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1.
Eur Respir J ; 33(4): 861-70, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19010982

RESUMO

Bronchopulmonary dysplasia (BPD) is characterised by impaired alveolarisation, inflammation and aberrant vascular development. Phosphodiesterase (PDE) inhibitors can influence cell proliferation, antagonise inflammation and restore vascular development and homeostasis, suggesting a therapeutic potential in BPD. The aim of the present study was to investigate PDE expression in the lung of hyperoxia-exposed mice, and to assess the viability of PDE4 as a therapeutic target in BPD. Newborn C57BL/6N mice were exposed to normoxia or 85% oxygen for 28 days. Animal growth and dynamic respiratory compliance were reduced in animals exposed to hyperoxia, paralleled by decreased septation, airspace enlargement and increased septal wall thickness. Changes were evident after 14 days and were more pronounced after 28 days of hyperoxic exposure. At the mRNA level, PDE1A and PDE4A were upregulated while PDE5A was downregulated under hyperoxia. Immunoblotting confirmed these trends in PDE4A and PDE5A at the protein expression level. Treatment with cilomilast (PDE4 inhibitor, 5 mg.kg(-1).day(-1)) between days 14 and 28 significantly decreased the mean intra-alveolar distance, septal wall thickness and total airspace area and improved dynamic lung compliance. Pharmacological inhibition of phosphodiesterase improved lung alveolarisation in hyperoxia-induced bronchopulmonary dysplasia, and thus may offer a new therapeutic modality in the clinical management of bronchopulmonary dysplasia.


Assuntos
Nucleotídeo Cíclico Fosfodiesterase do Tipo 4/metabolismo , Hiperóxia/enzimologia , Inibidores de Fosfodiesterase/farmacologia , Alvéolos Pulmonares/enzimologia , Animais , Animais Recém-Nascidos , Western Blotting , Complacência Pulmonar/efeitos dos fármacos , Camundongos , Camundongos Endogâmicos C57BL , Reação em Cadeia da Polimerase Via Transcriptase Reversa
2.
Adv Exp Med Biol ; 606: 455-65, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18183941

RESUMO

There is increasing evidence of the local effects within the gastro intestinal tract and the systemic functions of human milk oligosaccharides (HMO). In addition to the vast majority of in vitro data, animal studies underline the high potential of HMO to influence very different processes. HMO probably influence the composition of the gut microflora through effects on the growth of bifidus bacteria. Whether the concomitant low number of pathogenic microorganisms in breastfed infants is also caused by HMO is an intriguing question that still has yet to be proven. Due to the similarity of HMO to epithelial cell surface carbohydrates, an inhibitory effect on the adhesion of pathogens to the cell surface is most likely. If this could be shown in humans, HMO would provide a new way to prevent or treat certain infections. It would also indicate supplementing infant formula based on cow's milk with HMO, as those oligosaccharides are either not detectable or present only in low numbers in bovine milk. As some HMO can be absorbed and circulate in blood, systemic effects may also be influenced. Due to their similarities to selectin ligands, HMO have been tested in in vitro studies demonstrating their anti-inflammatory abilities. For example, it has been shown that sialic acid-containing oligosaccharides reduce the adhesion of leukocytes to endothelial cells, an indication for an immune regulatory effect of certain HMO. We cover these topics after a short introduction on the structures of HMO, with a particular emphasis on their blood group and secretor specificity.


Assuntos
Leite Humano/química , Oligossacarídeos/imunologia , Oligossacarídeos/farmacologia , Animais , Bifidobacterium/efeitos dos fármacos , Bifidobacterium/metabolismo , Adesão Celular/efeitos dos fármacos , Humanos , Leucócitos/efeitos dos fármacos , Antígenos do Grupo Sanguíneo de Lewis , Leite Humano/enzimologia , Oligossacarídeos/sangue , Oligossacarídeos/química
3.
Clin Physiol Funct Imaging ; 28(5): 332-6, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-18507668

