Levels of Growth Factors and IgA in the Colostrum of Women from Burundi and Italy

The primiparous IgA and IL-5 colostrum concentration based on maternal factor: corroborate the inflammation pathways to IgA colostrum synthesis

Background

Immunoglobulin A (IgA) plays a crucial role in the maturation the neonatal mucosal barrier. The accumulation of IgA antibody-secreting cells (ASCs) in the lactating mammary gland facilitates the secretion of IgA antibodies into milk, which are then passively to the suckling newborn, providing transient immune protection against gastrointestinal pathogens. Physiologically, full-term infants are unable to produce IgA, required for mucosal barrier maturation for at least 10 days after birth. Prior studies declare that interleukin 5 (IL-5) responsible to encourage of IgA-producing B cells maturation during lactating periods.

Objective

This purpose of this study was determine IgA and IL-5 colostrum concentration based on maternal factors.

Study design

Ninety primiparous with full-term pregnancy and vaginal delivery were enrolled in a cross-sectional study. Colostrum samples were collected on the first day after delivery, followed by the measurement of IgA and IL-5 concentrations using ELISA. Sociodemographic and maternal factors were recorded based on participants' self-reports using a questionnaire.

Result

The results showed that mean of colostrum IgA concentration in primiparous 24.9 ± 0.3 years old (95%CI: 24.3-25.6) was 1.51 ± 0.15µg/mL, while colostrum IL-5 concentration was 82.37 ± 20.2pg/mL. The results showed that IgA levels were not significantly correlated with age, education, occupation, weight, height, body mass index (BMI), fish consumption, or smoking habits but were significantly related to baby sex disappointment and weight gain during pregnancy (P<.05). Meanwhile, the IL-5 concentration was significantly correlated with smoking habits, baby's birth weight, and maternal age.

Conclusion

The composition of IgA and IL-5 in breast milk is strongly associated with several maternal factors including baby sex disappointment, weight gain during pregnancy, smoking habits, baby's birth weight, and maternal age. This maternal factor corroborate the recently evidence refer to inflammatory pathways involvement in colostrum IgA synthesis.

Longitudinal Correlations between Molecular Compositions of Stratum Corneum and Breast Milk Factors during Infancy: A Prospective Birth Cohort Study

Breast milk contains numerous factors that are involved in the maturation of the immune system and development of the gut microbiota in infants. These factors include transforming growth factor-β1 and 2, immunoglobin A, and lactoferrin. Breast milk factors may also affect epidermal differentiation and the stratum corneum (SC) barrier in infants, but no studies examining these associations over time during infancy have been reported. In this single-center exploratory study, we measured the molecular components of the SC using confocal Raman spectroscopy at 0, 1, 2, 6, and 12 months of age in 39 infants born at our hospital. Breast milk factor concentrations from their mothers' breast milk were determined. Correlation coefficients for the two datasets were estimated for each molecular component of the SC and breast milk factor at each age and SC depth. The results showed that breast milk factors and molecular components of the SC during infancy were partly correlated with infant age in months and SC depth, suggesting that breast milk factors influence the maturation of the SC components. These findings may improve understanding of the pathogenesis of skin diseases associated with skin barrier abnormalities.

An Exploration of Pepino (Solanum muricatum) Flavor Compounds Using Machine Learning Combined with Metabolomics and Sensory Evaluation

Flavor is one of the most important characteristics that directly determines the popularity of a food. Moreover, the flavor of fruits is determined by the interaction of multiple metabolic components. Pepino, an emerging horticultural crop, is popular for its unique melon-like flavor. We analyzed metabolomics data from three different pepino growing regions in Haidong, Wuwei, and Jiuquan and counted the status of sweetness, acidity, flavor, and overall liking ratings of pepino fruit in these three regions by sensory panels. The metabolomics and flavor ratings were also integrated and analyzed using statistical and machine learning models, which in turn predicted the sensory panel ratings of consumers based on the chemical composition of the fruit. The results showed that pepino fruit produced in the Jiuquan region received the highest ratings in sweetness, flavor intensity, and liking, and the results with the highest contribution based on sensory evaluation showed that nucleotides and derivatives, phenolic acids, amino acids and derivatives, saccharides, and alcohols were rated in sweetness (74.40%), acidity (51.57%), flavor (56.41%), and likability (33.73%) dominated. We employed 14 machine learning strategies trained on the discovery samples to accurately predict the outcome of sweetness, sourness, flavor, and liking in the replication samples. The Radial Sigma SVM model predicted with better accuracy than the other machine learning models. Then we used the machine learning models to determine which metabolites influenced both pepino flavor and consumer preference. A total of 27 metabolites most important for pepino flavor attributes to distinguish pepino originating from three regions were screened. Substances such as N-acetylhistamine, arginine, and caffeic acid can enhance pepino‘s flavor intensity, and metabolites such as glycerol 3-phosphate, aconitic acid, and sucrose all acted as important variables in explaining the liking preference. While glycolic acid and orthophosphate inhibit sweetness and enhance sourness, sucrose has the opposite effect. Machine learning can identify the types of metabolites that influence fruit flavor by linking metabolomics of fruit with sensory evaluation among consumers, which conduces breeders to incorporate fruit flavor as a trait earlier in the breeding process, making it possible to select and release fruit with more flavor.

