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Human Breast Milk: Bioactive Components, from Stem Cells to Health Outcomes

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Abstract

Purpose of Review

Breast milk (BM) is a peculiar fluid owing unique properties and resulting the ideal food during early neonatal period. As widely known, it can improve the outcome of both neonate and lactating mother, influencing their whole life. BM is characterized by several beneficial components; among these, a great role is played by BM own and specific microbiome, deeply investigated in many studies. Moreover, the use of metabolomics in BM analysis allowed a better characterization of its metabolic pathways that vary according to lactation stage and neonatal gestational age. The aim of this review is to describe growth factors, cytokines, immunity mediators, and stem cells (SCs) contained in BM and investigate their functions and effects on neonatal outcome, especially focusing on immuno- and neurodevelopment.

Recent Findings

We evaluated recent and updated literature on this field. The article that we analyzed to write this review have been found in MEDLINE using breast milk-derived stem cells, biofactors, growth factors, breastfeeding-related outcomes, neurodevelopment, and neonatal immunological system as keywords. Discovering and characterizing BM components could result very useful to clarify the pathophysiology of their influence on neonatal growth and even to improve artificial formulations’ composition. Moreover, since SCs abilities and their involvement in the development of several diseases, they could help to discover specific targets for new therapies.

Summary

It could be useful to characterize BM-derived SC markers, properties, and variations during lactation stages, to understand their potential role in therapeutic applications, since they could be noninvasively isolated from BM. More studies will help to describe more in detail the characteristics of mother-to-child communication through breastfeeding and its potential role in the next future.

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Abbreviations

ALA:

α-linolenic acid

AA:

Arachidonic acid

ABPs:

Antibacterial peptides

BDNF:

Brain-derived neurotrophic factor

BM:

Breast milk

BMDSCs:

Breast milk-derived stem cells

BMI:

Body mass index

BTN:

Butyrophilin

BW:

Birth weight

CLD:

Chronic lung disease

CD:

Cluster of differentiation

CK:

Cytokeratin

CNS:

Central nervous system

CRP:

C-reactive protein

Cu:

Copper

DHA:

Docosahexaenoic acid

EGF:

Epidermal growth factor

EGF:

Epidermal growth factor

ELBW:

Extremely low birth weight

EMT:

Epithelial-mesenchymal transition

Fas:

Fatty acids

FGF:

Fibroblast growth factors

GA:

Gestational age

G-CSF:

Granulocyte-colony stimulating factor

GDNF:

Glial cell line-derived neurotrophic factor

GFs:

Growth factors

GLP-1:

Glucagon-like peptide-1

HB-EGF:

Heparin-binding epidermal growth factor

hESCs:

Embryonic SCs

HGF:

Hepatocyte growth factor

HMOs:

Human milk oligosaccharides

Ig:

Immunoglobulins

Il:

Interleukins

IFN:

Interferon

IGFs:

Insulin growth factors

K:

Potassium

LA:

Linoleic acid

LF:

Lactoferrin

MGFM:

Milk fat globule membrane

miRNA:

microRNA

MLNs:

Mesenteric lymph nodes

MSCs:

Mesenchymal stem cells

MUC1:

Mucin 1

NANOG:

Homeobox protein

NEC:

Necrotizing enterocolitis

NICU:

Neonatal intensive care unit

NK:

Natural killers

NT-3:

Neurotropin

OCT4:

Octamer-binding transcription factor 4

ROP:

Retinopathy of prematurity

SCs:

Stem cells

SGA:

Small for GA

SOD:

Superoxido-dysmutase

SOX2:

Sex determining region Y-box

SP:

Side population

tdT+:

tdTomato + cells

TGF:

Transforming growth factor

TNF:

Tumor necrosis factors

VEGF:

Vascular endothelial growth factor

VLBW:

Very low birth weight

XDH/XO or XOR:

Xanthine oxidoreductase

Zn:

Zinc

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Authors and Affiliations

  1. Neonatal Intensive Care Unit, AOU University of Cagliari, SS 554 km 4,500, 09042, Monserrato, CA, Italy

    Flaminia Bardanzellu & Vassilios Fanos

  2. Clinical and Experimental Medicine Department, section of Pediatrics, University of Pisa, Via Roma, 55, 56126, Pisa, PI, Italy

    Diego Giampietro Peroni

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VF, DGP, and FB conceptualized the structure of the review. FB provided the literature update and wrote the initial version of the manuscript. VF and DGB critically revised, modified, and approved the work. Finally, all authors approved the final version of the manuscript.

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Correspondence to Flaminia Bardanzellu.

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Bardanzellu, F., Peroni, D.G. & Fanos, V. Human Breast Milk: Bioactive Components, from Stem Cells to Health Outcomes. Curr Nutr Rep 9, 1–13 (2020). https://doi.org/10.1007/s13668-020-00303-7

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