Anne Sütü ve Mikrobiyota Gelişimi
Sağlıklı mikrobiyotanın etkisine yönelik yapılan çalışmalarda, çocukların gelecekteki sağlığı için mikrobiyota gelişiminin büyük önem taşıdığı vurgulanmaktadır. Astım, şeker hastalığı, obezite gibi birçok hastalığın zarar görmüş ya da gelişmemiş bağırsak mikrobiyotası ile yakın ilişkisi bulunmaktadır. Anne sütü, sağlıklı bir bağırsak mikrobiyotasının gelişmesi için bebeğe aktarılan çok sayıda non-patojen bakteriyi içinde barındırmaktadır. Bununla birlikte, anne sütündeki mikroorganizmaların nereden geldiği hala tartışmalıdır. "Entero mammary pathway" adı verilen ve anne sütündeki mikroorganizmaların kaynağını açıklamak üzere geliştirilmiş olan teorinin ispatlanması için daha fazla araştırmaya ihtiyaç vardır. Bu teoriye göre, annenin bağırsak mikrobiyotası dendritik hücreler aracılığıyla süt kanallarına iletilmektedir. İçerdiği çeşitli mikrobiyal sistemleri ile yenidoğanlar için en önemli probiyotik olan anne sütü, Bifi do bakteriler tarafından tercih edilen oligosakkaritleri içermesi nedeniyle de bebek bağırsak mikrobiyotası için önemli bir prebiyotiktir. Sonuç olarak, anne sütü özellikle yaşamın ilk aylarında sağlıklı bağırsak mikrobiyotasının oluşumu için kritik önem taşır. Ülkemizde emzirme oranlarını iyileştirmeye yönelik politikalara devam edilmesi güçlü bir şekilde tavsiye edilmektedir.
Breastmilk and Development of Microbiota
Findings of the studies on the effect of the healthy microbiota development have a lot of implication for future healthy life in children. Many non-communicable diseases, such as asthma, diabetes, obesite, have a close relationship with a damaged or underdeveloped gut microbiota. Human milk is a source of huge non-pathogenic bacterial community which is transferred to infant for establishing a healthy gut microbiota. Nevertheless, the source of these breast milk’s microbes is still controversial. An explanative theory, which is called “entero-mammary pathway”, needs more research to be proven. According to this theory, gut microbiota of the mother is transferred to the mammary ducts by means of dendritic cells. Being the most important probiotic for newborn with diverse microbial system, breast milk is also an important prebiotic for infant gut microbiota containing oligosaccharides specifi cally preferred by Bifi do bacteria. As a conclusion, breast milk is critical for establishment of healthy gut microbiota particularly during the first months of life. Progressing the policies to improve breastfeeding rates in our country is strongly recommended.
___
- 1. Rautava S. Early microbial contact, the breast milk microbiome
and child health. Journal of Developmental Origins of Health and
Disease. 2016;7(1):5-14.
- 2. Aslan NN, Yardımcı H. Anne Sütü ve Mikrobiyota. Turkiye Klinikleri
Journal of Nutrition and Dietetics-Special Topics. 2017;3(2): 95-
100.
- 3. Arrieta MC, Stiemsma LT, Amenyogbe N, Brown EM, Finlay B. The
intestinal microbiome in early life: health and disease. Frontiers in
Immunology. 2014;5.
- 4. Çelebi GA, Uygun A. İntestinal mikrobiyota ve fekal transplantasyon.
Güncel Gastroenterol Derg. 2013;17:148-157.
- 5. Bergmann H, Rodríguez JM, Salminen S, Szajewska H. Probiotics
in human milk and probiotic supplementation in infant nutrition:
a workshop report. British Journal of Nutrition. 2014;112(7):1119-
1128.
- 6. Mueller NT, Bakacs E, Combellick J, Grigoryan Z, Dominguez-Bello
MG. The infant microbiome development: mom matters. Trends in
Molecular Medicine. 2015; 21(2):109-117.
- 7. Ottman N, Smidt H, De Vos WM, Belzer C. The function of our
microbiota: who is out there and what do they do?. Frontiers in
Cellular and Infection Microbiology. 2012;2.
- 8. Gomez-Gallego C, Garcia-Mantrana I, Salminen S, Collado MC. The
human milk microbiome and factors infl uencing its composition and
activity. In Seminars in Fetal and Neonatal Medicine. 2016;21(6):
400-405.
- 9. Patel RM, Denning PW. Intestinal microbiota and its relationship
with necrotizing enterocolitis. Pediatric Research, 2015;78(3):
232.
