Perspective: The Role of Human Breast-Milk Extracellular Vesicles in Child Health and Disease
Perspective: The Role of Human Breast-Milk Extracellular Vesicles in Child Health and Disease
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DOI：
10.1093/advances/nmaa094
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发表时间：
2021-01-01
影响因子：
9.3
通讯作者：
Munblit, Daniel
中科院分区：
文献类型：
--
作者：
O'Reilly, Daniel;Dorodnykh, Denis;Munblit, Daniel
人类母乳（HM）含有多种生物活性物质，决定其对儿童健康的影响。细胞外囊泡（EV）是存在于HM中的一组异质的分泌纳米颗粒，并且可能部分地负责其有益效果。EV在HM中的确切作用和内容在很大程度上仍然未知。为了研究这一点，我们对以HM EV为重点的文献进行了简短的叙述性综述，以了解可用数据的背景，然后对MEDLINE和Embase数据库进行了范围审查。我们确定了424篇非重复引文，包括19篇原始研究。从这个角度来看，我们总结了围绕HM EV的证据，强调了一些基于现有证据的理论考虑，并概述了与EV研究的复杂性和异质性相关的一些挑战。我们考虑如何从HM研究的现有数据符合EV研究（MISEV）指南的最低信息。在这些研究中，使用了各种研究方法，包括基于实验室的方法和翻译方法，并检查了一系列不同的EV含量，包括RNA、蛋白质和糖肽。我们在这些研究中观察到各种健康结果，包括过敏和特应性，坏死性小肠结肠炎和艾滋病毒。虽然已经证明了一些有希望的结果，但感兴趣的结果的异质性，方法学的局限性以及该领域研究数量相对较少，使得研究之间的比较或进一步的翻译工作成为问题。到目前为止，没有研究已经检查了HM EV在一个大的，不同的人群中的标准值，或关于潜在的重要影响因素，如时间（后乳与前乳），阶段（初乳与成熟乳），和婴儿年龄（早产与足月），这使得从实验室或“基础”研究外推是不可能的。未来的研究应侧重于解决目前文献中的不足之处，并利用MISEV指南为研究设计提供信息。
Human breast milk (HM) contains multiple bioactive substances determining its impact on children's health. Extracellular vesicles (EVs) are a heterogeneous group of secreted nanoparticles that are present in HM and may be partially responsible for its beneficial effects. The precise roles and content of EVs in HM remain largely unknown. To examine this, we performed a short narrative review on the literature focusing on HM EVs to contextualize the available data, followed by a scoping review of MEDLINE and Embase databases. We identified 424 nonduplicate citations with 19 original studies included. In this perspective, we summarize the evidence around HM EVs, highlight some theoretical considerations based on existing evidence, and provide an overview of some challenges associated with the complexity and heterogeneity of EV research. We consider how the existing data from HM studies conform to the minimal information for studies of EVs (MISEV) guidelines. Across the studies a variety of research methods were utilized involving both bench-based and translational methods, and a range of different EV contents were examined including RNA, proteins, and glycopeptides. We observed a variety of health outcomes in these studies, including allergy and atopy, necrotizing enterocolitis, and HIV. While some promising results have been demonstrated, the heterogeneity in outcomes of interest, methodological limitations, and relatively small number of studies in the field make comparison between studies or further translational work problematic. To date, no studies have examined normative values of HM EVs in a large, diverse population or with respect to potentially important influencing factors such as timing (hind- vs. foremilk), stage (colostrum vs. mature milk), and infant age (preterm vs. term), which makes extrapolation from bench or "basic" research impossible. Future research should focus on addressing the current inadequacies in the literature and utilize MISEV guidelines to inform study design.