RESUMO

In capnovolumetry, the expiratory CO2 concentration of exhaled air is plotted against the volume and thereby allows to determine functional dead space volumes. This method might offer additional information in lung function testing in children and adolescents with bronchial asthma. We aimed at determining whether a bronchospasmolysis (BSL) effect in the lower airways could also be detected by capnovolumetry as reflected by changes in the functional threshold dead space volumes (VDT). In 47 patients (aged 4-16 years) with a mild persistent bronchial asthma, VDT were determined before and after bronchodilation prior to starting therapy with inhaled steroids and after 6 months of treatment. Additionally, spirometry and body plethysmography were performed in all patients. There were significantly higher VDT values after BSL before and after 6 months of therapy (P<0.0001). VDT values before BSL were tendatively higher after 6 months of therapy compared with baseline values (P=0.07). VDT values correlated with parameters derived from conventional pulmonary function testing, i.e. vital capacity, forced expiratory volume in 1 s (FEV1), and maximum expiratory flow (MEF50). As VDT values particularly reflect the volumes of the lower bronchi this method may provide supplementary information to conventional lung function tests which are based on breathing mechanics. This seems to be especially helpful in situations where body plethysmography is not available or cooperation in forced expiration manoeuvres is insufficient.


Assuntos
Asma/diagnóstico , Testes Respiratórios/métodos , Medidas de Volume Pulmonar/métodos , Espaço Morto Respiratório , Adolescente , Agonistas de Receptores Adrenérgicos beta 2 , Resistência das Vias Respiratórias , Broncodilatadores , Dióxido de Carbono/metabolismo , Criança , Pré-Escolar , Feminino , Volume Expiratório Forçado , Humanos , Masculino , Pletismografia , Espirometria , Capacidade Vital
4.
Allergol Select ; 2(1): 32-38, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-31826035

RESUMO

BACKGROUND: Omalizumab is a successfully implemented supplementary therapy for improving asthma control in children aged 6 years and older with severe persistent allergic asthma. The dosage of omalizumab depends on body weight and IgE level, yet no parameter has been established to guide dosage changes during therapy. Clinical studies in patients with allergic asthma or allergic rhinitis revealed a clinically relevant improvement by using omalizumab leading to concentrations of free serum IgE reported to be lower than 50 ng/ml. Therefore, only the question concerning the concentrations of free IgE used in a therapy with omalizumab is regarded of clinical importance, while total IgE (free and omalizumab-bound IgE) increases during treatment. PATIENTS AND METHODS: Ten patients, 8 to 17 years of age, received therapy with omalizumab due to severe allergic asthma. In addition, the patients had pronounced rhinoconjunctivitis, food allergy, insect sting allergy, and/or neurodermitis. The total IgE in the serum was measured in the patients 3 - 6 months before each omalizumab injection as a potential progress parameter (Sandwich-Immunoassay ADVIA Centaur). RESULTS: Six months after beginning of the therapy with omalizumab, a significant decrease of the total IgE concentration was found, in comparison to the baseline values (p < 0.003). In all patients the tolerability of omalizumab was very good: there was a reduction in the frequency of the asthma exacerbations and rescue medications. All patients reported a clearly improved quality of life. CONCLUSIONS: A general increase in IgE was not observed in any of the children we treated with omalizumab. Apart from the development of routine assays to determine free serum IgE levels, the significance of the total serum IgE as a suitable control of an omalizumab therapy should be further investigated in controlled studies with regard to sensitivity and specificity. In order to only administer the lowest necessary dose of omalizumab especially in children and adolescents, the establishment of laboratory parameters (free IgE and/or total IgE) to adequately monitor the therapy is urgently needed. Patients undergoing an omalizumab therapy require medical supervision at close intervals.

5.
Eur J Med Res ; 1(3): 171-2, 1995 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-9389680

RESUMO

Soluble cell adhesion molecules such as sICAM-1 in serum and other biological fluids are suggested as being useful diagnostic parameters for a variety of diseases. Since increased concentrations during diseases are frequently less pronounced compared to other parameters, we tested whether it would be necessary to align the time of blood collection during the course of a clinical trial. In the 9 volunteers of our trial we found a statistically significant effect at the point in time of blood collection and corresponding serum concentrations of sICAM-1 (p < 0.01). The deviation of the concentrations at a certain time from the daily mean in each individual was seen to be as high as 15%. Our data suggest that daytime variations of serum sICAM-1 concentrations should be taken into consideration when longitudinal observations are planned.


