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Zhang L, Zhou Q, Li S, Han J, Yang Y, Lee SK, Kakulas F, Cao Y. Safety and Feasibility of Using Cell-Enriched Human Milk in the Treatment of Early Necrotizing Enterocolitis. Breastfeed Med 2022; 17:326-330. [PMID: 34935478 DOI: 10.1089/bfm.2021.0298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Necrotizing enterocolitis (NEC) is a severe intestinal disease that often occurs in preterm infants, and there currently is a lack of specific and effective therapy. Human milk is rich in cells that may become a potential NEC treatment. Research Aim: To evaluate the safety and feasibility of cell-enriched fresh human milk treatment for premature infants with stage I NEC. Materials and Methods: Infants born at <1,500 g birth weight who developed stage I NEC were enrolled. Along with routine treatment for these infants, those in the intervention group were treated with cell-enriched fresh mother's milk (1 mL/kg) once per day for seven consecutive days. The intervention feasibility and safety were monitored and evaluated as primary outcomes. Short-term outcomes, including the duration of antibiotics, days to full enteral feeding and prognosis, were investigated as secondary outcomes. Results: Forty infants were enrolled, and 20 infants were included in each group. The demographic characteristics of the two groups of infants were comparable. All infants in the intervention group completed cell-enriched fresh mother's milk feeding for 7 days without any adverse clinical issues. The infants' vital signs were within the normal range during and after the intervention. None of the enrolled patients progressed to stage II NEC or above. The time interval from milk pumping to feeding was 3.7 ± 0.5 hours. Conclusions: Using cell-enriched fresh mother's milk to treat premature infants with stage I NEC was safe and feasible.
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Affiliation(s)
- Lan Zhang
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Qi Zhou
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Shujuan Li
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Junyan Han
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China
| | - Yi Yang
- NHC Key Laboratory of Neonatal Diseases, Fudan University, Shanghai, China.,Pediatric Research Institute, Children's Hospital of Fudan University, Shanghai, China
| | - Shoo K Lee
- Department of Pediatrics, Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Canada.,Department of Pediatrics, University of Toronto, Toronto, Canada.,Department of Obstetrics and Gynecology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Foteini Kakulas
- Pathology and Laboratory Medicine, Medical School, The University of Western Australia, Crawley, Australia
| | - Yun Cao
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, China.,NHC Key Laboratory of Neonatal Diseases, Fudan University, Shanghai, China
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Sun H, Cao Y, Han S, Cheng R, Liu L, Liu J, Xia S, Zhang J, Li Z, Cheng X, Yang C, Pan X, Li L, Ding X, Wang R, Wu M, Li X, Shi L, Xu F, Yu F, Pan J, Zhang X, Li L, Yang J, Li M, Yan C, Zhou Q, Lu J, Wei M, Wang L, Yang L, Ye XY, Unger S, Kakulas F, Lee SK. A randomized controlled trial protocol comparing the feeds of fresh versus frozen mother's own milk for preterm infants in the NICU. Trials 2020; 21:170. [PMID: 32046760 PMCID: PMC7014600 DOI: 10.1186/s13063-019-3981-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 12/09/2019] [Indexed: 12/29/2022] Open
Abstract
Background Necrotizing enterocolitis (NEC) is the leading cause of death among preterm infants born at < 30 weeks’ gestation. The incidence of NEC is reduced when infants are fed human milk. However, in many neonatal intensive care units (NICUs), it is standard practice to freeze and/or pasteurize human milk, which deactivates bioactive components that may offer additional protective benefits. Indeed, our pilot study showed that one feed of fresh mother’s own milk per day was safe, feasible, and can reduce morbidity in preterm infants. To further evaluate the benefits of fresh human milk in the NICU, a randomized controlled trial is needed. Methods Our prospective multicenter, double-blinded, randomized, controlled trial will include infants born at < 30 weeks’ gestation and admitted to one of 29 tertiary NICUs in China. Infants in the intervention (fresh human milk) group (n = 1549) will receive at least two feeds of fresh human milk (i.e., within 4 h of expression) per day from the time of enrollment until 32 weeks’ corrected age or discharge to home. Infants in the control group (n = 1549) will receive previously frozen human milk following the current standard protocols. Following informed consent, enrolled infants will be randomly allocated to the control or fresh human milk groups. The primary outcome is the composite outcome mortality or NEC ≥ stage 2 at 32 weeks’ corrected age, and