Human milk probiotics
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Human milk probiotics, also known as human milk microbiota, refers to the bacterial component contained in human breast milk which could be a source of commensal, mutualistic, and potentially probiotic bacteria to the infant gut.[1] The World Health Organization defines ‘probiotics’ as ‘living organisms which, when administered in adequate amounts, confer a health benefit on the host.[2]
Occurence
Breast milk contains lactic acid bacteria, and consequently is a natural source of lactic acid bacteria for the newborn through breast-feeding, and may be considered a symbiotic food.[3] The normal concentration of bacteria in milk from healthy women was about 103 colony-forming units (cfu) per milliliter. The milk bacterial communities were generally complex.[4] Among the hundreds of taxonomic units detected in the milk of every woman, only 9 (Streptococcus, Staphylococcus, Serratia, Pseudomonas, Corynebacterium, Ralstonia, Propionibacterium, Sphingomonas, and Bradyrhizobiaceae) were present in every sample from every woman, but the milk bacterial community was generally stable over time within an individual.[5] ut.[1]
Characteristics
Breast milk was considered to be free of bacteria until about a decade ago when lactic acid bacteria were first described in human milk hygienically collected from healthy women.[3] Several studies have shown that there is a mother-to-infant transfer of bacterial strains belonging, at least, to the genera Lactobacillus, Staphylococcus, Enterococcus, and Bifidobacterium through breastfeeding, thus accounting for the close relationship of bacterial composition of the gut microbiota of breastfed infants with that found in the breast milk of their respective mothers.[1] Research has also found that there are similarities between human milk and infant gut microbial flora, suggesting that dietary exposure such as human milk probiotics consumption may have great contribution in supporting infant gut microbiota and immune development.[6]
Several factors may influence the composition of human milk probiotics, such as maternal BMI, infant sex, birth mode, and mode of breastfeeding etc.[7] A study done by Soto et al also revealed that lactobacilli and bifidobacterial are more commonly found in human milk of women who did not receive any antibiotics during pregnancy and lactation.[8] Among all the bacteria found in the human milk, the lactobacilli are most frequently found and draw high attention due to their potential probiotic effect. The three strains of lactobacilli with probiotic properties isolated were L. fermentum CECT5716, L. gasseri CECT5714 and L. salivarius CECT5713.[9] L. fermentum are one of the most abundant strains found in human breast milk.[10] It was discovered from the human fecal sample analysis in 1994 with great pH and bile tolerance along human digestive system. It is very significant in terms of its consideration as a probiotic.[11] Another prominent characteristic is anti-infectious activity which is probably due to their immuno-enhancing and anti-microbial abilities.[12] Mastitis is a common inflammatory disease associated with lactation. Two different studies showed that L. fermentum could improve mastitis condition by reducing the number of Streptococcus spp. load which is believed to be the causal agent and risk factor of mastitis. Other than exerting beneficial effects to pregnant and breastfeeding women, L. fermentum could also reduce the number of gastrointestinal and respiratory infection of infants.[12] Lactobacillus salivarius CECT 5713 was originally isolated from feces of a one-month-old breast-fed infant. Since it has been suggested that the gut microbiota of breast-fed infants reflects that of the maternal breast milk. RAPD and PFGE analysis revealed the presence of the strain L. salivarius CECT 5713 in the breast milk. L. salivarius CECT 5713 produced acetate, L-lactate and hydrogen peroxide, which may be responsible for its antimicrobial activity against most of the indicator organisms used in the study. Moreover, this strain showed a high survival rate after exposition to conditions simulating those found in the gastrointestinal tract.[13] Isolation of L. gasseri CECT5714 was achieved by obtaining a sample from the gastrointestinal tract and was discovered to be part of the lactobacillus acidophilus complex. Different dairy products such as yoghurts have also made use of L. gasseri CECT5714. A double-blinded, randomized control comparative study has been demonstrated that immunological effects on immune parameters involved in the allergic response such as a decreasing the number of IgE in plasma and increasing regulatory T cells. The probiotic products with L. gasseri CECT5714 also enhanced innate and specific immune parameters that may improve the general health status of children.[14]
