trihydroxybutyric acid and succinic acid, giving a urine metabolite signature on the late phase of labour.

CONCLUSIONS

The metabolomics analysis evidenced clusters of metabolites involved in labour condition able to discriminate between urine samples collected before the onset and during labour, potentially offering the promise of a robust screening test.

Allostasis and Resilience of the Human Individual Metabolic Phenotype

The urine metabotype of 12 individuals was followed over a period of 8-10 years, which provided the longest longitudinal study of metabolic phenotypes to date. More than 2000 NMR metabolic profiles were analyzed. The majority of subjects have a stable metabotype. Subjects who were exposed to important pathophysiological stressful conditions had a significant metabotype drift. When the stress conditions ceased, the original metabotypes were regained, while an irreversible stressful condition resulted in a permanent metabotype change. These results suggest that each individual occupies a well-defined region in the broad metabolic space, within which a limited degree of allostasis is permitted. The insurgence of significant stressful conditions causes a shift of the metabotype to another distinct region. The spontaneous return to the original metabolic region when the stressful conditions are removed suggests that the original metabotype has some degree of resilience. In this picture, precision medicine should aim at reinforcing the patient's metabolic resilience, that is, his or her ability to revert to his or her specific metabotype rather than to a generic healthy one.

Changes of amino acid metabolism in colon cancer HCT116 cells under different oxygen supply conditions

AIM: To identify metabolic changes of amino acids in HCT116 cells under low (5%) and normal oxygen (21%) supply conditions through metabonomic analysis, and to find new markers for early diagnosis and surgical and treatment effect monitoring, and new targets for colon cancer treatment.

METHODS: High performance liquid chromatography-mass spectrometry (UPLC-MS) was used to detect 40 kinds of amino acids in HCT116 cells under low (5%) and normal oxygen (21%) supply conditions. A total of 36 kinds of amino acids were detected.

RESULTS: Twenty different amino acids showed significant differences between HCT116 cells under low and normal oxygen supply conditions (P < 0.05), with isoleucine being the most significant.

CONCLUSION: Metabolic changes of amino acids occur in HCT116 cells under different oxygen supply conditions. The content of isoleucine in HCT116 cells is significantly higher under normal oxygen condition than under low oxygen condition.