Mastitis Modifies the Biogenic Amines Profile in Human Milk, with Significant Changes in the Presence of Histamine, Putrescine and Spermine

Intervention study of Yanghe decoction on plasma cell mastitis based on mammary microecology and metabolomics investigation

Plasma cell mastitis (PCM), a chronic breast inflammatory disease, is characterized by ductal dilatation and plasma cell infiltration. Traditional Chinese Medicine (TCM) Yanghe decoction is used to relieve mastitis symptoms clinically. However, its efficacy and mechanism on PCM remain undefined. The PCM patients receiving dexamethasone and metronidazole tablets, served as control group, with the other group receiving combination of Yanghe decoction, 15 cases each. Main symptom indicators included mass size, skin colour, skin temperature, breast pain, blood cell count (WBC), C reactive protein (CRP), interleukin (IL)-6, IL-4, serum prolactin (PRL), erythrocyte sedimentation rate (ESR), immunoglobulin A (IgA), IgM, and IgG levels. Secondary indicators included TCM syndrome and anxiety/depression scores. Breast differential flora (DF) and metabolites (DAMs) post-treatment between two groups were detected by 16S rRNA sequencing and metabolomics, with further correlation analysis. Post-treatment symptom scores exhibited lower than pre-treatment in both groups, with greater decline on WBC, CRP, IL-6, IL-4, PRL, and ESR, and enhanced IgA, IgM, and IgG levels in Yanghe decoction group than in control group. Notably, Yanghe decoction group demonstrated no significant DF, with decreased Corynebacterium and Rhodococcus, and elevated Staphylococcus, which correlated significantly with the above indicators. Moreover, 43 DAMs were detected between these two groups, with Glycerophosphocholine, 9,10-Epoxyoctadecenoic acid, Arachidic acid, and 4,5-Dihydroorotic acid showing strong correlations with the above flora. Based on the clarification of PCM improvement with Yanghe decoction, we preliminarily explored potential roles of breast tissue microorganisms and DAMs, providing scientific basis for its clinical application and potential clinical biomarkers in PCM.

Identification of Polyamines in Human Milk, Formula Milk, and Other Dairy Products: a Special Method Based on Precolumn Derivatization, Double-Florisil Purification, and Gas Chromatography-Triple Quadrupole Mass Spectrometry

Polyamines in human milk are essential for the rapid growth and development of neonates and infants. However, the concentrations of polyamines in human milk have not been well characterized and the special methods for detecting polyamines in human milk, formula milk, or other dairy products remain largely unavailable to date. In this study, an accurate and sensitive method based on trifluoroacetic acid anhydride (TFAA) derivatization, double solid-phase extraction (SPE) purification, and gas chromatography-triple quadrupole mass spectrometry (GC-QqQ MS) was established for the evaluation of polyamines in human milk, formula milk, and other dairy products. High coefficients of determination for internal calibration curves were obtained (R2 > 0.99). Low limits of detection (5.0, 1.0, and 0.5 nmol/dL) and limits of quantification (10.0, 3.0, and 1.0 nmol/dL) for putrescine, spermidine, and spermine, respectively, were also achieved. The precision (expressed as relative standard deviation, RSD < 9.0%) and recovery rates (78.3-108.4%) were satisfactory. Spermidine and spermine in human milk were found significantly higher than those in formula milk and commercial cow's milk. The difference of polyamine content in human milk and infant formula should be paid attention to, particularly when infant formula is used as a complete replacement for human milk.

Evaluation of the Efficacy of a Lactobacilli-Based Teat Detergents for the Microbiota of Cows Teats Using an Untargeted Metabolomics Approach

Teat cleaning pre- and post-milking is important for the overall health and hygiene of dairy cows. The purpose of this research was to evaluate the effectiveness of a teat detergents based on lactic acid bacteria according to changes in somatic cell count and cow-milk metabolites. Sixty-nine raw milk samples were collected from 11 Holstein-Friesian cows in China during 12 days of teat cleaning. An ultra-performance liquid chromatography-quadrupole-time of flight mass spectrometry-based untargeted metabolomic approach was applied to detect metabolomic differences after treatment with lactic acid bacteria and chemical teat detergents in cows with subclinical mastitis. The results suggest that the lactobacilli-based teat detergents could reduce somatic cell count and improve microhabitat of cow teat apex by adjusting the composition of metabolites. Furthermore, the somatic cell count could be decreased significantly within 10 days following the cleaning protocol. Lactic acid bacteria have the potential to be applied as a substitution to teat chemical detergents before and after milking for maintenance of healthy teats and breasts. Further, larger scale validation work is required to support the findings of the current study.