Benefits
Immunomodulatory properties
Intestinal colonisation is usually the result of the first contact of the newborn with microorganisms, which is critical for the development of the immune system. It has been illustrated that different composition of intestinal microbiota affects the incidence of certain pathologies with an important immunological component, such as allergic or inflammatory processes.[15] The immunomodulatory effects of probiotics have also been reported in animal models of pathologies. Different probiotic strains isolated from human could enhance both natural and acquired immune responses of mice.[15] In addition, the breast milk probiotic L. gasseri CECT5714 and L. coryniformis CECT5711 lowered the incidence and severity of the allergic response in an animal model of cow’s milk protein allergy.[15] In a recent report, L. fermentum CECT5716 showed a beneficial effect in an animal model of intestinal inflammation, reducing the inflammatory response and the intestinal damage.[16] Children with colic symptoms have an imbalance in the intestinal microbiota possibly, analyses of faecal samples found higher counts of coliform bacteria and lower counts of lactobacilli in infants with colic symptoms compared with children not suffering from colic.[16] On the other hand, probiotics have been shown to influence intestinal motility and sensory neurons as well as contractile activity of the intestine and to exert anti-inflammatory effects.[17]
Anti-microbial effects
Protection against bacterial and viral infection is one of the most frequent claims made for probiotic consumption. Different researches have been suggested to explain this anti-microbial activity. Some in vitro studies show that certain probiotic strains produce anti-microbial compounds, such as H2O2 and organic acids, that have been reported to suppress the growth of E. coli, Salmonella spp., and Listeria monocytogenes.[18] It has also been revealed that some bacteria present in human milk improve the intestinal barrier function by increasing mucin production and reducing intestinal permeability. However, competition with entero-toxigenic bacteria for nutrients and for epithelial intestinal cell receptor binding sites is the main anti-infective mechanism of probiotic bacteria. For example, lactobacilli and bifdobacteria could suppress the growth of pathogenic microorganisms such as Salmonella typhimurium and Clostridium perfringens by colonization of children’s intestine and competing for nutrients, thus preventing their adhesion. Intestinal colonization by commensal bacteria also plays a vital role in maintaining homeostasis of immune system. These bacteria stimulate TH1 response and counteract the trend towards TH2 response of neonatal immune system, which in turn reducing the incidence of the inflammatory processes such as necrotizing enterocolitis.[19]
Gastrointestinal benefits
There is increasing interest in the manipulation of intestinal microbiota for improving gastrointestinal function and nutrient absorption. Different reports illustrated that human milk probiotics colonize the intestine and increase faecal lactobacilli counts thus modifying intestinal microbiota in humans.[20] Moreover, molecular analysis showed that these bacteria are metabolically active in the human gut, enhancing the production of functional metabolites such as butyrate, which is the main energy source for colonocytes and plays a vital role in modulating intestinal function. Increase in faecal moisture, and in stool frequency and volume was observed which could be related to the increase in faecal concentration of butyric acid. Similarly, the administration of L. gasseri CECT5714 also caused an increase in faecal lactobacilli counts in a clinical trial in children. In the same study, the cytotoxicity of the faecal water of children who received the probiotic has been shown to be lower than that of the control children. Finally, in another clinical trial the supplementation of infant formulas with L. rhamnosus LGG has been showed to improve neonate growth pattern, which could suggest an increased bioavailability of nutrients in infants. The World Health Organization defines ‘probiotics’ as ‘living organisms which, when administered in adequate amounts, confer a health benefit on the host.[2][21]
References
- ↑ 1.0 1.1 1.2 Fernández L, Langa S, Martín V, Maldonado A, Jiménez E, Martín R, Rodríguez JM (March 2013). "The human milk microbiota: origin and potential roles in health and disease". review. Pharmacological Research. 69 (1): 1–10. doi:10.1016/j.phrs.2012.09.001. PMID 22974824.