Assuntos
Molécula 1 de Adesão Intercelular/sangue , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
6.
Eur J Med Res ; 5(11): 468-72, 2000 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-11121367

RESUMO

Endotoxins (ET) are able to activate leukocytes and other cell types and thus affect cell adhesion studies with regard to biological functions of human milk oligosaccharides (HMO). In our HMO preparations we detected ET in concentrations of 1.1 to 32.7 ng/mg. However, as we found in previous tests, an ET concentration of less than 100 pg/ml was necessary in order to avoid effects on the expression of CD11b and CD62L on human neutrophil granulocytes. Therefore, we used affinity chromatography with a detoxifying gel (polymixin B) which reduces the ET concentration of 414.9 +/- 121.5 (mean +/- SEM) and 47.9 +/- 5.9 pg/mg for the acidic and the neutral HMO, respectively. As only about 50 - 100 microg HMO per ml test solution are usually used in biological assays, the residual ET concentration does not interfere with cellular functions. We conclude that despite structural similarities between ET as lipopolysaccharides and complex HMO, a one step purification of HMO preparations was sufficient to get HMO material that can be used in cell culture systems.


Assuntos
Endotoxinas/isolamento & purificação , Leite Humano/química , Oligossacarídeos/análise , Cromatografia de Afinidade , Endotoxinas/análise , Humanos , Neutrófilos/efeitos dos fármacos , Oligossacarídeos/isolamento & purificação
8.
Isotopes Environ Health Stud ; 35(1-2): 119-25, 1999.
Artigo em Inglês | MEDLINE | ID: mdl-10902537

RESUMO

Human milk oligosaccharides seem to play an important role in the infant's defense against bacterial and viral infections of the gastrointestinal and the urogenital tract. In this study, we investigated the influence of dietary carbohydrates on the biosynthesis of lactose and oligosaccharides in the human mammary gland and their renal excretion by the human milk-fed infant. For this purpose, a lactating woman was given 27 g galactose (Gal) containing 2 g [13C] Gal (1-13C/99%) immediately after breakfast. In the following 36 h, milk (5-10 ml) was collected before each nursing. Infant's urine was collected over a period of 24 h. 13C-enrichment was measured in total milk, milk fat and protein, in the carbohydrate fraction as well as in urine by isotope ratio mass spectrometry (IRMS). Milk carbohydrates and deproteinized urine samples were fractionated by Sephadex G25 gel filtration and further analyzed by IRMS, high performance thin layer chromatography and and high pH anion exchange chromatography with pulsed amperometric detection (HPAEC-PAD). IRMS revealed that in milk a maximal delta 13CPDB was reached within 8 h after Gal intake which then rapidly declined in the following 8 h. The cumulative 13C-elimination over this first peak was 6.9% of the oral 13C-dose. The highest 13C-enrichment was detectable in the carbohydrate fraction, mainly in lactose and neutral oligosaccharides. Compared to the enrichment of human milk, the delta 13CPDB of infant's urine was delayed. In urine, the highest amount of 13C was found in the Sephadex G25 fractions which mainly contained lactose, fucosyl-lactose, lacto-N-tetraose (LNT), fucosyl-LNT and difucosyl-LNT. For further characterization, individual components were separated by HPAEC-PAD and subsequently analyzed by fast atom bombardment mass spectrometry and IRMS. The data show, that orally applied Gal is incorporated in milk, especially in lactose and neutral oligosaccharides. Obviously, some of these components were absorbed by the infant and then excreted with urine. There, oligosaccharides may serve as analogous receptors for bacterial or viral adhesion molecules, and, hence, may prevent urogenital infections in breastfed infants.


Assuntos
Galactose/administração & dosagem , Leite Humano/química , Oligossacarídeos/metabolismo , Oligossacarídeos/urina , Administração Oral , Isótopos de Carbono , Cromatografia em Camada Fina , Feminino , Humanos , Lactente , Lactação , Espectrometria de Massas
9.
Biol Neonate ; 88(2): 129-35, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-15908743

