Department of Cell and Developmental Biology, Institute of Biomedical Sciences, University of São Paulo (USP) - São Paulo, São Paulo, Brazil.
Physiol Rep. 2021 Feb;9(3):e14744. doi: 10.14814/phy2.14744.
During postnatal development, colostrum and breastmilk are sequentially the first sources of nutrition with protein components and bioactive molecules that confer protection and immunostimulatory function to the gut. Caseins, whey proteins, secretory immunoglobulin A (sIgA), mucins, tryptophan, and growth factors are among milk-borne elements that are directly important in the control of mucosa development and protection. Consequently, breastfeeding is associated with the low incidence of gastrointestinal inflammation and with the decrease in respiratory diseases during postnatal period. The novel coronavirus (SARS-CoV-2) binds to angiotensin II-converting enzyme (ACE2) on the cell membrane, allowing virus entrance, replication, and host commitment. ACE2 is expressed by different cell types, which include ciliated cells in the lungs and enterocytes in the intestine. Such cells are highly active in metabolism, as they internalize molecules to be processed and used by the organism. The disruption of ACE2 impairs leads to intestinal inflammation and decreased synthesis of serotonin, affecting motility. By reviewing the effects of SARS-CoV-2 in the gastrointestinal and respiratory tracts in infants, and gut responses to breastfeeding interruption, we suggest that it is important to maintain breastfeeding during SARS-CoV-2 infection, as it might be essential to protect newborns from gastrointestinal-associated disorders and relieve disease symptoms.
在产后发育过程中,初乳和母乳依次成为营养的第一来源,其中的蛋白质成分和生物活性分子赋予肠道保护和免疫刺激功能。酪蛋白、乳清蛋白、分泌型免疫球蛋白 A(sIgA)、粘蛋白、色氨酸和生长因子等都是乳源性元素,它们直接参与控制黏膜发育和保护。因此,母乳喂养与胃肠道炎症的低发生率以及产后呼吸道疾病的减少有关。新型冠状病毒(SARS-CoV-2)与细胞膜上的血管紧张素转换酶(ACE2)结合,允许病毒进入、复制和宿主承诺。ACE2 由不同的细胞类型表达,包括肺部的纤毛细胞和肠道的肠上皮细胞。这些细胞在代谢中非常活跃,因为它们内化分子以供机体处理和利用。ACE2 的破坏导致肠道炎症和 5-羟色胺合成减少,影响运动。通过回顾 SARS-CoV-2 在婴儿胃肠道和呼吸道中的作用以及肠道对母乳喂养中断的反应,我们建议在 SARS-CoV-2 感染期间保持母乳喂养非常重要,因为这可能对保护新生儿免受与胃肠道相关的疾病和缓解疾病症状至关重要。