Demmelmair Hans, Prell Christine, Timby Niklas, Lönnerdal Bo
Dr. von Hauner Childrens Hospital, University of Munich Medical Center, D-80337 München, Germany.
Department of Clinical Sciences, Pediatrics, Umeå University, SE-90187 Umeå, Sweden.
Nutrients. 2017 Jul 28;9(8):817. doi: 10.3390/nu9080817.
The provision of essential and non-essential amino acids for breast-fed infants is the major function of milk proteins. In addition, breast-fed infants might benefit from bioactivities of milk proteins, which are exhibited in the intestine during the digestive phase and by absorption of intact proteins or derived peptides. For lactoferrin, osteopontin and milk fat globule membrane proteins/lipids, which have not until recently been included in substantial amounts in infant formulas, in vitro experiments and animal models provide a convincing base of evidence for bioactivities, which contribute to the protection of the infant from pathogens, improve nutrient absorption, support the development of the immune system and provide components for optimal neurodevelopment. Technologies have become available to obtain these compounds from cow´s milk and the bovine compounds also exhibit bioactivities in humans. Randomized clinical trials with experimental infant formulas incorporating lactoferrin, osteopontin, or milk fat globule membranes have already provided some evidence for clinical benefits. This review aims to compare findings from laboratory and animal experiments with outcomes of clinical studies. There is good justification from basic science and there are promising results from clinical studies for beneficial effects of lactoferrin, osteopontin and the milk fat globule membrane complex of proteins and lipids. Further studies should ideally be adequately powered to investigate effects on clinically relevant endpoints in healthy term infants.
为母乳喂养的婴儿提供必需和非必需氨基酸是乳蛋白的主要功能。此外，母乳喂养的婴儿可能会从乳蛋白的生物活性中受益，这些生物活性在消化阶段于肠道中展现，并通过完整蛋白质或衍生肽的吸收来体现。对于乳铁蛋白、骨桥蛋白和乳脂肪球膜蛋白/脂质而言，直到最近它们才大量被纳入婴儿配方奶粉中，体外实验和动物模型为其生物活性提供了令人信服的证据基础，这些生物活性有助于保护婴儿免受病原体侵害、改善营养吸收、支持免疫系统发育并为最佳神经发育提供成分。现已具备从牛奶中获取这些化合物的技术，并且牛源化合物在人体中也展现出生物活性。使用含有乳铁蛋白、骨桥蛋白或乳脂肪球膜的实验性婴儿配方奶粉进行的随机临床试验已为临床益处提供了一些证据。本综述旨在比较实验室和动物实验的结果与临床研究的成果。从基础科学角度来看有充分的依据，并且临床研究也有关于乳铁蛋白、骨桥蛋白以及蛋白质和脂质的乳脂肪球膜复合物有益作用的有前景的结果。理想情况下，进一步的研究应有足够的样本量，以调查对健康足月儿临床相关终点的影响。
