Kanaprach Pasinee, Pongsakul Nutkridta, Apiwattanakul Nopporn, Muanprasat Chatchai, Supapannachart Sarayut, Nuntnarumit Pracha, Chutipongtanate Somchai
1 Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University , Bangkok, Thailand .
2 Pediatric Translational Research Unit, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University , Bangkok, Thailand .
Breastfeed Med. 2018 Apr;13(3):215-220. doi: 10.1089/bfm.2017.0208. Epub 2018 Feb 16.
Donor human milk is considered the next best nutrition following mother's own milk to prevent neonatal infection and necrotizing enterocolitis in preterm infants who are admitted at neonatal intensive care unit. However, donor milk biofunctionalities after preparative processes have rarely been documented.
To evaluate biofunctionalities preserved in donor milk after preparative processes by cell-based assays.
Ten pools of donor milk were produced from 40 independent specimens. After preparative processes, including bacterial elimination methods (holder pasteurization and cold-sterilization microfiltration) and storage conditions (-20°C freezing storage and lyophilization) with varied duration of storage (0, 3, and 6, months), donor milk biofunctionalities were examined by fetal intestinal cell growth and antimicrobial assays.
At baseline, raw donor milk exhibited 193.1% ± 12.3% of fetal intestinal cell growth and 42.4% ± 11.8% of antimicrobial activities against Escherichia coli. After bacteria eliminating processes, growth promoting activity was better preserved in pasteurized donor milk than microfiltrated donor milk (169.5% ± 14.3% versus 146.0% ± 11.8%, respectively; p < 0.005), whereas antimicrobial activity showed no difference between groups (38.3% ± 14.1% versus 53.7% ± 17.3%, respectively; p = 0.499). The pasteurized donor milk was further examined for the effects of storage conditions at 3 and 6 months. Freezing storage, but not lyophilization, could preserve higher growth-promoting activity during 6 months of storage (163.0% ± 9.4% versus 72.8% ± 6.2%, respectively; p < 0.005). Nonetheless, antimicrobial activity was lost at 6 months, regardless of the storage methods.
This study revealed that fetal intestinal cell growth and antimicrobial assays could be applied to measure donor milk biofunctionalities and support the utilization of donor milk within 3 months after preparative processes.
对于入住新生儿重症监护病房的早产儿，捐赠人乳被认为是仅次于母乳的最佳营养物质，可预防新生儿感染和坏死性小肠结肠炎。然而，制备过程后捐赠人乳的生物功能鲜有文献记载。
通过基于细胞的检测方法评估制备过程后捐赠人乳中保留的生物功能。
从40份独立样本中制备了10组捐赠人乳。在经过包括除菌方法（间歇式巴氏杀菌和冷除菌微滤）以及不同储存时长（0、3和6个月）的储存条件（-20°C冷冻储存和冻干）等制备过程后，通过胎儿肠道细胞生长检测和抗菌检测来检查捐赠人乳的生物功能。
基线时，未加工的捐赠人乳对胎儿肠道细胞生长的促进率为193.1%±12.3%，对大肠杆菌的抗菌活性为42.4%±11.8%。经过除菌处理后，巴氏杀菌的捐赠人乳比微滤的捐赠人乳更好地保留了生长促进活性（分别为169.5%±14.3%和146.0%±11.8%；p<0.005），而两组之间的抗菌活性没有差异（分别为38.3%±14.1%和53.7%±17.3%；p=0.499）。对巴氏杀菌的捐赠人乳进一步检测了3个月和6个月储存条件的影响。冷冻储存而非冻干能够在6个月的储存期内保留更高的生长促进活性（分别为163.0%±9.4%和72.8%±6.2%；p<0.005）。尽管如此，无论储存方法如何，抗菌活性在6个月时都会丧失。
本研究表明，胎儿肠道细胞生长检测和抗菌检测可用于衡量捐赠人乳的生物功能，并支持在制备过程后3个月内使用捐赠人乳。
