وصف
The effects of Human Milk Oligosaccharides (HMOs) on the infant gut are profound, influencing gut microbiome development and health trajectories through toddlerhood. Various HMOs, their doses, and periods of supplementation have been investigated, with clinical evidence supporting the supplementation of five key HMOs. HMOs are now incorporated into infant formula to mimic the benefits of breast milk, while non-human oligosaccharides are also explored for their potential benefits. Safety profiles and regulatory considerations are critical in the use of HMOs, which has advanced through improved synthesis and production techniques for clinical application. Real-world examples and case studies demonstrate the benefits of HMOs, and ongoing research is uncovering new possibilities for their application in promoting infant gut health.
ملخص
- Human milk oligosaccharides (HMOs) are non-digestible sugars found in breast milk, acting as prebiotics to promote the growth of beneficial gut bacteria, particularly Bifidobacteria. HMOs also function as decoys, preventing pathogens from attaching to the gut lining and thus reducing infections. These compounds contribute to a balanced immune response by modulating T-cell activity, reducing inflammation, and enhancing barrier function in the gut.
- HMOs are structurally diverse, consisting of five building blocks: glucose, galactose, N-acetylglucosamine, fucose, and sialic acid. The most common structure is a lactose core elongated with other sugars by enzymes like fucosyltransferases. HMOs are categorized as either neutral (fucosylated or non-fucosylated) or acidic (sialylated), with 2'FL and LNT being the most studied. They represent the third-largest solid component of human milk after lactose and lipids, providing minimal caloric value to the infant.
- Bifidobacteria utilize HMOs for energy and proliferation, producing short-chain fatty acids (SCFAs) like butyric and propionic acid, which have anti-inflammatory effects, support gut barrier function, and modulate immune cell activity. These bacteria also metabolize aromatic amino acids into compounds like indol lactic acid, phenyl lactic acid, and HPLA, activating pathways crucial for immune function and gut health. A healthy gut microbiome, shaped by HMOs, is critical for long-term health, immune development, and protection against diseases.
- Commercial synthesis of HMOs primarily involves microbial fermentation using engineered bacteria like E. coli or yeast to convert lactose into HMOs, followed by purification. Emerging techniques include plant production, where plants are genetically modified to produce HMOs. Regulatory bodies like the European Food Safety Authority (EFSA) and the U.S. Food and Drug Administration (FDA) have approved specific HMOs for use in infant formulas, adhering to strict safety assessments.
- Clinical studies demonstrate that HMO supplementation, particularly with 2'FL and LNT, is safe and well-tolerated, supporting normal growth and development in infants. HMO-supplemented formulas have been associated with reduced respiratory tract infections, antibiotic use, and improved immune biomarkers. Additionally, higher concentrations of specific HMOs in breast milk are linked to better cognitive and motor skill development in infants.
- Research on HMOs in older children and adults shows potential benefits for modulating gut microbiota, increasing Bifidobacteria abundance, and improving symptoms of irritable bowel syndrome (IBS). Non-human oligosaccharides like fructooligosaccharides (FOS) and galactooligosaccharides (GOS) also have prebiotic effects but are not structurally comparable to HMOs. While commercial availability of HMOs is currently limited to infant formulas, ongoing research continues to explore their broader health applications.
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