RESUMO

BACKGROUND AND OBJECTIVES: Preterm infants with intrauterine growth retardation (IUGR) reveal an increased risk for the development of acute and chronic pulmonary disorders, i.e. bronchopulmonary dysplasia (BPD). In order to investigate the effect of IUGR on pulmonary development, an easily reproducible animal model for fetal growth restriction has been established using hypoxia as a sole intervention in the last third of pregnancy. METHODS: Date-mated mice were randomly assigned to either being kept at a fraction of inspired oxygen (FiO2) of 0.10 (hypoxic group) starting at day 14 or under normoxic conditions until day 17.5 of gestation (control group). Variables of somatic growth were assessed and standardized histomorphometric analyses of pulmonary tissue were performed. Expression of surfactant proteins (SP)-A, -B, -C and -D was determined by quantitative rt-PCR as biochemical indicators for lung development and maturation. RESULTS: Fetuses were delivered preterm at 0.87 of gestation. Those grown under hypoxic conditions revealed significantly lower birth weights (median: 0.69 vs. 0.97 g in controls; p < 0.001), body lengths (median: 17.5 vs. 20.2 mm in controls; p < 0.001) and fronto-occipital diameters (median: 9.4 vs. 10.1 mm in controls; p < 0.001) compared to controls. Histomorphometric analyses were found to be without significant differences between both groups. On the transcriptional level, however, mRNA expression of SP-A, -B and -C but not SP-D could be shown to be significantly reduced in hypoxic fetuses compared to normoxic controls. CONCLUSIONS: In conclusion, hypoxic conditions from day 14 to 17.5 led to IUGR in preterm mice and to significant alterations of the developing surfactant system. We speculate restricted development of SP gene expression to be a causal factor for the increased risk of acute and chronic pulmonary disorders in preterm infants with IUGR.


Assuntos
Retardo do Crescimento Fetal/etiologia , Hipóxia/complicações , Pneumopatias/fisiopatologia , Pulmão/embriologia , Surfactantes Pulmonares/metabolismo , Animais , Modelos Animais de Doenças , Feminino , Pneumopatias/etiologia , Camundongos , Gravidez , Proteínas/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Transcrição Gênica
10.
J Pediatr Gastroenterol Nutr ; 15(1): 25-33, 1992 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-1403447

RESUMO

There are presently several fundamentally different technologies to produce infant formulas (IF), such as sterilization, spray-drying, and treatment at ultrahigh temperature (UHT). The effects of heat treatment on milk proteins in IF were analyzed by column chromatography, gel electrophoresis, and Kjeldahl analysis, revealing strong protein-protein and protein-lipid interactions in processed milk. These interactions were more pronounced in conventionally (in-can) sterilized than in spray-dried (powdered) and UHT products confirming their temperature dependency. Analysis of raw materials, intermediate and end products of IF processing revealed that after homogenization the first indications of protein denaturation occurred, but that in-can sterilization as the final heat treatment caused irreversible denaturation of proteins and strong protein-lipid interactions. Lowering of the pH to 4-5, which is physiological for the stomach of young infants, enhanced the interactions. Support for an impairment of protein digestibility was given by in vitro analysis of protein digestibility, demonstrating significantly lower digestibility of in-can sterilized IF compared to their spray-dried and UHT counterparts. To investigate the effect of heat treatment on chemical reactions, i.e., occurrence of Maillard products, we showed by a fluorimetric assay that the amount of "available" lysine is lower in sterilized than in powdered IF. Our findings suggest that a more differentiated view regarding the protein quality of IF is needed.


Assuntos
Proteínas do Leite/metabolismo , Animais , Cromatografia , Digestão , Eletroforese em Gel de Ágar , Temperatura Alta , Humanos , Técnicas In Vitro , Lactente , Alimentos Infantis/análise , Recém-Nascido , Leite/análise , Proteínas do Leite/análise , Solubilidade
11.
Am J Dis Child ; 146(5): 588-91, 1992 May.
Artigo em Inglês | MEDLINE | ID: mdl-1621661