the secondary outcomes are mortality, NEC ≥ stage 2, NEC needing surgery, late-onset sepsis, retinopathy of prematurity (ROP), bronchopulmonary dysplasia (BPD), weight gain, change in weight, increase in length, increase in head circumference, time to full enteral feeds, and finally, the number and type of critical incident reports, including feeding errors. Discussion Our double-blinded, randomized, controlled trial aims to examine whether fresh human milk can improve infant outcomes. The results of this study will impact both Chinese and international medical practice and feeding policy for preterm infants. In addition, data from our study will inform changes in health policy in NICUs across China, such that mothers are encouraged to enter the NICU and express fresh milk for their infants. Trial registration Chinese Clinical Trial Registry; #ChiCTR1900020577; registered January 1, 2019; http://www.chictr.org.cn/showprojen.aspx?proj=34276
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Affiliation(s)
- Huiqing Sun
- Department of Neonatology, Children's Hospital affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, 33 Longhuwaihuan Road, Zhengzhou, 450018, Henan, China
| | - Yun Cao
- Department of Neonatology, Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, 201102, Shanghai, China
| | - Shuping Han
- Department of Pediatrics, The Affiliated Obstetrics and Gynecology Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, 123 Tianfei Lane, Mochou Road, Qinhuai District, Nanjing, 210004, Jiangsu, China
| | - Rui Cheng
- Department of Neonatology, Children's Hospital of Nanjing Medical University, 72 Guangzhou Road, Gulou District, Nanjing, 210008, Jiangsu, China
| | - Ling Liu
- Department of Neonatology, Guizhou Maternity and Child Health Care Hospital, 63 Ruijin South Road, Guiyang, 530003, Guizhou, China
| | - Jiangqin Liu
- Department of Neonatology, Shanghai First Maternity and Infant Hospital, 2699 Gaoke West Road, Pudong New Area, Shanghai, 201204, China
| | - Shiwen Xia
- Department of Neonatology, The Women and Children's Health-Care Hospital of Hubei Province, 745 Wuluo Road, Jiedaokou, Hongshan District, Wuhan, 430070, Hubei, China
| | - Jiajie Zhang
- Department of Neonatology, Henan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan, China
| | - Zhankui Li
- Department of Neonatology, Northwest Women and Children Hospital, 1616 Yanxiang Road, Qujiang New District, Xian, 710061, Shanxi, China
| | - Xiuyong Cheng
- Department of Neonatology, The first affiliated hospital of Zhengzhou University Zhengzhou, 1 East Jianshe Road, Zhengzhou, 450052, Henan, China
| | - Chuanzhong Yang
- Department of Neonatology, Shenzhen Maternity and Child Healthcare Hospital, 2004 Hongjing Road, Futian District, Shenzhen, 518017, Guangdong, China
| | - Xinnian Pan
- Department of Neonatology, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China
| | - Long Li
- Department of Neonatology, Xinjiang Uiger Municipal People's Hospital, Tianchi Road, Urumqi, 830000, Xinjiang, China
| | - Xin Ding
- Department of Neonatology, Children's Hospital of Soochow University, 92 Zhongnan Street, SIP, Suzhou, 215025, Jiangsu, China
| | - Rensheng Wang
- Department of Neonatology, Xiamen Children's Hospital, 92-98 Yibin Road, Huli District, Xiamen, 361006, Fujian, China
| | - Mingyuan Wu
- Department of Neonatology, Women's Hospital School of Medicine Zhejiang University, 1 Xueshi Road, Hangzhou, 31006, Zhejiang, China
| | - Xiaoying Li
- Department of Neonatology, Qilu Children's Hospital of Shandong University, 430 Jingshi Road, Lixia District, Jinan, 250022, Shandong, China
| | - Liping Shi
- Department of Neonatology, Children's Hospital School of Medicine Zhejiang University, 3333 Binsheng Road Binjiang District, Zhejiang, 310003, Hangzhou, China
| | - Falin Xu
- Department of Neonatology, The Third Affiliated Hospital of Zhengzhou University, 7 Kangfuqian Street, Zhengzhou, 450052, Henan, China
| | - Fengqin Yu
- Department of Neonatology, Women and Children Hospital of Zhengzhou, 41 Jinshui Road, Zhengzhou, 450012, Henan, China
| | - Jiahua Pan
- Department of Neonatology, Anhui Provincial Hospital, 17 Qijiang Road, Hefei, 230001, Anhui, China
| | - Xiaolan Zhang
- Department of Neonatology, Xianmen Humanity Hospital, 3777 Xianyue Road, Xiamen, 361000, China
| | - Li Li
- Department of Neonatology, Children's Hospital of Capital Institute of Pediatrics, 2 Yabao Road, Chaoyang District, Beijing, 100020, China
| | - Jie Yang
- Department of Neonatology, Guangdong Women and Children Hospital, Guangzhou Medical University, 521-523, Xing Nan Road, Panyu, Guangzhou, 510000, China
| | - Mingxia Li
- Department of Neonatology, First Affiliated Hospital of Xinjiang Medical University, 137 Road, Urumqi, 830054, Xinjiang, China
| | - Changhong Yan
- Department of Neonatology, Jiangxi Children's Hospital, 122 Yangming Road, Nanchang, Jiangxi, China
| | - Qi Zhou
