Premature Infants have Lower Gastric Digestion Capacity for Human Milk Proteins than Term Infants.
Premature Infants have Lower Gastric Digestion Capacity for Human Milk Proteins than Term Infants.
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DOI：
10.1097/mpg.0000000000001835
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发表时间：
2018-05
影响因子：
2.9
通讯作者：
Dallas DC
中科院分区：
文献类型：
--
作者：
Demers-Mathieu V;Qu Y;Underwood MA;Borghese R;Dallas DC
早产儿的胃蛋白消化能力是否低于足月儿，以及人乳蛋白酶对总体胃消化的贡献程度尚不清楚，本研究对其进行了研究。从16对早产儿（24-32周胎龄（GA））和6对足月儿（38-40周GA）出生后5-42天内的母婴对中收集人乳和婴儿胃样本。对于每对，将人乳的等分试样调节至pH 4.5并在37 °C下孵育2小时以模拟没有胃蛋白酶（milkinc）的胃条件。它们的胃蛋白质消化能力被测量为蛋白水解（游离N-末端）和蛋白酶活性。采用双向ANOVA和Tukey事后检验比较早产儿和足月儿之间以及人乳、乳汁和胃样本之间的测量值。早产儿的胃蛋白质消化测量值显著低于足月儿。总的牛奶蛋白酶活性之间没有显着差异的人乳样品从长期和早产分娩的母亲。由于蛋白酶活性在模拟胃孵育中没有增加，因此牛奶蛋白酶可能对胃消化的贡献最小。早产儿胃蛋白质消化能力低于足月儿，这可能会损害营养获取。人乳蛋白酶对总体胃消化的贡献最小。牛奶蛋白酶的有限活性表明，这些酶不能补偿早产儿的胃蛋白质消化总体较低。
Whether premature infants have lower gastric protein digestive capacity than term infants and the extent to which human milk proteases contribute to overall gastric digestion are unknown and were investigated in this study. Human milk and infant gastric samples were collected from 16 preterm (24–32 wk gestational age (GA)) and 6 term (38–40 wk GA) mother-infant pairs within a range of 5–42 days postnatal age. For each pair, an aliquot of human milk was adjusted to pH 4.5 and incubated for 2 h at 37 °C to simulate the gastric conditions without pepsin (milkinc). Their gastric protein digestion capacity was measured as proteolysis (free N-terminals) and protease activities. Two-way ANOVA followed by Tukey’s post hoc test were applied to compare measurements between preterm and term infants as well as among human milk, milkinc and gastric samples. Measurements of gastric protein digestion were significantly lower in preterm infants than term infants. Overall milk protease activity did not differ between human milk samples from term- and preterm-delivering mothers. As protease activity did not increase with simulated gastric incubation, milk proteases likely contributed minimally to gastric digestion. Preterm infants have lower gastric protein digestion capacity than term infants, which could impair nutrient acquisition. Human milk proteases contribute minimally to overall gastric digestion. The limited activity of milk proteases suggests that these enzymes cannot compensate for the premature infant’s overall lower gastric protein digestion.