Good Misty, Sodhi Chhinder P, Yamaguchi Yukihiro, Jia Hongpeng, Lu Peng, Fulton William B, Martin Laura Y, Prindle Thomas, Nino Diego F, Zhou Qinjie, Ma Congrong, Ozolek John A, Buck Rachael H, Goehring Karen C, Hackam David J
1Divisions of Newborn Medicine,Children's Hospital of Pittsburgh,Pittsburgh,PA 15224,USA.
3General Pediatric Surgery,Johns Hopkins University and Bloomberg Children's Center,Johns Hopkins Hospital,Baltimore,MD 21287,USA.
Br J Nutr. 2016 Oct;116(7):1175-1187. doi: 10.1017/S0007114516002944. Epub 2016 Sep 9.
Necrotising enterocolitis (NEC) is a common disease in premature infants characterised by intestinal ischaemia and necrosis. The only effective preventative strategy against NEC is the administration of breast milk, although the protective mechanisms remain unknown. We hypothesise that an abundant human milk oligosaccharide (HMO) in breast milk, 2'-fucosyllactose (2'FL), protects against NEC by enhancing intestinal mucosal blood flow, and we sought to determine the mechanisms underlying this protection. Administration of HMO-2'FL protected against NEC in neonatal wild-type mice, resulted in a decrease in pro-inflammatory markers and preserved the small intestinal mucosal architecture. These protective effects occurred via restoration of intestinal perfusion through up-regulation of the vasodilatory molecule endothelial nitric oxide synthase (eNOS), as administration of HMO-2'FL to eNOS-deficient mice or to mice that received eNOS inhibitors did not protect against NEC, and by 16S analysis HMO-2'FL affected the microbiota of the neonatal mouse gut, although these changes do not seem to be the primary mechanism of protection. Induction of eNOS by HMO-2'FL was also observed in cultured endothelial cells, providing a link between eNOS and HMO in the endothelium. These data demonstrate that HMO-2'FL protects against NEC in part through maintaining mesenteric perfusion via increased eNOS expression, and suggest that the 2'FL found in human milk may be mediating some of the protective benefits of breast milk in the clinical setting against NEC.
坏死性小肠结肠炎(NEC)是早产儿的常见疾病,其特征为肠道缺血和坏死。预防NEC的唯一有效策略是给予母乳,尽管其保护机制尚不清楚。我们推测母乳中一种丰富的人乳寡糖(HMO),即2'-岩藻糖基乳糖(2'FL),通过增强肠黏膜血流来预防NEC,并且我们试图确定这种保护作用的潜在机制。给予HMO-2'FL可保护新生野生型小鼠免受NEC侵害,导致促炎标志物减少,并保留小肠黏膜结构。这些保护作用是通过上调血管舒张分子内皮型一氧化氮合酶(eNOS)来恢复肠道灌注而实现的,因为给予eNOS缺陷小鼠或接受eNOS抑制剂的小鼠HMO-2'FL并不能预防NEC,并且通过16S分析发现HMO-2'FL影响新生小鼠肠道微生物群,尽管这些变化似乎不是主要的保护机制。在培养的内皮细胞中也观察到HMO-2'FL对eNOS的诱导作用,这在内皮中建立了eNOS与HMO之间的联系。这些数据表明,HMO-2'FL部分通过增加eNOS表达来维持肠系膜灌注从而预防NEC,并表明母乳中发现的2'FL可能在临床环境中介导了母乳对NEC的一些保护作用。
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