医学
母乳
婴儿配方奶粉
小肠结肠炎
坏死性小肠结肠炎
母乳
回肠末端
内科学
生理学
胃肠病学
回肠
儿科
生物
生物化学
作者
Evelyn Jantscher‐Krenn,Monica Zherebtsov,Caroline Nissan,Kerstin Goth,Yigit S. Guner,Natasha Naidu,Biswa Choudhury,Anatoly Grishin,Henri R. Ford,Lars Bode
出处
期刊:Gut
[BMJ]
日期:2011-12-03
卷期号:61 (10): 1417-1425
被引量:309
标识
DOI:10.1136/gutjnl-2011-301404
摘要
Necrotising enterocolitis (NEC) is one of the most common and fatal intestinal disorders in preterm infants. Breast-fed infants are at lower risk for NEC than formula-fed infants, but the protective components in human milk have not been identified. In contrast to formula, human milk contains high amounts of complex glycans.To test the hypothesis that human milk oligosaccharides (HMO) contribute to the protection from NEC.Since human intervention studies are unfeasible due to limited availability of HMO, a neonatal rat NEC model was used. Pups were orally gavaged with formula without and with HMO and exposed to hypoxia episodes. Ileum sections were scored blindly for signs of NEC. Two-dimensional chromatography was used to determine the most effective HMO, and sequential exoglycosidase digestions and linkage analysis was used to determine its structure.Compared to formula alone, pooled HMO significantly improved 96-hour survival from 73.1% to 95.0% and reduced pathology scores from 1.98 ± 1.11 to 0.44 ± 0.30 (p<0.001). Within the pooled HMO, a specific isomer of disialyllacto-N-tetraose (DSLNT) was identified to be protective. Galacto-oligosaccharides, currently added to formula to mimic some of the effects of HMO, had no effect.HMO reduce NEC in neonatal rats and the effects are highly structure specific. If these results translate to NEC in humans, DSLNT could be used to prevent or treat NEC in formula-fed infants, and its concentration in the mother's milk could serve as a biomarker to identify breast-fed infants at risk of developing this disorder.
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