- Department of Neonatology, Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, 201102, Shanghai, China
| | - Jiao Lu
- Department of Neonatology, Shanghai General Hospital and Shanghai Jiaotong University, University 650, New Songjiang Road, Song Jiang, Shanghai, 201600, China
| | - Mou Wei
- Department of Neonatology, Guangzhou Women and Children's Medical Center, 9 Jinsui Road, Tianhe District, Guangzhou, 510623, Guangdong, China
| | - Laishuan Wang
- Department of Neonatology, Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, 201102, Shanghai, China
| | - Ling Yang
- Department of Neonatology, Children's Hospital of Hainan Province, 75 South Longkun Road, Haikou, 570206, Hainan Province, China
| | - Xiang Y Ye
- Maternal-Infant Care Research Centre, Mount Sinai Hospital, 700 University Avenue Rm 8-500, Toronto, ON, M5G 1X6, Canada
| | - Sharon Unger
- Maternal-Infant Care Research Centre, Mount Sinai Hospital, 700 University Avenue Rm 8-500, Toronto, ON, M5G 1X6, Canada.,Department of Paediatrics, Sinai Health System, 600 University Avenue, Room 19-2310, Toronto, Ontario, M5G 1X5, Canada
| | - Foteini Kakulas
- Medical School, Faculty of Health and Medical Sciences, The University of Western Australia (M570), School of Medicine and Pharmacology, 35 Stirling Highway, 6009 Perth, Crawley, Western Australia, Australia
| | - Shoo K Lee
- Maternal-Infant Care Research Centre, Mount Sinai Hospital, 700 University Avenue Rm 8-500, Toronto, ON, M5G 1X6, Canada. .,Department of Paediatrics, Sinai Health System, 600 University Avenue, Room 19-2310, Toronto, Ontario, M5G 1X5, Canada. .,Departments of Pediatrics, Obstetrics & Gynecology, and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
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3
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Sun H, Han S, Cheng R, Hei M, Kakulas F, Lee SK. Testing the feasibility and safety of feeding preterm infants fresh mother's own milk in the NICU: A pilot study. Sci Rep 2019; 9:941. [PMID: 30700726 PMCID: PMC6353969 DOI: 10.1038/s41598-018-37111-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 12/04/2018] [Indexed: 12/22/2022] Open
Abstract
Necrotizing enterocolitis (NEC) is the leading cause of death among infants born at <30 weeks’ gestation, but donor human milk can reduce the incidence of NEC. Unfortunately, freezing or pasteurizing human milk deactivates beneficial bioactive components. We evaluated the feasibility, safety, and impact of feeding very preterm infants fresh (unprocessed) mother’s own milk within 4 hours of expression. In our multicentre prospective cohort analytic study, we fed 109 control and 98 intervention infants previously frozen donor or mother’s own milk; only the intervention group was fed fresh mother’s own milk once daily from enrollment until 32 weeks’ corrected age. Control group mothers could not commit to provide fresh milk daily and were less likely receive antenatal corticosteroids than mothers in the intervention group. In the intervention group, 87.5% (98/112) of mothers were able to provide at least one feed of fresh milk a day. No critical incidents or non-compliance with the protocol were reported. The duration of mechanical ventilation and total parenteral nutrition use were shorter in the intervention group than controls (P < 0.01) but the length of hospital stay was similar (P = 0.57). Although the study might be underpowered, the intervention group had lower unadjusted rates of the composite outcome NEC ≥ stage 2 or mortality (8% vs 20%, P = 0.04), sepsis (22% vs 38%, P = 0.02), retinopathy of prematurity (17% vs 39%, P < 0.01) and bronchopulmonary dysplasia (32% vs 47%, P < 0.01) than the control. These results indicated that feeding fresh mother’s own milk once daily was safe, feasible, and may reduce morbidity.
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Affiliation(s)
- Huiqing Sun
- Department of Neonatology, Children's Hospital of Zhengzhou University, Zhengzhou, China.,Department of Neonatology, Henan Children's Hospital, Zhengzhou, China.,Department of Neonatology, Zhengzhou Children's Hospital, Zhengzhou, China
| | - Shuping Han
- Department of Pediatrics, The Affiliated Obstetrics and Gynecology Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Rui Cheng
- Department of Neonatology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Mingyan Hei
- Department of Pediatrics, The Third Xiangya Hospital of Central South University, Changsha, China.,Neonatal Center, Beijing Children's Hospital, Capital Medical University, Beijing, China
| | - Foteini Kakulas
- Medical School, Faculty of Health and Medical Sciences, The University of Western Australia, Crawley, Western Australia, Australia
| | - Shoo K Lee
- Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada. .,Department of Paediatrics, Department of Obstetrics & Gynecology, and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. .,Department of Paediatrics, Sinai Health System, Toronto, Ontario, Canada.