RESUMO

OBJECTIVE: To determine calcium and zinc retention from infant formulas based on protein hydrolysates. DESIGN: Randomized, crossover. SETTING: Newborn nursery at the California Primate Research Center, Davis. PARTICIPANTS: Suckling infant rhesus monkeys (N = 7), aged 6 weeks at the beginning of the study. Each infant received seven different formulas. INTERVENTIONS: Fasted infant monkeys were fed diets radiolabeled with calcium 47 and zinc 65. Retention was determined by counting whole body radioactivity immediately after dosing and 7 days after dosing. MEASUREMENTS AND RESULTS: Retention of 47Ca was a mean (+/- SEM) of 79% +/- 4% from casein hydrolysate and 72% +/- 6% from the whey protein hydrolysate formula. Calcium 47 retention from hydrolysates based on whey protein/casein mixtures (a ratio of 60:40 or 50:50) was similar despite differences in protein sources and calcium content. Calcium 47 retention from two types of soy/collagen hydrolysate formula was found to be 68% +/- 6% and 59% +/- 4%, respectively, which is significantly lower than retention from casein hydrolysate. Considering the different calcium content of these formulas, total calcium retention from milk protein hydrolysates was higher than from soy/collagen products. Retention of 65Zn from milk protein hydrolysates ranged from 18% +/- 3% to 29% +/- 4% and was higher than that from soy/collagen formulas with a mean retention of 7% +/- 3% and 10% +/- 4%, respectively. Despite these differences in 65Zn retention, total zinc retention from all soy/collagen formulas was similar due to their higher zinc content. CONCLUSIONS: Calcium and zinc bioavailability was high from formulas based on milk protein hydrolysate, but was considerably lower from soy hydrolysates. Higher levels of calcium and zinc provided in soy hydrolysate formula compensated for the lower bioavailability and resulted in similar amounts of calcium and zinc retained.


Assuntos
Cálcio/farmacocinética , Proteínas Alimentares/metabolismo , Hidrolisados de Proteína/metabolismo , Zinco/farmacocinética , Absorção , Animais , Animais Lactentes , Disponibilidade Biológica , Cálcio/análise , Macaca mulatta , Leite , Hidrolisados de Proteína/química , Distribuição Aleatória , Glycine max , Zinco/análise
12.
Z Ernahrungswiss ; 35(1): 22-31, 1996 Mar.
Artigo em Alemão | MEDLINE | ID: mdl-8815647

RESUMO

About a century ago, pediatricians observed that in feces of breast-fed infants, compared to those of bottle-fed infants, Bifidobacterium bifidum was the predominant microorganism. It was shown thereafter that aminosugar-containing oligosaccharides are growth factors for a specific strain of Bifidobacterium. Meanwhile, more than 130 lactose-derived oligosaccharides have been identified in human milk. Some of these oligosaccharides like Lacto-N-Tetraose and Lacto-N-Fucopentaose I and II do not occur in minute amounts but in concentrations up to 1-2 g/L. As the total amount of complex oligosaccharides is between 3-6 g/L those components have to be considered as major human milk constituents. There is striking evidence that human milk oligosaccharides are potent inhibitors of bacterial adhesion to epithelial surfaces, an initial stage of infective processes. Therefore, these oligosaccharides are considered to be soluble receptor analogues of epithelial cell surfaces participating in the non-immunological defense system of human milk-fed infants.


Assuntos
Leite Humano/química , Monossacarídeos/análise , Oligossacarídeos/química , Bifidobacterium/isolamento & purificação , Alimentação com Mamadeira , Aleitamento Materno , Sequência de Carboidratos , Fezes/microbiologia , Feminino , Humanos , Lactente , Dados de Sequência Molecular , Oligossacarídeos/análise
13.
Am J Dis Child ; 144(3): 360-3, 1990 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-2305747

RESUMO

An adequate supply of calcium is important for normal bone mineralization in infants. Special infant formulas have been developed to treat infants with a high risk of developing allergy. Similar to other diets, it is important that these products are nutritionally adequate. We have measured calcium retention from a new formula based on whey hydrolysate and compared it with conventional formulas, using extrinsic labeling with calcium 47 and the weanling rhesus monkey as an animal model. Retention of calcium was similar for all formulas studied: 45% +/- 4% (mean +/- SEM) from whey-hydrolysate, 47% +/- 2% from whey-predominant, and 53% +/- 7% from casein-predominant formula. Calcium retention from human milk, 72% +/- 3%, was significantly higher than from formula. Using these retention values and the calcium concentrations of the diets, infant formula and human milk deliver approximately equal amounts of calcium to the infant.


