无论分娩方式或胎龄如何，母乳喂养极低出生体重儿的肠道微生物组很快就会呈现出双歧杆菌含量低的个性化特征。

Independent of Birth Mode or Gestational Age, Very-Low-Birth-Weight Infants Fed Their Mothers' Milk Rapidly Develop Personalized Microbiotas Low in Bifidobacterium.

机构信息

Ottawa Institute of Systems Biology, Department of Biochemistry Immunology and Microbiology, University of Ottawa, Ottawa, Ontario, Canada.

Departments of Pediatrics and Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada.

出版信息

J Nutr. 2018 Mar 1;148(3):326-335. doi: 10.1093/jn/nxx071.

DOI:10.1093/jn/nxx071

PMID:29546315

Abstract

BACKGROUND

Very-low-birth-weight (VLBW; born weighing <1500 g) infant feeding with mother's own milk (mother's milk) is associated with numerous beneficial health outcomes. Several interventions, including the prophylactic use of probiotics, are being adopted to promote a gastrointestinal microbiota favorable to the gut health of VLBW infants. An improved understanding of the microbiota that results from mother's milk feeding would therefore facilitate progress in this field.

OBJECTIVE

A preplanned primary objective of this research was to characterize the development of the gut microbiota in exclusively mother's milk-fed VLBW infants and describe the reference taxonomic profile that results from mother's milk feeding.

METHODS

In this prospective longitudinal cohort study, we collected weekly stool samples from exclusively mother's milk-fed VLBW infants admitted to Mount Sinai Hospital and profiled their gastrointestinal microbiota development from birth (primary outcome of stool collection). In total, we profiled 231 stools from 54 exclusively mother's milk-fed VLBW infants with the use of V6-16S ribosomal RNA gene sequencing.

RESULTS

Bacterial evenness, but not bacterial richness, increased over time in VLBW infants (P < 0.001). Bifidobacterium relative abundances were consistently low in all microbiotas at all time points (<0.5% in 97% of samples). VLBW infant microbiotas did not cluster by birth mode, gestational age, or weeks after birth and instead clustered as a function of patient identity (R2 = 0.51, P < 0.001).

CONCLUSIONS

Exclusively mother's milk-fed VLBW infants rapidly develop personalized gut microbiotas that show increasing evenness and are seemingly unaffected by birth mode or gestational age at birth. The benefits from mother's milk feeding are likely modulated through microbes or pathways that are not dependent on Bifidobacterium because these microbes are present at low levels in VLBW infants. These results help define a reference VLBW infant microbiota profile derived from mother's milk, the optimal source of nutrition for these infants. This trial was registered at ISRCTN (http://www.isrctn.com/) as ISRCTN35317141.

摘要

背景

极低出生体重（VLBW；出生体重<1500 克）婴儿用其母亲的母乳（人乳）喂养与许多有益的健康结果相关。为了促进有利于 VLBW 婴儿肠道健康的胃肠道微生物群，目前正在采用包括预防性使用益生菌在内的多种干预措施。因此，更好地了解母乳喂养所产生的微生物群将有助于该领域的进展。

目的

本研究的一个预先计划的主要目标是描述单纯母乳喂养的 VLBW 婴儿肠道微生物群的发育，并描述母乳喂养产生的参考分类群特征。

方法

在这项前瞻性纵向队列研究中，我们从入住西奈山医院的单纯母乳喂养的 VLBW 婴儿中每周收集粪便样本，并从出生时开始对其胃肠道微生物群的发育进行分析（粪便收集的主要结果）。我们共对 54 名单纯母乳喂养的 VLBW 婴儿的 231 份粪便进行了 V6-16S 核糖体 RNA 基因测序分析。

结果

VLBW 婴儿的细菌均匀度（但不是细菌丰富度）随时间的推移而增加（P<0.001）。在所有时间点，双歧杆菌的相对丰度都很低（在 97%的样本中都<0.5%）。VLBW 婴儿的微生物群不以分娩方式、胎龄或出生后周数聚类，而是根据患者身份聚类（R2=0.51，P<0.001）。

结论

单纯母乳喂养的 VLBW 婴儿迅速形成具有个性化的肠道微生物群，其均匀度逐渐增加，并且似乎不受分娩方式或出生时的胎龄影响。母乳喂养的益处可能是通过微生物或不受双歧杆菌影响的途径来调节的，因为这些微生物在 VLBW 婴儿中含量较低。这些结果有助于确定源自母乳的 VLBW 婴儿参考微生物群谱，母乳是这些婴儿的最佳营养来源。本试验在 ISRCTN（http://www.isrctn.com/）注册，注册号为 ISRCTN35317141。