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4
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Kugananthan S, Gridneva Z, Lai CT, Hepworth AR, Mark PJ, Kakulas F, Geddes DT. Associations between Maternal Body Composition and Appetite Hormones and Macronutrients in Human Milk. Nutrients 2017; 9:E252. [PMID: 28282925 PMCID: PMC5372915 DOI: 10.3390/nu9030252] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 02/18/2017] [Accepted: 03/07/2017] [Indexed: 12/18/2022] Open
Abstract
Human milk (HM) appetite hormones and macronutrients may mediate satiety in breastfed infants. This study investigated associations between maternal adiposity and concentrations of HM leptin, adiponectin, protein and lactose, and whether these concentrations and the relationship between body mass index and percentage fat mass (%FM) in a breastfeeding population change over the first year of lactation. Lactating women (n = 59) provided milk samples (n = 283) at the 2nd, 5th, 9th and/or 12th month of lactation. Concentrations of leptin, adiponectin, total protein and lactose were measured. Maternal %FM was measured using bioimpedance spectroscopy. Higher maternal %FM was associated with higher leptin concentrations in both whole (0.006 ± 0.002 ng/mL, p = 0.008) and skim HM (0.005 ± 0.002 ng/mL, p = 0.007), and protein (0.16 ± 0.07 g/L, p = 0.028) concentrations. Adiponectin and lactose concentrations were not associated with %FM (0.01 ± 0.06 ng/mL, p = 0.81; 0.08 ± 0.11 g/L, p = 0.48, respectively). Whole milk concentrations of adiponectin and leptin did not differ significantly over the first year of lactation. These findings suggest that the level of maternal adiposity during lactation may influence the early appetite programming of breastfed infants by modulating concentrations of HM components.
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Affiliation(s)
- Sambavi Kugananthan
- School of Human Sciences, The University of Western Australia, Crawley WA 6009, Australia.
- School of Molecular Sciences, The University of Western Australia, Crawley WA 6009, Australia.
| | - Zoya Gridneva
- School of Molecular Sciences, The University of Western Australia, Crawley WA 6009, Australia.
| | - Ching T Lai
- School of Molecular Sciences, The University of Western Australia, Crawley WA 6009, Australia.
| | - Anna R Hepworth
- School of Molecular Sciences, The University of Western Australia, Crawley WA 6009, Australia.
| | - Peter J Mark
- School of Human Sciences, The University of Western Australia, Crawley WA 6009, Australia.
| | - Foteini Kakulas
- School of Molecular Sciences, The University of Western Australia, Crawley WA 6009, Australia.
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley WA 6009, Australia.
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5
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Melnik BC, Kakulas F, Geddes DT, Hartmann PE, John SM, Carrera-Bastos P, Cordain L, Schmitz G. Milk miRNAs: simple nutrients or systemic functional regulators? Nutr Metab (Lond) 2016; 13:42. [PMID: 27330539 PMCID: PMC4915038 DOI: 10.1186/s12986-016-0101-2] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 06/15/2016] [Indexed: 11/10/2022] Open
Abstract
Milk is rich in miRNAs that appear to play important roles in the postnatal development of all mammals. Currently, two competing hypotheses exist: the functional hypothesis, which proposes that milk miRNAs are transferred to the offspring and exert physiological regulatory functions, and the nutritional hypothesis, which suggests that these molecules do not reach the systemic circulation of the milk recipient, but merely provide nutrition without conferring active regulatory signals to the offspring. The functional hypothesis is based on indirect evidence and requires further investigation. The nutritional hypothesis is primarily based on three mouse models, which are inherently problematic: 1) miRNA-375 KO mice, 2) miRNA-200c/141 KO mice, and 3) transgenic mice presenting high levels of miRNA-30b in milk. This article presents circumstantial evidence that these mouse models may all be inappropriate to study the physiological traffic of milk miRNAs to the newborn mammal, and calls for new studies using more relevant mouse models or human milk to address the fate and role of milk miRNAs in the offspring and the adult consumer of cow's milk.
