Influence of milk-feeding type and genetic risk of developing coeliac disease on intestinal microbiota of infants: the PROFICEL study.
Subject: Breast feeding (Health aspects)
Celiac disease (Genetic aspects)
Celiac disease (Risk factors)
Microbiota (Symbiotic organisms)
Author: de Vries, Linda
Pub Date: 11/01/2012
Publication: Name: Breastfeeding Review Publisher: Australian Breastfeeding Association Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2012 Australian Breastfeeding Association ISSN: 0729-2759
Issue: Date: Nov, 2012 Source Volume: 20 Source Issue: 3
Geographic: Geographic Scope: United States Geographic Code: 1USA United States
Accession Number: 310739994
Full Text: Influence of milk-feeding type and genetic risk of developing coeliac disease on intestinal microbiota of infants: the PROFICEL study Palma GD, Capilla A, Nova E, Castillejo G, Varea V, Pozo T, Garrote JA, Polanco I, Lopez A, Ribes-Koninckx C, Marcos A, Garcia-Novo MD, Calvo C, Ortigosa L, Pena-Quintana L, Palau F, Sanz Y 2012, PLoS One 7(2): e30791.

Coeliac Disease (CD) is a chronic inflammatory disorder of the small intestine that presents with small intestinal villous atrophy and signs of malabsorption following gluten consumption. The major genetic risk factor in CD is represented by several Human Leukocyte Antigen (HLA)-DP genes. It is thought that interactions between environmental factors and predisposing genes could be involved in the development of CD. Gluten is the main environmental factor responsible but other factors such as the type of milk feeding may also increase the disease risk. Breastfeeding appears to have a protective effect against the risk of CD development. However, the mechanisms for this are unknown. It is known that breastfed infants have different gastrointestinal microbiota to artificially fed infants. Microbial colonisation contributes to the physiological development of the gut and the maturation of the immune system, so this study investigated whether the type of milk fed and HLA-genotype influence the intestinal microbiota composition during the first 4 months of life in infants with a family history of CD.

The study included 164 healthy newborns with at least one first-degree relative with CD, classified according to their HLA-DQ genotype. Faecal microbiota was analysed at 7 days, and at 1 and 4 months of age. Those infants exclusively breastfed at all stages were included in the breastfed group; while those who received artificial baby milk, either exclusively or as both artificial baby milk and breastmilk, at each sampling time were included in the artificial baby milk-fed group. Of the 164 infants, 28.4% were classified in the high genetic (>20% probability) risk of developing CD group, 42.59% in the intermediate (>7% probability) risk group and 29.01% in the lowest risk (<1%) group.

The researchers found that breastmilk promoted more gut colonisation with different bacteria than artificial baby milk. They found that breastfeeding provides certain Bifidobacterium spp. to the infant gut. Increased numbers of Bacteroides fragilis group and Staphylococcus group, and reduced numbers of Bifidobacterium spp. and B. Longum were detected in infants with increased genetic risk of developing CD, including in subgroups of either breastfed or artificial baby milk-fed infants. In breastfed infants the increased genetic risk of developing CD was associated with increased C. leptum group numbers, while in the artificial baby milk-fed group it was associated with increased Staphylococcus or B. fragilis group numbers In addition, specific faecal microbiota was associated with the genetic risk of developing CD based on HLA-DQ genotype, irrespective of milk feeding type. These results suggested that HLA-DQ genotype influences microbial colonisation pattern early in life, which could be an additional factor in the development of disease later.

The authors concluded that the type of milk infants receive and the HLA-DQ genotype differently influence the bacterial colonisation pattern of the newborn intestine during the first 4 months of life, which could affect the risk of developing CD in later life. Breastfeeding reduced the genotype-related differences in microbiota composition, which could partly explain the protective role attributed to it in this disorder. Further research is being carried out by the authors to investigate the role played by early intestinal colonisation patterns in this cohort of infants. LV

LD Linda de Vries MBBS, BA, Cert IV Breastfeeding Education (Counselling), IBCLC
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