- ↑ 2.0 2.1 Joint FAO/WHO Expert Consultation on Evaluation of Health and Nutritional Properties of Probiotics (October 2001). "Health and nutritional properties of probiotics in food including powder milk with live lactic acid bacteria" (PDF). review. Prevention. Amerian Córdoba Park Hotel, Córdoba, Argentina. 5 (1): 1.
- ↑ 3.0 3.1 Martín R, Langa S, Reviriego C, Jimínez E, Marín ML, Xaus J, et al. (December 2003). "Human milk is a source of lactic acid bacteria for the infant gut". primary. The Journal of Pediatrics. 143 (6): 754–8. doi:10.1016/j.jpeds.2003.09.028. PMID 14657823.
- ↑ Hunt KM, Foster JA, Forney LJ, Schütte UM, Beck DL, Abdo Z, et al. (2011). "Characterization of the diversity and temporal stability of bacterial communities in human milk". primary. PLOS One. 6 (6): e21313. Bibcode:2011PLoSO...621313H. doi:10.1371/journal.pone.0021313. PMID 21695057.
- ↑ Soto A, Martín V, Jiménez E, Mader I, Rodríguez JM, Fernández L (July 2014). "Lactobacilli and bifidobacteria in human breast milk: influence of antibiotherapy and other host and clinical factors". primary. Journal of Pediatric Gastroenterology and Nutrition. 59 (1): 78–88. doi:10.1097/MPG.0000000000000347. PMC 4086764. PMID 24590211.
- ↑ Martín V, Maldonado-Barragán A, Moles L, Rodriguez-Baños M, Campo RD, Fernández L, et al. (February 2012). "Sharing of bacterial strains between breast milk and infant feces". primary. Journal of Human Lactation. 28 (1): 36–44. doi:10.1177/0890334411424729. hdl:10261/52892. PMID 22267318.
- ↑ Munblit D, Peroni DG, Boix-Amorós A, Hsu PS, Van't Land B, Gay MC, et al. (August 2017). "Human Milk and Allergic Diseases: An Unsolved Puzzle". review. Nutrients. 9 (8): 894. doi:10.3390/nu9080894. PMID 28817095.
- ↑ Soto A, Martín V, Jiménez E, Mader I, Rodríguez JM, Fernández L (July 2014). "Lactobacilli and bifidobacteria in human breast milk: influence of antibiotherapy and other host and clinical factors". primary. Journal of Pediatric Gastroenterology and Nutrition. 59 (1): 78–88. doi:10.1097/MPG.0000000000000347. PMC 4086764. PMID 24590211.
- ↑ Lara-Villoslada F, Olivares M, Sierra S, Rodríguez JM, Boza J, Xaus J (October 2007). "Beneficial effects of probiotic bacteria isolated from breast milk". review. The British Journal of Nutrition. 98 Suppl 1 (1): S96–100. doi:10.1017/S0007114507832910. PMID 17922969.
- ↑ Soto A, Martín V, Jiménez E, Mader I, Rodríguez JM, Fernández L (July 2014). "Lactobacilli and bifidobacteria in human breast milk: influence of antibiotherapy and other host and clinical factors". primary. Journal of Pediatric Gastroenterology and Nutrition. 59 (1): 78–88. doi:10.1097/MPG.0000000000000347. PMC 4086764. PMID 24590211.
- ↑ Maldonado J, Cañabate F, Sempere L, Vela F, Sánchez AR, Narbona E, et al. (January 2012). "Human milk probiotic Lactobacillus fermentum CECT5716 reduces the incidence of gastrointestinal and upper respiratory tract infections in infants". primary. Journal of Pediatric Gastroenterology and Nutrition. 54 (1): 55–61. doi:10.1097/MPG.0b013e3182333f18. PMID 21873895.