Association between Maternal Characteristics and Immune Factors TGF-β1, TGF-β2, and IgA in Colostrum: An Exploratory Study in Japan

Colostrum is the first food for newborns and it contains various crucial immune factors. The concentrations of immune factors in breast milk may change depending on maternal characteristics such as body mass index, collection day, and age at first pregnancy. In this exploratory study, we investigated the association between TGF-β1, TGF-β2, and IgA in colostrum and rarely studied factors that affect breast milk components, including the use of labor-inducing medication, colostrum secretion, sex of newborns, breast or nipple problems, and nipple care. Breast milk samples were collected from 42 mothers and analyzed for TGF-β1, TGF-β2, and IgA. The results suggest that parity and mode of delivery may be correlated with the concentrations of immune factors in colostrum. However, we found no association between the immune factors in colostrum and the use of labor-inducing medications, colostrum secretion, sex of newborns, breast or nipple problems, and nipple care. These findings have some implications for further analysis of the effects of immune factors in breast milk on the prognosis of allergies in children.

Gestational Diabetes Mellitus Changes Human Colostrum Immune Composition

Breast milk is considered a complete food for babies. Up to 7 days postpartum, it is known as colostrum, rich in immunological compounds, responsible for providing nutrition and ensuring immune protection. However, some maternal factors, such as gestational diabetes mellitus (GDM), can change the concentration of bioactive compounds present in the colostrum and may affect the development of the newborn’s immune system. The effect of GDM on colostrum cytokine, chemokine, and growth factors is not well described. Thus, the present study evaluated whether the occurrence of GDM changes the concentration of biomarkers in the colostrum. A cross-sectional study was carried out on postpartum women who had healthy pregnancies and women who had been diagnosed with GDM. A sample of colostrum was collected for Luminex analysis. Our results showed that GDM mothers had higher secretion of cytokines and chemokines in the colostrum, with a higher concentration of IFN-g, IL-6, and IL-15, and a lower concentration of IL-1ra. Among growth factors, we identified a decreased concentration of GM-CSF in the colostrum of GDM mothers. Thus, the data obtained support the idea that the disease leads to immune alterations in the colostrum.

Lessons from neonatal β-cell epigenomic for diabetes prevention and treatment

Pancreatic β-cell expansion and functional maturation during the birth-to-weaning period plays an essential role in the adaptation of plasma insulin levels to metabolic needs. These events are driven by epigenetic programs triggered by growth factors, hormones, and nutrients. These mechanisms operating in the neonatal period can be at least in part reactivated in adult life to increase the functional β-cell mass and face conditions of increased insulin demand such as obesity or pregnancy. In this review, we will highlight the importance of studying these signaling pathways and epigenetic programs to understand the causes of different forms of diabetes and to permit the design of novel therapeutic strategies to prevent and treat this metabolic disorder affecting hundreds of millions of people worldwide.

Clinical and immunological aspects of microRNAs in neonatal sepsis

Neonatal sepsis constitutes a highly relevant public health challenge and is the most common cause of infant morbidity and mortality worldwide. Recent studies have demonstrated that during infection epigenetic changes may occur leading to reprogramming of gene expression. Post-transcriptional regulation by short non-coding RNAs (e.g., microRNAs) have recently acquired special relevance because of their role in the regulation of the pathophysiology of sepsis and their potential clinical use as biomarkers. ~22-nucleotide of microRNAs are not only involved in regulating multiple relevant cellular and molecular functions, such as immune cell function and inflammatory response, but have also been proposed as good candidates as biomarkers in sepsis. Nevertheless, establishing clinical practice guidelines based on microRNA patterns as biomarkers for diagnosis and prognosis in neonatal sepsis has yet to be achieved. Given their differential expression across tissues in neonates, the release of specific microRNAs to blood and their expression pattern can differ compared to sepsis in adult patients. Further in-depth research is necessary to fully understand the biological relevance of microRNAs and assess their potential use in clinical settings. This review provides a general overview of microRNAs, their structure, function and biogenesis before exploring their potential clinical interest as diagnostic and prognostic biomarkers of neonatal sepsis. An important part of the review is focused on immune and inflammatory aspects of selected microRNAs that may become biomarkers for clinical use and therapeutic intervention.