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Affiliation(s)
- Bodo C Melnik
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany
| | - Foteini Kakulas
- School of Chemistry and Biochemistry, Faculty of Science, The University of Western Australia, Crawley, Australia
| | - Donna T Geddes
- School of Chemistry and Biochemistry, Faculty of Science, The University of Western Australia, Crawley, Australia
| | - Peter E Hartmann
- School of Chemistry and Biochemistry, Faculty of Science, The University of Western Australia, Crawley, Australia
| | - Swen Malte John
- Department of Dermatology, Environmental Medicine and Health Theory, University of Osnabrück, Osnabrück, Germany
| | | | - Loren Cordain
- Department of Health and Exercise Science, Colorado State University, Fort Collins, USA
| | - Gerd Schmitz
- Institute of Clinical Chemistry and Laboratory Medicine, University Clinics of Regensburg, Regensburg, Germany
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6
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Alsaweed M, Lai CT, Hartmann PE, Geddes DT, Kakulas F. Human Milk Cells and Lipids Conserve Numerous Known and Novel miRNAs, Some of Which Are Differentially Expressed during Lactation. PLoS One 2016; 11:e0152610. [PMID: 27074017 PMCID: PMC4830559 DOI: 10.1371/journal.pone.0152610] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 03/16/2016] [Indexed: 12/21/2022] Open
Abstract
Human milk (HM) is rich in miRNAs, which are thought to contribute to infant protection and development. We used deep sequencing to profile miRNAs in the cell and lipid fractions of HM obtained post-feeding from 10 lactating women in months 2, 4, and 6 postpartum. In both HM fractions, 1,195 mature known miRNAs were identified, which were positively associated with the cell (p = 0.048) and lipid (p = 0.010) content of HM. An additional 5,167 novel miRNA species were predicted, of which 235 were high-confidence miRNAs. HM cells contained more known miRNAs than HM lipids (1,136 and 835 respectively, p<0.001). Although the profile of the novel miRNAs was very different between cells and lipids, with the majority conserved in the cell fraction and being mother-specific, 2/3 of the known miRNAs common between cells and lipids were similarly expressed (p>0.05). Great similarities between the two HM fractions were also found in the profile of the top 20 known miRNAs. These were largely similar also between the three lactation stages examined, as were the total miRNA concentration, and the number and expression of the known miRNAs common between cells and lipids (p>0.05). Yet, approximately a third of all known miRNAs were differentially expressed during the first 6 months of lactation (p<0.05), with more pronounced miRNA upregulation seen in month 4. These findings indicate that although the total miRNA concentration of HM cells and lipids provided to the infant does not change in first 6 months of lactation, the miRNA composition is altered, particularly in month 4 compared to months 2 and 6. This may reflect the remodeling of the gland in response to infant feeding patterns, which usually change after exclusive breastfeeding, suggesting adaptation to the infant’s needs.
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Affiliation(s)
- Mohammed Alsaweed
- School of Chemistry and Biochemistry, The University of Western Australia, Crawley, Western Australia, Australia
- College of Applied Medical Sciences, Majmaah University, Almajmaah, Riyadh, Saudi Arabia
| | - Ching Tat Lai
- School of Chemistry and Biochemistry, The University of Western Australia, Crawley, Western Australia, Australia
| | - Peter E. Hartmann
- School of Chemistry and Biochemistry, The University of Western Australia, Crawley, Western Australia, Australia
| | - Donna T. Geddes
- School of Chemistry and Biochemistry, The University of Western Australia, Crawley, Western Australia, Australia
| | - Foteini Kakulas
- School of Chemistry and Biochemistry, The University of Western Australia, Crawley, Western Australia, Australia
- * E-mail:
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7
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Affiliation(s)
- Foteini Kakulas
- Faculty of Science, School of Chemistry and Biochemistry, University of Western Australia , Crawley, Australia
| | - Donna T Geddes
- Faculty of Science, School of Chemistry and Biochemistry, University of Western Australia , Crawley, Australia
| | - Peter E Hartmann
- Faculty of Science, School of Chemistry and Biochemistry, University of Western Australia , Crawley, Australia
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8
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Alsaweed M, Lai CT, Hartmann PE, Geddes DT, Kakulas F. Human milk miRNAs primarily originate from the mammary gland resulting in unique miRNA profiles of fractionated milk. Sci Rep 2016; 6:20680. [PMID: 26854194 PMCID: PMC4745068 DOI: 10.1038/srep20680] [Citation(s) in RCA: 116] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 01/11/2016] [Indexed: 12/11/2022] Open
Abstract
Human milk (HM) contains regulatory biomolecules including miRNAs, the origin and functional significance of which are still undetermined. We used TaqMan OpenArrays to profile 681 mature miRNAs in HM cells and fat, and compared them with maternal peripheral blood mononuclear cells (PBMCs) and plasma, and bovine and soy infant formulae. HM cells and PBMCs (292 and 345 miRNAs, respectively) had higher miRNA content than HM fat and plasma (242 and 219 miRNAs, respectively) (p < 0.05). A strong association in miRNA profiles was found between HM cells and fat, whilst PBMCs and plasma were distinctly different to HM, displaying marked inter-individual variation. Considering the dominance of epithelial cells in mature milk of healthy women, these results suggest that HM miRNAs primarily originate from the mammary epithelium, whilst the maternal circulation may have a smaller contribution. Our findings demonstrate that unlike infant formulae, which contained very few human miRNA, HM is a rich source of lactation-specific miRNA, which could be used as biomarkers of the performance and health status of the lactating mammary gland. Given the recently identified stability, uptake and functionality of food- and milk-derived miRNA in vivo, HM miRNA are likely to contribute to infant protection and development.
