Rodriguez-Palmero M, Koletzko B, Kunz C, Jensen R
Department of Pediatrics, Ludwig-Maximilians-University of Munich, Germany.
Clin Perinatol. 1999 Jun;26(2):335-59.
Human milk lipids contain preformed LCPUFA in considerable amounts, which serve as precursors for the formation of prostaglandins, prostacyclins, and other lipid mediators, as well as essential components in membrane-rich tissues (such as the brain and the retina), thus affecting functional outcomes. Besides a balanced nutrient composition and a number of conditionally essential nutrients, human milk provides different types and classes of bioactive factors, such as enzymes, hormones, and growth factors, many of which appear to have a role in supporting infantile growth and development. The bioactive agents include antimicrobial factors (e.g., secretory IgA, oligosaccharides, FA); anti-inflammatory agents; transporters (e.g., lactoferrin); and digestive enzymes (e.g., BSSL). Several nonpeptide hormones (thyroid hormones, cortisol, progesterone, pregnanediol, estrogens, and artificial contraceptive) and peptide hormones and growth factors (erythropoietin, hHG, gonadotropin-releasing hormone, epidermal growth factor insulin, insulin-like growth factor-I, nerve growth factor, transforming growth factor-alpha, gastrointestinal regulatory peptides and thyroid-parathyroid hormones) have been isolated and quantitated in human milk. Some of these components are also involved in the maturation of the gastrointestinal tract of the infant. In addition to the passive benefits provided by human milk, several data support the hypothesis that breastfeeding promotes the development of the infant's own immune system, which might confer long-term benefits for the newborn infant. The risk of IDDM, Crohn's disease, and atopic disease is lower in individuals who had been breastfed during infancy. Areas of major interest in human milk research include the study of human milk synthesis and the contributions of dietary composition and maternal metabolism to human milk composition, infantile utilization of human milk components, and the study of bioactive components, such as oligosaccharides, proteins and peptides, and lipids and their in vivo fate and biologic effects in the recipient infant.
人乳脂类含有大量预制的长链多不饱和脂肪酸(LCPUFA),它们是前列腺素、前列环素及其他脂质介质形成的前体,也是富含膜组织(如脑和视网膜)的必需成分,从而影响功能结局。除了营养成分均衡和多种条件性必需营养素外,人乳还提供不同类型和类别的生物活性因子,如酶、激素和生长因子,其中许多似乎在支持婴儿生长发育中发挥作用。生物活性剂包括抗菌因子(如分泌型IgA、寡糖、脂肪酸)、抗炎剂、转运蛋白(如乳铁蛋白)和消化酶(如胆汁盐刺激脂肪酶)。几种非肽类激素(甲状腺激素、皮质醇、孕酮、孕二醇、雌激素和人工避孕药)以及肽类激素和生长因子(促红细胞生成素、人绒毛膜生长激素、促性腺激素释放激素、表皮生长因子、胰岛素、胰岛素样生长因子-I、神经生长因子、转化生长因子-α、胃肠调节肽和甲状腺-甲状旁腺激素)已在人乳中分离和定量。这些成分中的一些也参与婴儿胃肠道的成熟。除了人乳提供的被动益处外,一些数据支持母乳喂养促进婴儿自身免疫系统发育的假说,这可能会给新生儿带来长期益处。婴儿期接受母乳喂养的个体患1型糖尿病、克罗恩病和特应性疾病的风险较低。人乳研究的主要关注领域包括人乳合成的研究、饮食组成和母体代谢对人乳成分的贡献、婴儿对人乳成分的利用,以及生物活性成分(如寡糖、蛋白质和肽、脂质及其在受体婴儿体内的命运和生物学效应)的研究。