Breast milk immune composition varies during the transition stage of lactation: characterization of immunotypes in the MAMI cohort.

Background: Breast milk is a complex and dynamic fluid needed for infant development and protection due to its content of bioactive factors such as immunoglobulins (Igs). Most studies focus primarily on IgA, but other types of Ig and even other immune components (cytokines and adipokines) may also play significant roles in neonatal health. As a first step, we aimed to characterize the Ig profile, many cytokines, and two adipokines (leptin and adiponectin) at two sampling time points within the transitional stage, which is the least studied phase in terms of these components. The secondary objective was to identify different breast milk immunotypes in the MAMI cohort substudy, and finally, we further aimed at analyzing maternal and infant characteristics to identify influencing factors of breast milk immune composition. Methods: Breast milk samples from 75 mothers were studied between days 7 and 15 postpartum. The Igs, cytokines, and adipokine levels were determined by a multiplex approach, except for the IgA, IgM, and leptin that were evaluated by ELISA. Results: IgA, IgM, IgE, IgG2, IL-1ß, IL-5, IL-6, IL-10, and IL-17 were significantly higher on day 7 with respect to day 15. The multiple factor analysis (MFA) allowed us to identify two maternal clusters (immunotypes) depending on the breast milk immune profile evolution from day 7 to day 15, mainly due to the IgE and IgG subtypes, but not for IgA and IgM, which always presented higher levels early in time. Conclusion: All these results demonstrated the importance of the dynamics of the breast milk composition in terms of immune factors because even in the same lactation stage, a difference of 1 week has induced changes in the breast milk immune profile. Moreover, this immune profile does not evolve in the same way for all women. The dynamic compositional changes may be maternal-specific, as we observed differences in parity and exclusive breastfeeding between the two BM immunotype groups, which could potentially impact infant health.

Comparison of the marginal fit of milled yttrium stabilized zirconium dioxide crowns obtained by scanning silicone impressions and by scanning stone replicas.

PURPOSE: To determine the discrepancy in monolithic zirconium dioxide crowns made with computer-aided design and computer-aided manufacturing (CAD/CAM) systems by comparing scans of silicone impressions and of master casts. MATERIALS AND METHODS: From a Cr-Co master die of a first upper left molar, 30 silicone impressions were taken. The 30 silicone impressions were scanned with the laboratory scanner, thus obtaining 30 milled monolithic yttrium stabilized zirconium dioxide (YSZD) crowns (the silicone group). They were poured and the working models were scanned, obtaining 30 milled monolithic yttrium stabilized zirconium dioxide (YSZD) crowns (the plaster group). Three predetermined points were analyzed in each side of the crown (Mesial, Distal ,Vestibular and Palatal), and the marginal fit was evaluated with SEM (×600). The response variable is the discrepancy from the master model. A repeated measures ANOVA with two within subject factors was performed to study significance of main factors and interaction. RESULTS: Mean marginal discrepancy was 22.42±35.65 µm in the silicone group and 8.94±14.69 µm in the plaster group. The statistical analysis showed significant differences between the two groups and also among the four aspects. Interaction was also significant (P=.02). CONCLUSION: The mean marginal fit values of the two groups were within the clinically acceptable values. Significant differences were found between the groups according to the aspects studied. Various factors influenced the accuracy of digitizing, such as the design, the geometry, and the preparation guidance, as well as the texture, roughness and the color of the scanned material.

Biomarkers of Morbid Obesity and Prediabetes by Metabolomic Profiling of Human Discordant Phenotypes.

Metabolomic studies aimed to dissect the connection between the development of type 2 diabetes and obesity are still scarce. In the present study, fasting serum from sixty-four adult individuals classified into four sex-matched groups by their BMI [non-obese versus morbid obese] and the increased risk of developing diabetes [prediabetic insulin resistant state versus non-prediabetic non-insulin resistant] was analyzed by LC- and FIA-ESI-MS/MS-driven metabolomic approaches. Altered levels of [lyso]glycerophospholipids was the most specific metabolic trait associated to morbid obesity, particularly lysophosphatidylcholines acylated with margaric, oleic and linoleic acids [lysoPC C17:0: R=-0.56, p=0.0003; lysoPC C18:1: R=-0.61, p=0.0001; lysoPC C18:2 R=-0.64, p<0.0001]. Several amino acids were biomarkers of risk of diabetes onset associated to obesity. For instance, glutamate significantly associated with fasting insulin [R=0.5, p=0.0019] and HOMA-IR [R=0.46, p=0.0072], while glycine showed negative associations [fasting insulin: R=-0.51, p=0.0017; HOMA-IR: R=-0.49, p=0.0033], and the branched chain amino acid valine associated to prediabetes and insulin resistance in a BMI-independent manner [fasting insulin: R=0.37, p=0.0479; HOMA-IR: R=0.37, p=0.0468]. Minority sphingolipids including specific [dihydro]ceramides and sphingomyelins also associated with the prediabetic insulin resistant state, hence deserving attention as potential targets for early diagnosis or therapeutic intervention.