- 10. Isolauri E. Development of healthy gut microbiota early in life.
Journal of Paediatrics and Child Health. 2012; 48(3):1-6.
- 11. Thum C, Cookson AL, Otter DE, McNabb WC, Hodgkinson AJ,
Dyer J, Roy NC. Can nutritional modulation of maternal intestinal
microbiota infl uence the development of the infant gastrointestinal
tract?. The Journal of Nutrition. 2012;142(11):1921-1928.
- 12. Goldsmith F, O’Sullivan A, Smilowitz JT, Freeman SL. Lactation and
intestinal microbiota: how early diet shapes the infant gut. Journal
of Mammary Gland Biology and Neoplasia. 2015; 20(3-4):149-
158.
- 13. Tuzun, F., Kumral, A., Duman, N., & Ozkan, H. Breast milk jaundice:
effect of bacteria present in breast milk and infant feces. Journal of
Pediatric Gastroenterology and Nutrition. 2013;56(3): 328-332.
- 14. Jeurink PV, Van Bergenhenegouwen J, Jimenez E, Knippels LMJ.,
Fernández L, Garssen J, Knol J, Rodríguez JM, Martin R. Human
milk: a source of more life than we imagine. Benefi cial Microbes.
2012;4(1):17-30.
- 15. Fernández L, Langa S, Martín V, Maldonado A, Jiménez E, Martín R,
Rodríguez JM The human milk microbiota: origin and potential roles
in health and disease. Pharmacological Research. 2013;69(1):
1-10.
- 16. Rogier EW, Frantz AL, Bruno ME, Wedlund L, Cohen DA,
Stromberg AJ, Kaetzel CS. Lessons from mother: long-term
impact of antibodies in breast milk on the gut microbiota and
intestinal immune system of breastfed offspring. Gut Microbes.
2014;5(5):663-668.
- 17. Jost T, Lacroix C, Braegger CP, Chassard C. New insights in gut
microbiota establishment in healthy breast fed neonates. PloS One.
2012;7:e44595.
- 18. Guaraldi F, Guglielmo S. Effect of breast and formula feeding on gut
microbiota shaping in newborns. Frontiers in Cellular and Infection
Microbiology 2012;2:1-4.
- 19. Bode L, McGuire M, Rodriguez JM, Geddes DT, Hassiotou F,
Hartmann PE, McGuire, MK. It’s alive: microbes and cells in human
milk and their potential benefi ts to mother and infant. Advances
in Nutrition: An International Review Journal. 2014;5(5):571-573.
- 20. Grönlund MM, Grzeβkowiak Ł, Isolauri E, Salminen S. Infl uence of
mother's intestinal microbiota on gut colonization in the infant. Gut
Microbes. 2011;2(4):227-233.
- 21. Cabrera-Rubio R, Collado MC, Laitinen K, Salminen S, Isolauri E,
Mira A. The human milk microbiome changes over lactation and
is shaped by maternal weight and mode of delivery. The American
Journal of Clinical Nutrition. 2012;96(3):544-551.
- 22. Coppa GV, Zampini L, Galeazzi T, Gabrielli O. Prebiotics in human
milk: a review. Digestive and Liver Disease. 2006;38:291-294.
- 23. Jost, T., Lacroix, C., Braegger, C., & Chassard, C. Assessment of
bacterial diversity in breast milk using culture-dependent and
culture-independent approaches. British Journal of Nutrition.
2013;110(7):1253-1262.
- 24. Ward TL, Hosid S, Ioshikhes I, Altosaar I. Human milk metagenome:
a functional capacity analysis. BMC Microbiology. 2013;13(1):116.
- 25. Hunt KM, Foster JA, Forney LJ, Schütte UM, Beck DL, Abdo Z, Fox
LK., Williams JE, McGuire MK, McGuire MA. Characterization of the
diversity and temporal stability of bacterial communities in human
milk. Plos One. 2011:6(6);e21313.
- 26. Murphy K, Curley D, O’Callaghan TF, O’Shea CA, Dempsey EM,
O’Toole PW, Ross RP, Ryan CA, Stanton C. The composition of
human milk and infant faecal microbiota over the fi rst three months
of life: a pilot study. Scientifi c Reports. 2017;7:40597.
- 27. Fitzstevens JL, Smith KC, Hagadorn JI, Caimano MJ, Matson AP,
Brownell EA. Systematic review of the human milk microbiota.