A potentially probiotic strain of Enterococcus faecalis from human milk that is avirulent, antibiotic sensitive, and nonbreaching of the gut barrier

Human milk is a key source of promising probiotic lactic acid bacteria. The Enterococcus species, because of their dual commensal and pathogenic nature, demand critical safety analysis to establish them as probiotic candidates. In this study, eighteen E. faecalis strains from human milk of mothers living in Pakistan were typed at the strain level by riboprinting. The typed strains were then evaluated in vitro for physiological safety and the presence of transmissible antibiotic resistance genes, adhesion genes, biogenic amines, and virulence factors. Selected strains were then checked for tolerance to gastrointestinal acid and bile as criteria for probiotic efficacy. Molecular typing revealed that the strains fell into five distinct clusters or ribotypes. Testing revealed that they were non-hemolytic; however, all strains had gelatinase activity except NPL-493. The isolates were susceptible to most clinically important antibiotics except streptomycin. Molecular screening for antibiotic resistance genes, adhesion genes, biogenic amines, and virulence factors indicated that none of the strains possessed resistance genes for aminoglycosides, vancomycin, bacitracin, tetracycline, or clindamycin. Most virulence factors were absent except for the genes gelE and efaAs associated with gut adhesion and translocation, which were present in all except NPL-493. Strain NPL-493 was the most promising probiotic candidate demonstrating significant tolerance to the acid, bile, and digestive enzymes in the human GIT and antibacterial activity against multiple pathogens. The study concluded that E. faecalis NPL-493 from human milk was safe among all the strains and could be considered a potential probiotic.

Human Milk Antioxidative Modifications in Mastitis: Further Beneficial Effects of Cranberry Supplementation

Mastitis is the inflammation of one or several mammal lobes which can be accompanied by a mammary gland infection, and is the leading cause of undesired early weaning in humans. However, little information exists regarding the changes that this disease may induce in the biochemical composition of human milk, especially in terms of oxidative status. Given that newborns are subject to a significant increase in total ROS burden in their transition to neonatal life and that their antioxidant defense system is not completely developed, the aim of this study was to evaluate antioxidant defense (glutathione peroxidase (GPx), reduced glutathione (GSH), total polyphenol content (TPP), and total antioxidant capacity (TAC)) in milk samples from mothers suffering from mastitis and controls. We also measured the oxidative damage to lipids (malondyaldehyde (MDA)) and proteins (carbonyl group content (CGC)) in these samples. Finally, we tested whether dietary supplementation with cranberries (a product rich in antioxidants) in these breastfeeding mothers during 21 days could improve the oxidative status of milk. GPx activity, TPP, and TAC were increased in milk samples from mastitis-affected women, providing a protective mechanism to the newborn drinking mastitis milk. MDA concentrations were diminished in the mastitis group, confirming this proposal. Some oxidative damage might occur in the mammary gland since the CGC was increased in mastitis milk. Cranberries supplementation seems to strengthen the antioxidant system, further improving the antioxidative state of milk.

Differences in Polyamine Content between Human Milk and Infant Formulas

Human milk is the gold standard for nutrition during the first months of life, but when breastfeeding is not possible, it may be replaced by infant formulas, either partially or totally. Polyamines, which play an important role in intestinal maturation and the development of the immune system, are found both in human milk and infant formulas, the first exogenous source of these compounds for the newborn. The aim of this study was to evaluate the occurrence and evolution of polyamines in human milk during the first semester of lactation and to compare the polyamine content with that of infant formulas. In total, 30 samples of human milk provided by six mothers during the first five months of lactation as well as 15 different types of infant formulas were analyzed using UHPLC-FL. Polyamines were detected in all human milk samples but with great variation among mothers. Spermidine and spermine levels tended to decrease during the lactation period, while putrescine remained practically unchanged. Considerable differences were observed in the polyamine contents and profiles between human milk and infant formulas, with concentrations being up to 30 times lower in the latter. The predominant polyamines in human milk were spermidine and spermine, and putrescine in infant formulas.