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Affiliation(s)
- Mohammed Alsaweed
- School of Chemistry and Biochemistry, The University of Western Australia, Crawley, Western Australia, Australia.,College of Applied Medical Sciences, Majmaah University, Almajmaah, Riyadh, Saudi Arabia
| | - Ching Tat Lai
- School of Chemistry and Biochemistry, The University of Western Australia, Crawley, Western Australia, Australia
| | - Peter E Hartmann
- School of Chemistry and Biochemistry, The University of Western Australia, Crawley, Western Australia, Australia
| | - Donna T Geddes
- School of Chemistry and Biochemistry, The University of Western Australia, Crawley, Western Australia, Australia
| | - Foteini Kakulas
- School of Chemistry and Biochemistry, The University of Western Australia, Crawley, Western Australia, Australia
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9
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Agarwal V, Toshniwal P, Smith NE, Smith NM, Li B, Clemons TD, Byrne LT, Kakulas F, Wood FM, Fear M, Corry B, Swaminathan Iyer K. Enhancing the efficacy of cation-independent mannose 6-phosphate receptor inhibitors by intracellular delivery. Chem Commun (Camb) 2016; 52:327-30. [DOI: 10.1039/c5cc06826f] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Intracellular delivery of M6P/IGFII receptor inhibitors exhibits better efficacy than extracellular inhibitors to regulate TGFβ1 mediated upregulation of profibrotic marker, collagen I.
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Seymour T, Twigger AJ, Kakulas F. Pluripotency Genes and Their Functions in the Normal and Aberrant Breast and Brain. Int J Mol Sci 2015; 16:27288-301. [PMID: 26580604 PMCID: PMC4661882 DOI: 10.3390/ijms161126024] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 11/05/2015] [Accepted: 11/06/2015] [Indexed: 12/11/2022] Open
Abstract
Pluripotent stem cells (PSCs) attracted considerable interest with the successful isolation of embryonic stem cells (ESCs) from the inner cell mass of murine, primate and human embryos. Whilst it was initially thought that the only PSCs were ESCs, in more recent years cells with similar properties have been isolated from organs of the adult, including the breast and brain. Adult PSCs in these organs have been suggested to be remnants of embryonic development that facilitate normal tissue homeostasis during repair and regeneration. They share certain characteristics with ESCs, such as an inherent capacity to self-renew and differentiate into cells of the three germ layers, properties that are regulated by master pluripotency transcription factors (TFs) OCT4 (octamer-binding transcription factor 4), SOX2 (sex determining region Y-box 2), and homeobox protein NANOG. Aberrant expression of these TFs can be oncogenic resulting in heterogeneous tumours fueled by cancer stem cells (CSC), which are resistant to conventional treatments and are associated with tumour recurrence post-treatment. Further to enriching our understanding of the role of pluripotency TFs in normal tissue function, research now aims to develop optimized isolation and propagation methods for normal adult PSCs and CSCs for the purposes of regenerative medicine, developmental biology, and disease modeling aimed at targeted personalised cancer therapies.
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Affiliation(s)
- Tracy Seymour
- School of Chemistry and Biochemistry, Faculty of Science, the University of Western Australia, Perth, Western Australia 6009, Australia.
- School of Medicine and Pharmacology, Faculty of Medicine, Dentistry and Health Sciences, the University of Western Australia, Perth, Western Australia 6009, Australia.
| | - Alecia-Jane Twigger
- School of Chemistry and Biochemistry, Faculty of Science, the University of Western Australia, Perth, Western Australia 6009, Australia.
| | - Foteini Kakulas
- School of Chemistry and Biochemistry, Faculty of Science, the University of Western Australia, Perth, Western Australia 6009, Australia.
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11
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Cannon AM, Kakulas F, Hepworth AR, Lai CT, Hartmann PE, Geddes DT. The Effects of Leptin on Breastfeeding Behaviour. Int J Environ Res Public Health 2015; 12:12340-55. [PMID: 26437426 PMCID: PMC4626972 DOI: 10.3390/ijerph121012340] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 09/07/2015] [Accepted: 09/23/2015] [Indexed: 11/27/2022]
Abstract
Breastfed infants have a reduced risk of becoming overweight and/or obese later in life. This protective effect has been partly attributed to leptin present in breastmilk. This study investigated 24-h variations of skim milk leptin and its relationship with breastmilk macronutrients and infant breastfeeding patterns. Exclusive breastfeeding mothers of term singletons (n = 19; age 10 ± 5 weeks) collected pre- and post-feed breastmilk samples for every breastfeed over a 24-h period and test-weighed their infants to determine milk intake at every breastfeed over a 24-h period. Samples (n = 454) were analysed for leptin, protein, lactose and fat content. Skim milk leptin concentration did not change with feeding (p = 0.184). However, larger feed volumes (>105 g) were associated with a decrease in post-feed leptin levels (p = 0.009). There was no relationship between the change in leptin levels and change in protein (p = 0.313) or lactose levels (p = 0.587) between pre- and post-feed milk, but there was a trend for a positive association with changes in milk fat content (p = 0.056). Leptin concentration significantly increased at night (p < 0.001) indicating a possible 24-h pattern. Leptin dose (ng) was not associated with the time between feeds (p = 0.232). Further research should include analysis of whole breastmilk and other breastmilk fractions to extend these findings.