Nutrition in Clinical Practice. 2016;32:354–364
- 28. Collado MC, Delgado S, Maldonado A, Rodríguez JM. Assessment
of the bacterial diversity of breast milk of healthy women by
quantitative realβtime PCR. Letters in Applied Microbiology.
2009;48(5):523-528.
- 29. Urbaniak C, Angelini M, Gloor GB, Reid G. Human milk microbiota
profi les in relation to birthing method, gestation and infant gender.
Microbiome. 2016;4(1):2-9.
- 30. Boix-Amorós A, Collado MC, Mira A. Relationship between milk
microbiota, bacterial load, macronutrients, and human cells during
lactation. Frontiers in Microbiology. 2016;7:492.
- 31. Khodayar-Pardo P, Mira-Pascual L, Collado MC, Martinez-Costa C.
Impact of lactation stage, gestational age and mode of delivery on
breast milk microbiota. Journal of Perinatology. 2014;34(8): 599.
- 32. LaTuga MS, Stuebe A, Seed PC. A review of the source and function
of microbiota in breast milk. Seminars in Reproductive Medicine.
2014;32(01):068-073.
- 33. Martín V, Maldonado-Barragán A, Moles L, Rodriguez-Baños M,
Campo RD, Fernández L, Rodríguez JM, Jiménez E. Sharing of
bacterial strains between breast milk and infant feces. Journal of
Human Lactation. 2012;28(1):36-44.
- 34. Schanche M, Avershina E, Dotterud C, Øien T, Storrø O, Johnsen
R, Rudi K. High-resolution analyses of overlap in the microbiota
between mothers and their children. Current Microbiology.
2015;71(2):283-290.
- 35. Solís G, de Los Reyes-Gavilan, CG, Fernández N, Margolles A,
Gueimonde M. Establishment and development of lactic acid
bacteria and bifi dobacteria microbiota in breast-milk and the infant
gut. Anaerobe. 2010;16(3):307-310.
- 36. Martín R, Heilig GHJ, Zoetendal EG, Smidt H, Rodríguez JM.
Diversity of the Lactobacillus group in breast milk and vagina ofhealthy women and potential role in the colonization of the infant
gut. Journal of Applied Microbiology. 2007;103(6):2638-2644.
- 37. Wang X, Lu H, Feng Z, Cao J, Fang C, Xu X, Zhao L, Shen J.
Development of human breast milk microbiota-associated mice as
a method to identify breast milk bacteria capable of colonizing gut.
Frontiers in Microbiology. 2017;8:1242.
- 38. Rodríguez JM. The origin of human milk bacteria: is there a
bacterial entero-mammary pathway during late pregnancy and
lactation?. Advances in Nutrition: An International Review Journal.
2014:5(6);779-784.
- 39. Martín R, Langa S, Reviriego C, Jimínez E, Marín ML, Xaus J,
Fernández L, Rodríguez JM. Human milk is a source of lactic
acid bacteria for the infant gut. The Journal of Pediatrics,
2003;143(6):754-758.
- 40. Marcobal A, Sonnenburg JL. Human milk oligosaccharide
consumption by intestinal microbiota. Clinical Microbiology and
Infection. 2012;18(4):12-15.
- 41. De Leoz MLA, Kalanetra KM, Bokulich NA, Strum JS, Underwood
MA, German JB, Mills DA, Lebrilla CB. Human milk glycomics and
gut microbial genomics in infant feces show a correlation between
human milk oligosaccharides and gut microbiota: a proof-ofconcept
study. Journal of Proteome Research. 2014;14(1):491-
502.
- 42. Coppa GV, Bruni S, Morelli L, Soldi S, Gabrielli O. The fi rst
prebiotics in humans: human milk oligosaccharides. Journal of
Clinical Gastroenterology. 2004;38:80-83.
- 43. Castanys-Muñoz E, Martin MJ, Vazquez E. Building a benefi cial
microbiome from birth. Advances in Nutrition: An International
Review Journal. 2016;7(2):323-330.
- 44. Kabaran, S. Anne Sütünün İmmün Sistem ve Mikrobiyota Üzerine
Etkisi. Turkiye Klinikleri Journal of Nutrition and Dietetics-Special
Topics. 2016; 2(2):7-11.
- 45. 2013 Türkiye Nüfus ve Sağlık Araştırması. Hacettepe Üniversitesi
Nüfus Etütleri Enstitüsü, TC Kalkınma Bakanlığı ve TÜBİTAK. 2014;
Ankara, Türkiye.