- ↑ 12.0 12.1 Arroyo R, Martín V, Maldonado A, Jiménez E, Fernández L, Rodríguez JM (June 2010). "Treatment of infectious mastitis during lactation: antibiotics versus oral administration of Lactobacilli isolated from breast milk". primary. Clinical Infectious Diseases. 50 (12): 1551–8. doi:10.1086/652763. PMID 20455694.
- ↑ Martín R, Jiménez E, Olivares M, Marín ML, Fernández L, Xaus J, Rodríguez JM (October 2006). "Lactobacillus salivarius CECT 5713, a potential probiotic strain isolated from infant feces and breast milk of a mother-child pair". primary. International Journal of Food Microbiology. 112 (1): 35–43. doi:10.1016/j.ijfoodmicro.2006.06.011. PMID 16843562.
- ↑ Martínez-Cañavate A, Sierra S, Lara-Villoslada F, Romero J, Maldonado J, Boza J, et al. (September 2009). "A probiotic dairy product containing L. gasseri CECT5714 and L. coryniformis CECT5711 induces immunological changes in children suffering from allergy". primary. Pediatric Allergy and Immunology. 20 (6): 592–600. doi:10.1111/j.1399-3038.2008.00833.x. PMID 19594864.
- ↑ 15.0 15.1 15.2 Björkstén B, Naaber P, Sepp E, Mikelsaar M (March 1999). "The intestinal microflora in allergic Estonian and Swedish 2-year-old children". primary. Clinical and Experimental Allergy. 29 (3): 342–6. doi:10.1046/j.1365-2222.1999.00560.x. PMID 10202341.
- ↑ 16.0 16.1 Peran L, Sierra S, Comalada M, Lara-Villoslada F, Bailón E, Nieto A, et al. (January 2007). "A comparative study of the preventative effects exerted by two probiotics, Lactobacillus reuteri and Lactobacillus fermentum, in the trinitrobenzenesulfonic acid model of rat colitis". primary. The British Journal of Nutrition. 97 (1): 96–103. doi:10.1017/S0007114507257770. PMID 17217564.
- ↑ Bergmann H, Rodríguez JM, Salminen S, Szajewska H (October 2014). "Probiotics in human milk and probiotic supplementation in infant nutrition: a workshop report". review. The British Journal of Nutrition. 112 (7): 1119–28. doi:10.1017/S0007114514001949. PMID 25160058.
- ↑ Martín R, Olivares M, Marín ML, Fernández L, Xaus J, Rodríguez JM (February 2005). "Probiotic potential of 3 Lactobacilli strains isolated from breast milk". primary. Journal of Human Lactation. 21 (1): 8–17, quiz 18-21, 41. doi:10.1177/0890334404272393. PMID 15681631.
- ↑ Dani C, Biadaioli R, Rubaltelli FF (2002). "Potential role of probiotics in the prevention of necrotizing enterocolitis". review. Philadelphia: Lippincott Williams & Wilkins.
- ↑ Olivares M, Díaz-Ropero MA, Gómez N, Lara-Villoslada F, Sierra S, Maldonado JA, et al. (March 2006). "Oral administration of two probiotic strains, Lactobacillus gasseri CECT5714 and Lactobacillus coryniformis CECT5711, enhances the intestinal function of healthy adults". primary. International Journal of Food Microbiology. 107 (2): 104–11. doi:10.1016/j.ijfoodmicro.2005.08.019. PMID 16271414.
- ↑ Vendt N, Grünberg H, Tuure T, Malminiemi O, Wuolijoki E, Tillmann V, et al. (February 2006). "Growth during the first 6 months of life in infants using formula enriched with Lactobacillus rhamnosus GG: double-blind, randomized trial". primary. Journal of Human Nutrition and Dietetics. 19 (1): 51–8. doi:10.1111/j.1365-277X.2006.00660.x. PMID 16448475.
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