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Affiliation(s)
- Anna M Cannon
- School of Chemistry and Biochemistry, Faculty of Science, The University of Western Australia, Perth, Western Australia 6009, Australia.
| | - Foteini Kakulas
- School of Chemistry and Biochemistry, Faculty of Science, The University of Western Australia, Perth, Western Australia 6009, Australia.
| | - Anna R Hepworth
- School of Chemistry and Biochemistry, Faculty of Science, The University of Western Australia, Perth, Western Australia 6009, Australia.
| | - Ching Tat Lai
- School of Chemistry and Biochemistry, Faculty of Science, The University of Western Australia, Perth, Western Australia 6009, Australia.
| | - Peter E Hartmann
- School of Chemistry and Biochemistry, Faculty of Science, The University of Western Australia, Perth, Western Australia 6009, Australia.
| | - Donna T Geddes
- School of Chemistry and Biochemistry, Faculty of Science, The University of Western Australia, Perth, Western Australia 6009, Australia.
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12
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Trend S, de Jong E, Lloyd ML, Kok CH, Richmond P, Doherty DA, Simmer K, Kakulas F, Strunk T, Currie A. Leukocyte Populations in Human Preterm and Term Breast Milk Identified by Multicolour Flow Cytometry. PLoS One 2015; 10:e0135580. [PMID: 26288195 PMCID: PMC4545889 DOI: 10.1371/journal.pone.0135580] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 07/24/2015] [Indexed: 12/12/2022] Open
Abstract
Background Extremely preterm infants are highly susceptible to bacterial infections but breast milk provides some protection. It is unknown if leukocyte numbers and subsets in milk differ between term and preterm breast milk. This study serially characterised leukocyte populations in breast milk of mothers of preterm and term infants using multicolour flow cytometry methods for extended differential leukocyte counts in blood. Methods Sixty mothers of extremely preterm (<28 weeks gestational age), very preterm (28–31 wk), and moderately preterm (32–36 wk), as well as term (37–41 wk) infants were recruited. Colostrum (d2–5), transitional (d8–12) and mature milk (d26–30) samples were collected, cells isolated, and leukocyte subsets analysed using flow cytometry. Results The major CD45+ leukocyte populations circulating in blood were also detectable in breast milk but at different frequencies. Progression of lactation was associated with decreasing CD45+ leukocyte concentration, as well as increases in the relative frequencies of neutrophils and immature granulocytes, and decreases in the relative frequencies of eosinophils, myeloid and B cell precursors, and CD16- monocytes. No differences were observed between preterm and term breast milk in leukocyte concentration, though minor differences between preterm groups in some leukocyte frequencies were observed. Conclusions Flow cytometry is a useful tool to identify and quantify leukocyte subsets in breast milk. The stage of lactation is associated with major changes in milk leukocyte composition in this population. Fresh preterm breast milk is not deficient in leukocytes, but shorter gestation may be associated with minor differences in leukocyte subset frequencies in preterm compared to term breast milk.
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Affiliation(s)
- Stephanie Trend
- Centre for Neonatal Research and Education, The University of Western Australia, Perth, Western Australia, Australia
- School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Emma de Jong
- Centre for Neonatal Research and Education, The University of Western Australia, Perth, Western Australia, Australia
- School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia
- School of Veterinary and Life Sciences, Murdoch University, Perth, Western Australia, Australia
| | - Megan L. Lloyd
- Centre for Neonatal Research and Education, The University of Western Australia, Perth, Western Australia, Australia
- School of Pathology and Laboratory Medicine, The University of Western Australia, Perth, Western Australia, Australia
| | - Chooi Heen Kok
- Centre for Neonatal Research and Education, The University of Western Australia, Perth, Western Australia, Australia
- Neonatal Clinical Care Unit, King Edward Memorial Hospital for Women, Perth, Western Australia, Australia
| | - Peter Richmond
- School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Dorota A. Doherty
- School of Women’s and Infants’ Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Karen Simmer
- Centre for Neonatal Research and Education, The University of Western Australia, Perth, Western Australia, Australia
- Neonatal Clinical Care Unit, King Edward Memorial Hospital for Women, Perth, Western Australia, Australia
| | - Foteini Kakulas
- School of Chemistry and Biochemistry, The University of Western Australia, Perth, Australia
| | - Tobias Strunk
- Centre for Neonatal Research and Education, The University of Western Australia, Perth, Western Australia, Australia
- Neonatal Clinical Care Unit, King Edward Memorial Hospital for Women, Perth, Western Australia, Australia
| | - Andrew Currie
- Centre for Neonatal Research and Education, The University of Western Australia, Perth, Western Australia, Australia
- School of Paediatrics and Child Health, The University of Western Australia, Perth, Western Australia, Australia
- School of Veterinary and Life Sciences, Murdoch University, Perth, Western Australia, Australia
- * E-mail:
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13
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Twigger AJ, Hepworth AR, Lai CT, Chetwynd E, Stuebe AM, Blancafort P, Hartmann PE, Geddes DT, Kakulas F. Gene expression in breastmilk cells is associated with maternal and infant characteristics. Sci Rep 2015; 5:12933. [PMID: 26255679 PMCID: PMC4542700 DOI: 10.1038/srep12933] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 07/15/2015] [Indexed: 01/11/2023] Open
Abstract
Breastmilk is a rich source of cells with a heterogeneous composition comprising early-stage stem cells, progenitors and more differentiated cells. The gene expression profiles of these cells and their associations with characteristics of the breastfeeding mother and infant are poorly understood. This study investigated factors associated with the cellular dynamics of breastmilk and explored variations amongst women. Genes representing different breastmilk cell populations including mammary epithelial and myoepithelial cells, progenitors, and multi-lineage stem cells showed great variation in expression. Stem cell markers ESRRB and CK5, myoepithelial marker CK14, and lactocyte marker α-lactalbumin were amongst the genes most highly expressed across all samples tested. Genes exerting similar functions, such as either stem cell regulation or milk production, were found to be closely associated. Infant gestational age at delivery and changes in maternal bra cup size between pre-pregnancy and postpartum lactation were associated with expression of genes controlling stemness as well as milk synthesis. Additional correlations were found between genes and dyad characteristics, which may explain abnormalities related to low breastmilk supply or preterm birth. Our findings highlight the heterogeneity of breastmilk cell content and its changes associated with characteristics of the breastfeeding dyad that may reflect changing infant needs.
