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HIV 感染和未感染哺乳期妇女母乳血浆中的总抗氧化能力、sCD14 和 TGF-β2 水平。

Levels of Total Antioxidant Capacity, sCD14, and TGF-β2 in Breast Milk Plasma of HIV-Infected and HIV-Uninfected Lactating Women.

机构信息

Department of Chemical Pathology, Midlands State University Medical School, Gweru, Zimbabwe.

Department of Chemical Pathology, University of Zimbabwe Medical School, Harare, Zimbabwe.

出版信息

Breastfeed Med. 2021 Oct;16(10):821-826. doi: 10.1089/bfm.2021.0025. Epub 2021 May 19.

Abstract

Breast milk provides nourishment for infants and nonnutritive bioactive factors, which possess key protective and developmental benefits essential in shaping the infant immune system. However, the impact of human immunodeficiency virus (HIV) and universal antiretroviral therapy (ART) on breast milk nutritional composition and immunity status is not well documented. The study aimed to compare breast milk immune factors; total antioxidant capacity (TAC), soluble cluster of differentiation 14 (sCD14), and transcription growth factor-beta 2 (TGF-β2) levels between HIV-infected and HIV-uninfected lactating mothers and determine the association between breast milk parameters with HIV disease progression and duration of ART. Breast milk sCD14, TAC, and TGF-β2 were quantified using enzyme-linked immunosorbent assays and spectrophotometric techniques in 57 HIV-infected breast feeding mothers on option B therapy for prevention of vertical transmission of HIV and 57 HIV-uninfected mothers at 6 weeks postpartum. The plasma HIV viral load was measured on enrollment and demographic data were recorded. Mean breast milk plasma TAC levels were significantly lower in HIV-infected mothers (1,250.5 ± 280.4 μmolTE/L) compared to the HIV-uninfected participants (1,915.4 ± 326 μmolTE/L;  < 0.001). Soluble CD14 levels in HIV-infected mothers were significantly higher (7,059.3 ± 1,604.7 ng/mL) compared to the HIV-uninfected group (5,670.7 ± 1,268.3 pg/mL;  < 0.001). Similarly, TGF-β2 concentration was also significantly elevated in the HIV-infected mothers (1,426.1 ± 695.4 pg/mL) compared to the HIV-uninfected counterparts (709.2 ± 196.8 pg/mL;  < 0.001). A positive correlation was observed between breast milk plasma sCD14 concentration and the plasma viral load ( = 0.576,  < 0.001), while a significant negative correlation was observed with the duration of ART ( = -0.285,  = 0.032). TAC and TGF-β2 concentrations were inversely correlated with plasma viral load levels. HIV-infected mothers are at risk of oxidative stress. Nutritional intervention with antioxidant rich foods is recommended for this vulnerable group during breastfeeding.

摘要

母乳为婴儿提供营养和非营养生物活性因子,这些因子具有关键的保护和发育益处,对于塑造婴儿免疫系统至关重要。然而,人类免疫缺陷病毒(HIV)和普遍的抗逆转录病毒治疗(ART)对母乳营养成分和免疫状态的影响尚未得到充分记录。本研究旨在比较感染 HIV 和未感染 HIV 的哺乳期母亲的母乳免疫因子;总抗氧化能力(TAC)、可溶性分化簇 14(sCD14)和转化生长因子-β2(TGF-β2)水平,并确定母乳参数与 HIV 疾病进展和 ART 持续时间的关系。使用酶联免疫吸附试验和分光光度技术在接受 B 方案(预防 HIV 垂直传播)的 57 名 HIV 感染母乳喂养母亲和产后 6 周的 57 名 HIV 未感染母亲的母乳中定量检测 sCD14、TAC 和 TGF-β2。在入组时测量血浆 HIV 病毒载量,并记录人口统计学数据。与 HIV 未感染参与者(1,915.4 ± 326 μmolTE/L;  < 0.001)相比,HIV 感染母亲的母乳血浆 TAC 水平明显较低(1,250.5 ± 280.4 μmolTE/L)。与 HIV 未感染组(5,670.7 ± 1,268.3 pg/mL;  < 0.001)相比,HIV 感染母亲的可溶性 CD14 水平明显升高。同样,与 HIV 未感染组(709.2 ± 196.8 pg/mL;  < 0.001)相比,HIV 感染母亲的 TGF-β2 浓度也明显升高。母乳血浆 sCD14 浓度与血浆病毒载量呈正相关( = 0.576,  < 0.001),而与 ART 持续时间呈显著负相关( = -0.285,  = 0.032)。TAC 和 TGF-β2 浓度与血浆病毒载量水平呈负相关。HIV 感染的母亲有发生氧化应激的风险。建议在母乳喂养期间,为这一脆弱群体提供富含抗氧化剂的营养干预。

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