Effect of digestion and storage of human milk on free fatty acid concentration and cytotoxicity.
Effect of digestion and storage of human milk on free fatty acid concentration and cytotoxicity.
复制标题
母乳消化和储存对游离脂肪酸浓度和细胞毒性的影响。
DOI：
10.1097/mpg.0000000000000441
复制
发表时间：
2014
影响因子：
2.9
通讯作者：
Schmid-Schönbein,GeertW
中科院分区：
文献类型：
--
作者：
Penn,AlexanderH;Altshuler,AngelinaE;Small,JamesW;Taylor,SharonF;Dobkins,KarenR;Schmid-Schönbein,GeertW
目的：脂肪在肠道中被消化成游离脂肪酸(FFAs)，FFAs是去污剂，因此在微摩尔浓度下对细胞有毒性。粘膜屏障保护成人肠道中的细胞，但这种屏障在早产儿中可能不会完全发育。脂肪酶消化的婴儿配方奶粉，而不是新鲜的人奶，含有升高的游离脂肪酸，对肠道细胞具有细胞毒性，因此可能导致坏死性小肠结肠炎(NEC)的肠道损伤，但即使是完全喂养母乳的婴儿也可能患上NEC。方法：将培养的大鼠肠上皮细胞或人中性粒细胞暴露于DM中，新鲜采集的乳汁在4℃或−20℃下保存12周，然后用0.1或1 mg/mL胰腺脂肪酶和/或胰酶和/或胰凝乳酶处理2小时(37℃)。结果：DM和乳汁在4℃或−20℃下保存3天，然后消化即可产生细胞毒性。在−20℃下保存8周和12周后，细胞毒性增加。蛋白酶消化减少，但不能消除细胞死亡。结论：目前的储存方式可能允许牛奶变得具有细胞毒性，并导致NEC的肠道损伤。
Objectives:Fat is digested in the intestine into free fatty acids (FFAs), which are detergents and therefore toxic to cells at micromolar concentration. The mucosal barrier protects cells in the adult intestine, but this barrier may not be fully developed in premature infants. Lipase-digested infant formula, but not fresh human milk, has elevated FFAs and is cytotoxic to intestinal cells, and therefore could contribute to intestinal injury in necrotizing enterocolitis (NEC), but even infants exclusively fed breast milk may develop NEC. Our objective was to determine whether stored milk and milk from donor milk (DM) banks could also become cytotoxic, especially after digestion.Methods:We exposed cultured rat intestinal epithelial cells or human neutrophils to DM and milk collected fresh and stored at 4 C or− 20 C for up to 12 weeks and then treated for 2 hours (37 C) with 0.1 or 1 mg/mL pancreatic lipase and/or trypsin and chymotrypsin.Results:DM and milk stored 3 days (at 4 C or− 20 C) and then digested were cytotoxic. Storage at− 20 C for 8 and 12 weeks resulted in an additional increase in cytotoxicity. Protease digestion decreased, but did not eliminate cell death.Conclusions:Present storage practices may allow milk to become cytotoxic and contribute to intestinal damage in NEC.