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AJCN:揭示母乳喂养免于婴儿感染HIV的分子机制

  1. AJCN
  2. HIV-1
  3. 分子机制
  4. 婴儿
  5. 母乳喂养

来源:生物谷 2012-11-18 11:34

2012年8月17日 讯 /生物谷BIOON/ --8月15日,国际杂志American Journal of Clinical Nutrition刊登了一个国际研究小组的最新研究成果,研究者在文章中发现了,感染HIV的母亲以母乳来喂养婴儿,婴儿感染HIV的风险(HIV的传播风险)反而比较低的原因。 “在发展中国家,HIV感染的母亲面临着其是否要以母乳来喂养自己的孩子的问题。

2012年8月17日 讯 /生物谷BIOON/ --8月15日,国际杂志American Journal of Clinical Nutrition刊登了一个国际研究小组的最新研究成果,研究者在文章中发现了,感染HIV的母亲以母乳来喂养婴儿,婴儿感染HIV的风险(HIV的传播风险)反而比较低的原因。

“在发展中国家,HIV感染的母亲面临着其是否要以母乳来喂养自己的孩子的问题。母乳喂养可以使得婴儿暴露于病毒之中,并且可以增加婴儿由于HIV感染死亡的风险。但是非母乳喂养同样也可以增加婴儿因为肠道或者呼吸道感染而导致的死亡风险。研究者Bode和其同事开始着手研究为何许多母乳喂养的婴儿并不会受到HIV-1的感染,尽管其因为母乳而接触到了母亲身体的HIV。在抗逆转录病毒药物存在的情况下,也会有10%-15%的婴儿受到母亲HIV的感染。

研究者发现,一种称为人乳寡糖类(HMO)的免疫活性成分可以保护婴儿机体免于HIV的传播和感染,HMO是一种由葡糖单糖构成的碳水化合物。这些复杂的寡糖类是人乳中第三大丰富的成分,并不被消化,因此可以可以在婴儿的胃肠道粘膜表面高度积累起来,抵御HIV的感染。

HMO扮演着益生元的作用,可以促进婴儿肠道有益微生物菌群的生长。另外HMO在结构上类似于称为聚糖类的糖链,聚糖类通常存在于上皮细胞表面,可以作为“诱饵”受体来抑制致病菌的结合。HMO表现出抗炎的活性,而且其可以调节东旭细胞的免疫细胞效应。

研究者分析了来自赞比亚卢萨卡200多位HIV感染的目前母乳样品中的HMO含量和其组分,结果表明,母乳中高浓度的HMO和高度保护婴儿免于HIV的感染直接相关,未来揭示HMO如何抑制HIV的传播和感染或许为HIV的抗逆转录病毒疗法提供帮助。相关研究由国立卫生研究院等机构提供支持。(生物谷Bioon.com)

编译自:Breastfeeding May Protect Infants from HIV Transmission

Human milk oligosaccharide concentration and risk of postnatal transmission of HIV through breastfeeding1,2,3

Lars Bode, Louise Kuhn, Hae-Young Kim, Lauren Hsiao, Caroline Nissan, Moses Sinkala, Chipepo Kankasa, Mwiya Mwiya, Donald M Thea, and Grace M Aldrovandi

Background: The inefficiency of HIV breast-milk transmission may be caused by the presence of immunologically active factors, including human milk oligosaccharides (HMOs). Objective: We investigated whether HMO concentrations are associated with a reduced risk of postnatal HIV transmission. Design: A nested case-control study was conducted within a larger cohort study of HIV-infected women and their infants followed from birth to 24 mo in Lusaka, Zambia. Breast-milk samples collected at 1 mo from 81 HIV-infected women who transmitted via breastfeeding, a random sample of 86 HIV-infected women who did not transmit despite breastfeeding, and 36 uninfected breastfeeding women were selected. Total and specific HMO concentrations were measured by HPLC and compared between groups with adjustment for confounders by using logistic regression. Results: HIV-infected women with total HMOs above the median (1.87 g/L) were less likely to transmit via breastfeeding (OR: 0.45; 95% CI: 0.21, 0.97; P = 0.04) after adjustment for CD4 count and breast-milk HIV RNA concentrations; a trend toward higher concentrations of lacto-N-neotetraose being associated with reduced transmission (OR: 0.49; 95% CI: 0.23, 1.04; P = 0.06) was also observed. The proportion of 3′-sialyllactose (3′-SL) per total HMOs was higher among transmitting than among nontransmitting women (P = 0.003) and correlated with higher plasma and breast-milk HIV RNA and lower CD4 counts. Neither Secretor nor Lewis status distinguished between transmitting and nontransmitting women. Conclusions: Higher concentrations of non-3′-SL HMOs were associated with protection against postnatal HIV transmission independent of other known risk factors. Further study of these novel, potentially anti-HIV components of breast milk is warranted. This trial was registered at clinicaltrials.gov as NCT00310726.

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