Assuntos
Cálcio/metabolismo , Alimentos Infantis , Proteínas do Leite/metabolismo , Leite Humano/metabolismo , Animais , Caseínas/metabolismo , Macaca mulatta , Hidrolisados de Proteína/metabolismo , Glycine max , Proteínas do Soro do Leite
14.
Ann Nutr Metab ; 40(5): 252-62, 1996.
Artigo em Inglês | MEDLINE | ID: mdl-9001685

RESUMO

In this study, glycoproteins and oligosaccharides with sialyl Lewis a, sialyl Lewis x, Lewis x, and Lewis y epitopes were isolated by ultracentrifugation and fast-protein liquid chromatography from human milk of mothers with term or preterm infants. The identification of these epitopes on whey proteins was achieved by monoclonal antibodies and lectins after Western blotting. Lactose-derived oligosaccharides were characterized by high-performance thin-layer chromatography and high-pH anion-exchange chromatography with pulsed amperometric detection. These carbohydrate epitopes which are potential ligands for selections are not of cellular origin but appear in the soluble fraction of milk. Here, they are present as lactose-derived oligosaccharides (molecular weight < 10 kD) or bound to proteins with a high molecular weight (> 100 kD). Lewis antigens might represent another category of protective nonimmunological substances in human milk with the potential to influence inflammatory processes in human milk fed infants.


Assuntos
Moléculas de Adesão Celular/metabolismo , Leite Humano/química , Anticorpos Monoclonais , Antígeno CA-19-9 , Sequência de Carboidratos , Cromatografia Líquida de Alta Pressão , Gangliosídeos/metabolismo , Glicoproteínas/química , Glicoproteínas/isolamento & purificação , Humanos , Lactose/química , Antígenos do Grupo Sanguíneo de Lewis/metabolismo , Antígenos CD15/metabolismo , Dados de Sequência Molecular , Oligossacarídeos/química , Oligossacarídeos/isolamento & purificação , Oligossacarídeos/metabolismo , Antígeno Sialil Lewis X
15.
Br J Nutr ; 82(5): 391-9, 1999 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-10673912

RESUMO

Human milk is commonly considered to be unique when compared with the milk of other species with regard to its high content of complex fucosylated and sialylated lactose-derived oligosaccharides. We describe the application of high-pH anion-exchange chromatography with pulsed amperometric detection and TLC to characterize and quantitate neutral and sialylated lactose-derived oligosaccharides in milk from three Asian elephants and human milk. The lactose contents of elephant and human milks were 25-30 g/l and about 66 g/l respectively, whereas total oligosaccharide concentration was about three times higher in elephant milk and comprised up to 40% (10% in human milk) of the carbohydrate content. The ratio neutral: acidic components was different in the milk of the two species; in elephant milk, the N-acetylneuraminic acid-containing oligosaccharides made up almost half of the total amount v. 30% in human milk. Most oligosaccharides in elephant milk were more fucosylated and/or sialylated compared with human milk components. By mild acid hydrolysis, fucose and N-acetylneuraminic acid were cleaved off from complex components, and this resulted in increased amounts of fucose, galactose, N-acetylneuraminic acid, lactose and lacto-N-neo-tetraose. Unique to elephant milk are the high levels of 3'-galactosyllactose (up to 4 g/l) and lacto-N-neo-tetraose which are present in human milk only in trace amounts. Elephant and human milks have high levels and unique patterns of oligosaccharides which may reflect the relative importance of these components in neonatal host defence, in endothelial leucocyte interactions or in brain development.


Assuntos
Elefantes , Leite/química , Oligossacarídeos/análise , Animais , Cromatografia em Camada Fina , Feminino , Humanos , Lactose/análise , Lactose/metabolismo , Leite Humano/química , Oligossacarídeos/metabolismo
16.
J Pediatr Gastroenterol Nutr ; 33(5): 565-9, 2001 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-11740230

RESUMO

BACKGROUND: Premature infants receiving alimentation with cow milk-based formulas run a considerably high risk of incipient late metabolic acidosis, an early stage developing of manifest late metabolic acidosis. Is bone metabolism involved in pathophysiologic mechanisms characterizing this early stage of retention acidosis? METHODS: Urinary ionography was performed in 10 premature infants with spontaneous development of incipient late metabolic acidosis (indicated by urine pH < 5.4 on 2 consecutive days) and 10 pair-matched premature infants with normal values of urine pH; both groups were receiving full oral nutrition with the same standard formula. Moreover, in 37 premature infants with incipient late metabolic acidosis who were randomly allocated to oral therapy with 2 mmol. kg(-1). d(-1) of either NaHCO 3 or NaCl over a period of 7 days, urinary excretion of calcium and phosphorus was assessed on day 1 and day 7. RESULTS: Incipient late metabolic acidosis was accompanied by increased phosphaturia in premature infants receiving full oral nutrition. Seventeen premature infants receiving NaCl therapy (19 treatment periods) showed increased calciuria from day 1 to day 7, whereas, in 20 premature infants receiving NaHCO 3 therapy (23 treatment periods), calcium or phosphorus excretion in urine did not increase. CONCLUSIONS: The data of urinary calcium and phosphorus excretion in premature infants support the hypothesis that bone mineralization may already be impaired in the early stage of incipient late metabolic acidosis.