Oropharyngeal administration of colostrum for preventing necrotizing enterocolitis and late-onset sepsis in preterm infants with gestational age ≤ 32 weeks: a pilot single-center randomized controlled trial

Background

Oropharyngeal administration of colostrum (OAC) may provide immunoprotective and anti-inflammatory effects that potentially reduce the incidence of necrotizing enterocolitis (NEC) and late-onset sepsis and improve short-term outcomes. Our objective was to evaluate the role of OAC in the early prevention of NEC and late-onset sepsis in preterm infants with gestational age (GA) ≤ 32 weeks.

Methods

A pilot, single-center, 1:1 parallel randomized controlled trial was conducted in a 40-bed tertiary neonatal intensive care unit (NICU) in China from 1 January 2019 to 30 September 2020. Preterm infants were randomly divided into two groups with GA ≤ 32 weeks. The OAC group included preterm infants who received 0.4 ml of maternal colostrum via the oropharyngeal route every 3 h for 10 days beginning within the first 48 h after birth, and the control group included preterm infants who received normal saline instead. Data from the two groups were collected and compared.

Results

A total of 127 infants in the OAC group and 125 infants in the control group were enrolled. The incidence of NEC (Bell stage 2 or 3) and late-onset sepsis were lower in the OAC group [2.36% vs. 10.40%, relative risk (RR) 0.23 (95% confidence interval (CI) 0.07, 0.78), adjusted RR 0.23 (95% CI 0.06, 0.84); 4.72% vs. 13.60%, RR 0.35 (95% CI 0.14, 0.85), adjusted RR 0.36 (95% CI 0.14, 0.95)]. In addition, the incidence of proven sepsis and intraventricular hemorrhage (IVH) (stage 3 or 4) were lower in the OAC group [2.36% vs. 8.80%, RR 0.27 (95% CI 0.08, 0.94); 1.57% vs. 7.20%, RR 0.22 (95% CI 0.05, 0.99)], and the time to achieve full enteral feeding was shorter (23.13 ± 9.45 days vs. 28.50 ± 14.80 days). No adverse reactions were observed in either group.

Conclusions

Oropharyngeal administration of colostrum is a safe and simple NICU procedure that may yield a potential effect in decreasing the incidences of NEC, late-onset sepsis, and severe IVH and shorten the time to achieve full enteral feeding in preterm infants with GA ≤ 32 weeks.

Trial registration

Chinese Clinical Trial Registry, ChiCTR1900023697, Registered 8 June 2019, retrospectively registered.

The Breast Milk Immunoglobulinome

Breast milk components contribute to the infant’s immune development and protection, and among other immune factors, immunoglobulins (Igs) are the most studied. The presence of IgA in milk has been known for a long time; however, less information is available about the presence of other Igs such as IgM, IgG, and their subtypes (IgG1, IgG2, IgG3, and IgG4) or even IgE or IgD. The total Ig concentration and profile will change during the course of lactation; however, there is a great variability among studies due to several variables that limit establishing a clear pattern. In this context, the aim of this review was firstly to shed light on the Ig concentration in breast milk based on scientific evidence and secondly to study the main factors contributing to such variability. A search strategy provided only 75 studies with the prespecified eligibility criteria. The concentrations and proportions found have been established based on the intrinsic factors of the study—such as the sampling time and quantification technique—as well as participant-dependent factors, such as lifestyle and environment. All these factors contribute to the variability of the immunoglobulinome described in the literature and should be carefully addressed for further well-designed studies and data interpretation.