Influence of Breastfeeding Factors on Polyamine Content in Human Milk

The polyamine content of human breast milk, which is the first exogenous source of polyamines for the newborn, can be affected by several factors associated with the mother, the infant, or breastfeeding itself. The aim of this study was to evaluate the influence of different breastfeeding factors on the polyamines found in human milk. For this study, a cohort of 83 mothers was considered for up to 4 months, and a subgroup of 33 mothers were followed during the first six months of breastfeeding. Two breast milk samples were collected at each sampling point (foremilk and hindmilk) and the polyamine content was determined by UHPLC-FL. Polyamine levels varied considerably between the mothers and tended to decrease over time. Putrescine was the minor polyamine, whereas spermidine and spermine contents were very similar. The concentrations of the three polyamines were significantly higher in hindmilk than foremilk (p < 0.001). Spermidine and spermine levels decreased significantly through the lactation progress (p < 0.05). Finally, slightly higher levels of polyamines were observed in the milk of mothers providing partial, rather than full, breastfeeding, although the differences were not significant. The polyamine content in human milk was found to change during a single feed (foremilk versus hindmilk) and as lactation progressed, mainly in response to the specific circumstances of the newborn.

Histamine Intolerance in Children: A Narrative Review

Histamine intolerance is defined as a disequilibrium of accumulated histamine and the capacity for histamine degradation. This clinical term addresses a non-immunologically mediated pathology when histamine ingested with food is not particularly high, however its degradation is decreased. This paper aims to provide a narrative review on etiopathology, epidemiology, possible diagnostic algorithms and diagnostic challenges of histamine intolerance in children. The clinical picture of histamine intolerance in children is similar to that observed in adults apart from male predominance found in paediatric patients. Both in children and adults, a histamine-reduced diet is typically the treatment of choice. Diamine oxidase supplementation offers another treatment option. There is no symptom or test pathognomonic for histamine intolerance. Nevertheless, manifestations of chronic gastrointestinal symptoms, measurements of diamine oxidase deficits, positive results of histamine provocation tests and improvement in symptoms with histamine-reduced diet considerably increase the probability of histamine intolerance diagnosis. These factors have been included in the proposed diagnostic algorithm for histamine intolerance. In children histamine intolerance most likely co-occurs with allergies and bowel diseases, which creates an additional diagnostic challenge. As the evidence for children is poor further research is needed the determine epidemiology, validate diagnostic algorithms and establish possible treatment options regarding histamine intolerance.

The Determinants of the Human Milk Metabolome and Its Role in Infant Health

Human milk is needed for optimal growth as it satisfies both the nutritional and biological needs of an infant. The established relationship between breastfeeding and an infant’s health is attributable to the nutritional and non-nutritional, functional components of human milk including metabolites such as the lipids, amino acids, biogenic amines and carbohydrates. These components have diverse roles, including protecting the infant against infections and guiding the development of the infant’s immature immune system. In this review, we provide an in-depth and updated insight into the immune modulatory and anti-infective role of human milk metabolites and their effects on infant health and development. We also review the literature on potential determinants of the human milk metabolome, including maternal infectious diseases such as human immunodeficiency virus and mastitis.

The microbiology and treatment of human mastitis

Mastitis, which is generally described as an inflammation of breast tissue, is a common and debilitating disease which frequently results in the cessation of exclusive breastfeeding and affects up to 33% of lactating women. The condition is a primary cause of decreased milk production and results in organoleptic and nutritional alterations in milk quality. Recent studies employing culture-independent techniques, including metagenomic sequencing, have revealed a loss of bacterial diversity in the microbiome of mastitic milk samples compared to healthy milk samples. In those infected, the pathogens Staphylococcus aureus, Staphylococcus epidermidis and members of corynebacteria have been identified as the predominant etiological agents in acute, subacute and granulomatous mastitis, respectively. The increased incidence of antibiotic resistance in the causative species is also a key cause of concern for treatment of the disease, thus leading to the need to develop novel therapies. In this respect, probiotics and bacteriocins have revealed potential as alternative treatments.