Assuntos
Acidose Tubular Renal/urina , Desenvolvimento Ósseo/fisiologia , Osso e Ossos/metabolismo , Cálcio/urina , Doenças do Prematuro/urina , Fósforo/urina , Acidose Tubular Renal/tratamento farmacológico , Acidose Tubular Renal/fisiopatologia , Humanos , Concentração de Íons de Hidrogênio , Lactente , Recém-Nascido de Baixo Peso , Recém-Nascido , Recém-Nascido Prematuro , Doenças do Prematuro/tratamento farmacológico , Doenças do Prematuro/fisiopatologia , Rim/fisiologia , Bicarbonato de Sódio/uso terapêutico , Cloreto de Sódio/uso terapêutico
17.
J Nutr ; 130(12): 3014-20, 2000 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-11110861

RESUMO

In examining the functional aspects of human milk oligosaccharides (HMO), it is not known whether they are digested during the passage through the infant's gastrointestinal tract. HMO were prepared from individual milk samples (n = 6) and separated into neutral and acidic compounds by chromatography. These oligosaccharide fractions were studied for their digestibility by human salivary amylase, porcine pancreatic amylase and brush border membrane vesicles (BBMV) isolated from porcine small intestine; we also examined the effect of low pH on these structures. The characterization of HMO and their digestion products was performed by high-pH anion-exchange chromatography with pulsed amperometric detection (HPAEC-PAD) as well as TLC. It was shown that neither salivary amylase nor pancreatic amylase cleaved HMO. Only after a 2-h incubation with BBMV were slight modifications of the HMO observed. HPAEC-PAD analysis revealed two new components within the neutral oligosaccharide fractions; these were characterized by mass spectrometric analysis as lacto-N:-triose and galactose. Only lacto-N:-triose was present within digestion assays of oligosaccharides, which did not contain fucosyl or N:-acetylneuraminic acid residues. These results suggest that <5% of the HMO are digested in the intestinal tract. Hence, HMO may play a role as prebiotics or as factors influencing the local immune system of the intestine in breast-fed infants.


Assuntos
Digestão , Sistema Digestório/metabolismo , Leite Humano/química , Oligossacarídeos/metabolismo , Amilases/análise , Cromatografia Líquida de Alta Pressão , Fezes/química , Feminino , Galactose/análise , Humanos , Concentração de Íons de Hidrogênio , Técnicas In Vitro , Lactação , Espectrometria de Massas , Microvilosidades/metabolismo , Leite Humano/enzimologia , Leite Humano/metabolismo , Oligossacarídeos/química , Fatores de Tempo , Trissacarídeos/análise , Urinálise
18.
J Pediatr Gastroenterol Nutr ; 25(1): 46-50, 1997 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-9226526

RESUMO

BACKGROUND: Premature infants receiving alimentation with cow's milk formulas are at a considerably high risk of developing incipient late metabolic acidosis, an early stage in the development of manifest late metabolic acidosis. Is it possible to reduce this risk by modification of the composition of a standard formula? METHODS: The mineral composition of a cow's milk preterm formula A was modified (formula B) with the aim of reducing the alimentary load to that of human milk. 160 premature infants were fed either mother's milk (n = 50) or the modified formula B (enriched with sodium and potassium) (n = 110), and their urine pH was tested twice a week. Randomly collected subgroups of infants were studied in detail for nutrient balances. The results were compared with earlier observations of 282 premature infants fed either mother's milk (n = 28) or the standard formula A (n = 254). RESULTS: Incipient late metabolic acidosis was observed in nine of 78 premature infants receiving mother's milk, 53 of 254 premature infants receiving the standard formula A, and only one of 110 premature infants fed the modified formula B. Net acid excretion was 0.58 mmol/kg/day in 11 premature infants receiving alimentation with the modified formula B compared with 1.73 mmol/kg/day in 23 premature infants fed formula A. This reduction was mainly due to an increased alkali excess (sodium + potassium-chloride) in intake and urine. CONCLUSIONS: Reduction of renal acid load with the modified formula B had a preventive effect on the rate of development of incipient late metabolic acidosis in premature infants.