The effect of antenatal care on colostrum avoidance in pastoralists: The case of Afar, Northeast Ethiopia

Breastfeeding is sufficient for infants in the first 6 months of life and is important to maintain maternal health. Evidences revealed that neonatal mortality is higher among children who received colostrum as compared to those who are deprived of colostrum. Therefore, this study aimed to assess the factors associated with colostrum avoidance practice among pastoralists in Afar Regional State, Northeast Ethiopia. A community-based cross-sectional study was conducted on 1188 mother-child pairs in Afar Regional State in June 2016. Univariable and multivariable logistic regression analyses were carried out to identify the predictors of colostrum avoidance. Statistical significance was declared at P-value <.05. About 40% of children deprived of colostrum. Mothers aged 20 to 34 years (AOR: 1.79; 95% CI: 1.18, 2.73), not attending antenatal checkup (AOR: 1.82; 95% CI: 1.64, 2.85), receiving prelacteal feeding (AOR: 2.21; CI: 1.88, 3.93) and late initiation of breastfeeding (AOR: 2.71; 95% CI: 2.02, 3.65) were positively associated with colostrum avoidance. Nearly 4 in 10 children deprived of colostrum. Therefore, promoting antenatal care and strengthening service-based counseling on proper newborn feeding practices will be important to improve colostrum feeding.

Human Breast Milk: Bioactive Components, from Stem Cells to Health Outcomes

PURPOSE OF REVIEW

Breast milk (BM) is a peculiar fluid owing unique properties and resulting the ideal food during early neonatal period. As widely known, it can improve the outcome of both neonate and lactating mother, influencing their whole life. BM is characterized by several beneficial components; among these, a great role is played by BM own and specific microbiome, deeply investigated in many studies. Moreover, the use of metabolomics in BM analysis allowed a better characterization of its metabolic pathways that vary according to lactation stage and neonatal gestational age. The aim of this review is to describe growth factors, cytokines, immunity mediators, and stem cells (SCs) contained in BM and investigate their functions and effects on neonatal outcome, especially focusing on immuno- and neurodevelopment.

RECENT FINDINGS

We evaluated recent and updated literature on this field. The article that we analyzed to write this review have been found in MEDLINE using breast milk-derived stem cells, biofactors, growth factors, breastfeeding-related outcomes, neurodevelopment, and neonatal immunological system as keywords. Discovering and characterizing BM components could result very useful to clarify the pathophysiology of their influence on neonatal growth and even to improve artificial formulations' composition. Moreover, since SCs abilities and their involvement in the development of several diseases, they could help to discover specific targets for new therapies. It could be useful to characterize BM-derived SC markers, properties, and variations during lactation stages, to understand their potential role in therapeutic applications, since they could be noninvasively isolated from BM. More studies will help to describe more in detail the characteristics of mother-to-child communication through breastfeeding and its potential role in the next future.

Does Caesarean Section or Preterm Delivery Influence TGF-β2 Concentrations in Human Colostrum?

Human colostrum (HC) is a rich source of immune mediators that play a role in immune defences of a newly born infant. The mediators include transforming growth factor β (TGF-β) which exists in three isoforms that regulate cellular homeostasis and inflammation, can induce or suppress immune responses, limit T helper 1 cells (Th1) reactions and stimulate secretory immunoglobulin A (IgA) production. Human milk TGF-β also decreases apoptosis of intestinal cells and suppresses macrophage cytokine expression. The aim of the study was to determine the concentration of TGF-β2 in HC obtained from the mothers who delivered vaginally (VD) or by caesarean section (CS), and to compare the concentrations in HC from mothers who delivered at term (TB) or preterm (PB). In this study, 56% of preterm pregnancies were delivered via CS. The concentrations of TGF-β2 were measured in HC from 299 women who delivered in the 1st Department of Obstetrics and Gynaecology, Medical University of Warsaw: 192 (VD), 107 (CS), 251 (TB), and 48 (PB). The colostrum samples were collected within 5 days post-partum. TGF-β2 levels in HC were measured by the enzyme-linked immunosorbent assay (ELISA) test with the Quantikine ELISA Kit-Human TGF-β2 (cat.no. SB250). Statistical significance between groups was calculated by the Student t-test using StatSoft Statistica 13 software. The mean TGF-β2 concentration in patients who delivered at term or preterm were comparable. The levels of TGF-β2 in HC were higher after preterm than term being 4648 vs. 3899 ng/mL (p = 0.1244). The delivery via CS was associated with higher HC concentrations of TGF-β2. The levels of TGF-β2 were significantly higher in HC after CS than VD (7429 vs. 5240 ng/mL; p = 0.0017). The data from this study suggest: caesarean section was associated with increased levels of TGF-β2 in HC. The increased levels of TGF-β2 in HC of women who delivered prematurely require further research. Early and exclusive breast-feeding by mothers after caesarean section and premature births with colostrum containing high TGF-β2 levels may prevent the negative impact of pathogens which often colonize the gastrointestinal tract and may reduce the risk of chronic diseases in this group of patients.

