Impact of pasteurization of human milk on its gastric digestion: an in vivo study in the preterm infant

Autor: DE OLIVEIRA, Samira, Bourlieu-Lacanal, Claire, Ménard, Olivia, Le Gouar, Yann, Bellanger, Amandine, Dirson, Emelyne, Rousseau, Florence, Moustiés, Célia, PERRIER, Candice, Pladys, Patrick, Dupont, Didier, Deglaire, Amélie
Přispěvatelé: Science et Technologie du Lait et de l'Oeuf (STLO), Institut National de la Recherche Agronomique (INRA)-AGROCAMPUS OUEST, Service de Pédiatrie, Centre Hospitalier Universitaire [Rennes], Lactarium - Unité Nutrition et Diététique Infantile, Sécurité et Qualité des Produits d'Origine Végétale (SQPOV), Institut National de la Recherche Agronomique (INRA)-Avignon Université (AU), Avignon Université (AU)-Institut National de la Recherche Agronomique (INRA), Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro)-Institut national d'enseignement supérieur pour l'agriculture, l'alimentation et l'environnement (Institut Agro), Avignon Université (AU)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Zdroj: ESPGHAN (European Society for Paediatric Gastroenterology, Hepatology and Nutrition) 49. Annual Meeting
ESPGHAN (European Society for Paediatric Gastroenterology, Hepatology and Nutrition) 49. Annual Meeting, May 2016, Athènes, Greece. 2016
Popis: Objectives and study: Human milk is the ideal food for neonatal nutrition and optimal growth.When the mother's own milk is unavailable or limited, pasteurized human milk from milk banks ispreferentially administered instead of infant formula, especially for preterm hospitalized neonates.Holder pasteurization (62.5 °C, 30 min) is applied for sanitary reasons but alters human milkcomponents such as enzymes and immunoglobulins. In vitro studies have also shown thatpasteurization of human milk impacts its hydrolysis and disintegration in term newborns (De Oliveiraet al., 2016). Our study aimed at investigating the impact of pasteurization of human milk on itsgastric digestion in preterm infants.-Methods: In vivo study was conducted at Rennes Hospital on preterm infants (n=12) fed by afeeding nasogastric tube each three hours (NCT02112331). Over a six-day sequence, gastric aspirateswere collected twice a day, before and after administration of raw or pasteurized human milk.Samples were collected at 35, 60 or 90 min after meal ingestion. Gastric volume and pH weremeasured. Structural changes of the digesta were evaluated by confocal microscopy and laser lightscattering. In digesta, residual intact proteins left were followed by gel electrophoresis (SDS-PAGE)submitted to densitometry, and lipolysis degree was evaluated by gas and thin layer chromatographyfitted to flame ionization detector.-Results: On average (±SD), infants were 27.5 ± 12.3 days old at the first day of the study. Birthweight was 1.4 ± 0.3 kg and gestational age 29.6 ± 1.0 weeks. Digestive kinetics presented high interand intra-individual variabilities. Regarding proteins, results showed a rapid disappearance of intactcaseins and lactoferrin, but a resistance of alpha-lactalbumin. The contribution of meal gastricemptying or hydrolysis in protein disappearance depended on the protein. Some pre-lipolysis wasdetermined in milk before digestion and it was in overall significantly lower in pasteurized than inraw milk, likely due to the heat-denaturation of endogenous lipases. During gastric digestion thekinetics of lipolysis were not affected by pasteurization (p > 0.05). The lipolysis degree ranged from 6to 20% at 90 min. This relatively limited extent of gastric lipolysis was observed for both raw andpasteurized human milk, and was illustrated by the microscopic observations: some native milk fatglobule structure (hydrophobic core enveloped by an amphiphilic membrane) persisted through thegastric digestion for both raw and pasteurized human milk. Regarding the structure, pasteurizationled to heat-induced protein aggregates in the soluble phase and at the interface of the human milkfat globule membrane, and also impacted the protein aggregation and emulsion disintegrationduring gastric digestion.-Conclusion: This study represents a unique and important dataset on the behavior of pasteurizedversus raw human milk. The gastric digestion is a key step which can further modulate nutrientabsorption and infant nutrition. Digestive hydrolysis may also impact on gut microbiota, a majorcontributor to the development of the intestinal and systemic immune systems in the neonatalperiod. Physiologic and metabolic consequences remain to be investigated.
Databáze: OpenAIRE
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