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Affiliation(s)
- Alecia-Jane Twigger
- School of Chemistry and Biochemistry, Faculty of Science, The University of Western Australia, 35 Stirling Highway, Crawley WA 6009, Australia
| | - Anna R Hepworth
- School of Chemistry and Biochemistry, Faculty of Science, The University of Western Australia, 35 Stirling Highway, Crawley WA 6009, Australia
| | - Ching Tat Lai
- School of Chemistry and Biochemistry, Faculty of Science, The University of Western Australia, 35 Stirling Highway, Crawley WA 6009, Australia
| | - Ellen Chetwynd
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, School of Medicine, University of North Carolina, 3010 Old Clinic Building, CB 7615, Chapel Hill, NC 27599, USA
| | - Alison M Stuebe
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, School of Medicine, University of North Carolina, 3010 Old Clinic Building, CB 7615, Chapel Hill, NC 27599, USA
| | - Pilar Blancafort
- 1] Department of Pharmacology, School of Medicine, University of North Carolina, 120 Mason Farm Road, Chapel Hill, NC 27599, USA [2] Cancer Epigenetics group, the Harry Perkins Institute of Medical Research, and School of Anatomy, Physiology and human Biology, The University of Western Australia, 35 Stirling Highway, Crawley WA 6009, Australia
| | - Peter E Hartmann
- School of Chemistry and Biochemistry, Faculty of Science, The University of Western Australia, 35 Stirling Highway, Crawley WA 6009, Australia
| | - Donna T Geddes
- School of Chemistry and Biochemistry, Faculty of Science, The University of Western Australia, 35 Stirling Highway, Crawley WA 6009, Australia
| | - Foteini Kakulas
- School of Chemistry and Biochemistry, Faculty of Science, The University of Western Australia, 35 Stirling Highway, Crawley WA 6009, Australia
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14
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Abstract
Glioblastoma (GBM) is the most common and fatal type of primary brain tumor. Gliosarcoma (GSM) is a rarer and more aggressive variant of GBM that has recently been considered a potentially different disease. Current clinical treatment for both GBM and GSM includes maximal surgical resection followed by post-operative radiotherapy and concomitant and adjuvant chemotherapy. Despite recent advances in treating other solid tumors, treatment for GBM and GSM still remains palliative, with a very poor prognosis and a median survival rate of 12–15 months. Treatment failure is a result of a number of causes, including resistance to radiotherapy and chemotherapy. Recent research has applied the cancer stem cells theory of carcinogenesis to these tumors, suggesting the existence of a small subpopulation of glioma stem-like cells (GSCs) within these tumors. GSCs are thought to contribute to tumor progression, treatment resistance, and tumor recapitulation post-treatment and have become the focus of novel therapy strategies. Their isolation and investigation suggest that GSCs share critical signaling pathways with normal embryonic and somatic stem cells, but with distinct alterations. Research must focus on identifying these variations as they may present novel therapeutic targets. Targeting pluripotency transcription factors, SOX2, OCT4, and Nanog homeobox, demonstrates promising therapeutic potential that if applied in isolation or together with current treatments may improve overall survival, reduce tumor relapse, and achieve a cure for these patients.
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Affiliation(s)
- Tracy Seymour
- School of Medicine and Pharmacology, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia , Crawley, WA , Australia ; Hartmann Human Lactation Research Group, School of Chemistry and Biochemistry, Faculty of Science, The University of Western Australia , Crawley, WA , Australia
| | - Anna Nowak
- School of Medicine and Pharmacology, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia , Crawley, WA , Australia
| | - Foteini Kakulas
- Hartmann Human Lactation Research Group, School of Chemistry and Biochemistry, Faculty of Science, The University of Western Australia , Crawley, WA , Australia
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