Assuntos
Acidose Tubular Renal/dietoterapia , Alimentos Infantis , Doenças do Prematuro/dietoterapia , Recém-Nascido Prematuro/fisiologia , Recém-Nascido Pequeno para a Idade Gestacional/fisiologia , Urina/química , Acidose Tubular Renal/prevenção & controle , Cálcio/metabolismo , Cálcio/urina , Creatinina/urina , Humanos , Concentração de Íons de Hidrogênio , Lactente , Alimentos Infantis/efeitos adversos , Alimentos Infantis/análise , Recém-Nascido , Doenças do Prematuro/prevenção & controle , Masculino , Minerais/metabolismo , Minerais/urina , Nitrogênio/metabolismo , Nitrogênio/urina , Fósforo/metabolismo , Fósforo/urina , Potássio/metabolismo , Potássio/urina , Estudos Prospectivos , Sódio/metabolismo , Sódio/urina
19.
Klin Padiatr ; 207(6): 334-40, 1995.
Artigo em Alemão | MEDLINE | ID: mdl-8569136

RESUMO

A standard preterm formula was supplemented with calcium (Ca) and phosphorus (P) (F-CaP: Ca 87 mg/dl, P 43 mg/dl) and compared to the non-supplemented form (F: Ca 62 mg/dl, P 36 mg/dl). VLBW and small-for-gestational-age infants (n = 79) were included in the study which was performed to look for adverse effects and to decide about a reasonable start and duration of supplementation. In preterm infants with a birth weight lower than 1500 g and a body weight of more than 2000 g, the additional supplementation with Ca and P lead to a significant higher Ca- and P-retention without further load for the kidney. In addition, preterm infants with a body weight lower than 1500 g also had a better retention of Ca and P. Both, F-CaP and F lead to a high urinary excretion of phosphorus, a high renal net acid excretion and a relatively high activity of serum alkaline phosphatase. Anthropometric measurements did not reveal any evidence for an impaired caloric absorption due to an increased fecal fat excretion. Hypercalcemia or hyperphosphatermia was not seen. Hypercalciuria occurred in less than 5% of the samples studied. The results of this study indicate that a continuation of the supplementation with Ca and P is justified in VLBW infants with a body weight of more than 2000 g. There was no evidence for adverse effects of Ca and P supplementation in VLBW infants with a body weight lower than 1500 g, who might therefore also benefit from supplementation. Further studies are necessary to investigate unsatisfactory metabolic conditions of these children e.g. the high renal load.


Assuntos
Cálcio da Dieta/administração & dosagem , Alimentos Fortificados , Alimentos Infantis , Doenças do Prematuro/dietoterapia , Recém-Nascido Pequeno para a Idade Gestacional , Fósforo/administração & dosagem , Antropometria , Ingestão de Energia/efeitos dos fármacos , Feminino , Humanos , Recém-Nascido , Recém-Nascido de muito Baixo Peso , Masculino , Necessidades Nutricionais , Valor Nutritivo
20.
J Chromatogr B Biomed Appl ; 685(2): 211-21, 1996 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-8953162

RESUMO

A method is described to separate and characterize neutral and acidic lactose-derived oligosaccharides without prior derivatization or reduction by high-pH anion-exchange chromatography and pulsed amperometric detection (HPAEC-PAD). This method has been applied to human milk oligosaccharides from donors with different blood group specificity (A, Le(a) and A, Le(b). Neutral and acidic components were separated from each other by anion-exchange chromatography. A distinct separation of individual components was obtained by size-exclusion chromatography on Fractogel TSK HW 50S (acidic oligosaccharides) or Fractogel TSK HW 40S (neutral oligosaccharides containing up to 6 monomers) and Bio-Gel P-4 size exclusion (neutral oligosaccharides containing more than 6 monomers). Furthermore the moral response factors after HPAEC-PAD have been determined for 28 components.


Assuntos
Cromatografia Líquida/métodos , Leite Humano/química , Oligossacarídeos/análise , Sequência de Carboidratos , Cromatografia em Gel , Cromatografia por Troca Iônica , Cromatografia em Camada Fina , Feminino , Humanos , Concentração de Íons de Hidrogênio , Antígenos do Grupo Sanguíneo de Lewis , Oligossacarídeos/química
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