Enteral Nutrition Supplemented with Transforming Growth Factor-β, Colostrum, Probiotics, and Other Nutritional Compounds in the Treatment of Patients with Inflammatory Bowel Disease

Enteral nutrition seems to play a significant role in the treatment of both adults and children with active Crohn's disease, and to a lesser degree in the treatment of patients with active ulcerative colitis. The inclusion of some special factors in the enteral nutrition formulas might increase the rate of the efficacy. Actually, enteral nutrition enriched in Transforming Growth Factor-β reduced the activity index and maintained remission in patients with Crohn's disease. In addition, a number of experimental animal studies have shown that colostrum exerts a significantly positive result. Probiotics of a special type and a certain dosage could also reduce the inflammatory process in patients with active ulcerative colitis. Therefore, the addition of these factors in an enteral nutrition formula might increase its effectiveness. Although the use of these formulas is not supported by large clinical trials, it could be argued that their administration in selected cases as an exclusive diet or in combination with the drugs used in patients with inflammatory bowel disease could benefit the patient. In this review, the authors provide an update on the role of enteral nutrition, supplemented with Transforming Growth Factor-β, colostrum, and probiotics in patients with inflammatory bowel disease.

Effects of Probiotic Supplementation on TGF-β1, TGF-β2, and IgA Levels in the Milk of Japanese Women: An Open-Label Pilot Study

Background: Dietary probiotics supplementation in lactating mothers may help prevent allergic disease in infants. However, owing to a lack of consistency in nutritional and safety outcomes associated with probiotics, this topic remains controversial.

Methods: In this open-label pilot trial conducted between April 2013 and December 2013, we evaluated the safety of probiotic supplementation with 5 × 10⁹ CFU of Lactobacillus casei LC5, 5 × 10⁹ CFU of Bifidobacterium longum BG7, and 2 × 10⁸ CFU of Bacillus coagulans SANK70258 in lactating women who exhibited allergies for 2 months (1–3 months postpartum); we also evaluated the effects of probiotic supplementation on transforming growth factor-β (TGF-β) and immunoglobulin A (IgA) levels in human milk. Participants self-selected to join the probiotic (n = 41; age [median (interquartile range [IQR]), y] 33 [27–39], body mass index [BMI] [median (IQR), kg/m²] 21.8 [19.5–22.8]) or no supplementation control group (n = 19; age [median (IQR), y] 33 [23–43], BMI [median (IQR), kg/m²) 19.6 [18.4–22.1]). Probiotics (three tablets) received were taken as daily supplements. Milk samples were collected at 1, 2, and 3 months postpartum, and TGF-β1, TGF-β2, and IgA levels were measured.

Results: No adverse effects were observed in the probiotic group, according to the self-recorded diary during the study period. Milk IgA decreased with increasing postpartum months in both groups. In contrast, TGF- β1 and β2 were not affected by lactation periods, and showed different patterns over time between the two groups. TGF-β1, TGF-β1, and IgA levels were significantly correlated at baseline (respectively p < 0.05). However, the correlation between TGF-β1 and IgA became non-significant by the end of the intervention (p = 0.063).

Conclusion: Altogether, probiotic supplementation was tolerated with respect to no dropout and 91.5% adherence. Although probiotic supplementation might affect human milk TGF-β levels, a positive effect of probiotic supplementation was not entirely supported. Future placebo-controlled studies are needed to further support the efficacy and safety of probiotic supplementation.

Clinical Trial Registration:www.umin.ac.jp/ctr/, identifier: UMIN000036059.

A Review of Bioactive Factors in Human Breastmilk: A Focus on Prematurity

Preterm birth is an increasing worldwide problem. Prematurity is the second most common cause of death in children under 5 years of age. It is associated with a higher risk of several pathologies in the perinatal period and adulthood. Maternal milk, a complex fluid with several bioactive factors, is the best option for the newborn. Its dynamic composition is influenced by diverse factors such as maternal age, lactation period, and health status. The aim of the present review is to summarize the current knowledge regarding some bioactive factors present in breastmilk, namely antioxidants, growth factors, adipokines, and cytokines, paying specific attention to prematurity. The revised literature reveals that the highest levels of these bioactive factors are found in the colostrum and they decrease along the lactation period; bioactive factors are found in higher levels in preterm as compared to full-term milk, they are lacking in formula milk, and decreased in donated milk. However, there are still some gaps and inconclusive data, and further research in this field is needed. Given the fact that many preterm mothers are unable to complete breastfeeding, new information could be important to develop infant supplements that best match preterm human milk.