Department of Dentistry, University of Alberta, Edmonton, AB, Canada.
State Key Laboratory of Food Science and Technology, Nanchang University. Nanchang, China.
J Crohns Colitis. 2019 Mar 30;13(4):431-441. doi: 10.1093/ecco-jcc/jjy186.
For women with inflammatory bowel disease [IBD], it is not very well known how IBD or IBD treatment affects their breast milk components. We aimed to investigate whether breast milk composition differs in healthy control [HC] versus IBD mothers in terms of antibodies, cytokines, and metabolite,s to identify potential impact of IBD breast milk on neonatal immune system.
Breast milk specimens from HC [n = 17] and IBD [n = 31 for Crohn's disease [CD]; and n = 41 for ulcerative colitis [UC]; were collected at 3 and 6 months postpartum [PP3] and [PP6], respectively. Faecal samples were also collected. Cytokines and immunoglobulins [IgA/IgG/IgE] were analysed by multiplex Meso Scale Discovery [MSD] and commercial kits. Moreover, breast milk metabolites were analysed by 1H nuclear magnetic resonance [NMR].
We found that breast milk from IBD mothers showed significantly lower levels of IgA, sugar metabolite [lactose], and 2-aminobutyrate. In contrast, we observed that breast milk from mothers with IBD had increased levels of pro-inflammatory cytokines and higher energy metabolites [lactate and succinate] than milk from healthy mothers. In addition, we noticed that the type of treatment [5-aminosalicylic acid versus biologics] influenced the milk cytokines and metabolites profile.
The reduction in immunoprotective components of IBD breast milk such as sIgA and lactose theoretically may modulate the potential protective effects of breastfeeding. On the other hand, presence of higher levels of pro-inflammatory cytokines, lactate, and succinate may predispose the offspring to an inflammatory condition or impact on the gut microbiome. Better understanding of the role of succinate in infants and its potential effects on microbiome or mucosal immunity merits further investigations.
对于患有炎症性肠病（IBD）的女性，尚不清楚 IBD 或 IBD 治疗如何影响其母乳成分。我们旨在研究健康对照组（HC）与 IBD 母亲的母乳成分在抗体、细胞因子和代谢物方面是否存在差异，以确定 IBD 母乳对新生儿免疫系统的潜在影响。
分别在产后 3 个月（PP3）和 6 个月（PP6）收集 17 名 HC 和 31 名克罗恩病（CD）、41 名溃疡性结肠炎（UC）IBD 母亲的母乳标本。还收集了粪便样本。通过 Meso Scale Discovery（MSD）和商业试剂盒分析细胞因子和免疫球蛋白（IgA/IgG/IgE）。此外，通过 1H 核磁共振（NMR）分析母乳代谢物。
我们发现 IBD 母亲的母乳中 IgA、糖代谢物（乳糖）和 2-氨基丁酸水平显著降低。相比之下，我们发现 IBD 母亲的母乳中促炎细胞因子水平升高，而与健康母亲的母乳相比，能量代谢物（乳酸和琥珀酸）更高。此外，我们注意到治疗类型（5-氨基水杨酸与生物制剂）影响母乳细胞因子和代谢物谱。
IBD 母乳中免疫保护成分（如 sIgA 和乳糖）的减少理论上可能会改变母乳喂养的潜在保护作用。另一方面，更高水平的促炎细胞因子、乳酸和琥珀酸可能使后代易患炎症状态或对肠道微生物组产生影响。更好地了解琥珀酸在婴儿中的作用及其对微生物组或黏膜免疫的潜在影响值得进一步研究。
