Human milk oligosaccharide

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Human milk oligosaccharides (HMOs), also known as human milk glycans, are short polymers of simple sugars that can be found in high concentrations in human breast milk. [1] Human milk oligosaccharides promote the development of the immune system, can reduce the risk of pathogen infections and improve brain development and cognition. [1] The HMO profile of human breast milk shapes the gut microbiota of the infant by selectively stimulating bifidobacteria and other bacteria. [2]

Contents

Functions

Chemical structure of 2'-fucosyllactose consisting of lactose and fucose subunits 2'-Fucosyllactose.svg
Chemical structure of 2'-fucosyllactose consisting of lactose and fucose subunits

In contrast to the other components of breast milk that are absorbed by the infant through breastfeeding, HMOs are indigestible for the nursing child. However, they have a prebiotic effect and serve as food for intestinal bacteria, especially bifidobacteria. [3]  The dominance of these intestinal bacteria in the gut reduces the colonization with pathogenic bacteria (probiosis) and thereby promotes a healthy intestinal microbiota and reduces the risk of dangerous intestinal infections. Recent studies suggest that HMOs significantly lower the risk of viral and bacterial infections and thus diminish the chance of diarrhoea and respiratory diseases.

This protective function of the HMOs is activated when in contact with specific pathogens, such as certain bacteria or viruses. These have the ability to bind themselves to the glycan receptors (receptors for long chains of connected sugar molecules on the surface of human cells) located on the surface of the intestinal cells and can thereby infect the cells of the intestinal mucosa. Researchers have discovered that HMOs mimic these glycan receptors so the pathogens bind themselves to the HMOs rather than the intestinal cells. This reduces the risk of an infection with a pathogen. [1] [4] It has also been demonstrated that HMOs can bind to several intestinal viruses, such as norovirus and Norwalk virus, moreover they can reduce the virus load from influenza and RSV. [5]

In addition to this, HMOs seem to influence the reaction of specific cells of the immune system in a way that reduces inflammatory responses. [1] [6] It is also suspected that HMOs reduce the risk of premature infants becoming infected with the potentially life-threatening disease necrotizing enterocolitis (NEC). [1]

Some of the metabolites directly affect the nervous system or the brain and can sometimes influence the development and behavior of children in the long term. There are studies that indicate certain HMOs supply the child with sialic acid residues. Sialic acid is an essential nutrient for the development of the child’s brain and mental abilities. [1] [6]

In experiments designed to test the suitability of HMOs as a prebiotic source of carbon for intestinal bacteria it was discovered that they are highly selective for a commensal bacteria known as Bifidobacteria longum biovar infantis. The presence of genes unique to B. infantis , including co-regulated glycosidases, and its efficiency at using HMOs as a carbon source may imply a co-evolution of HMOs and the genetic capability of select bacteria to utilize them. [7]

Occurrence

Milk oligosaccharides seem to be more abundant in humans than in other animals and to be more complex and varied. [8] Oligosaccharides in primate milk are generally more complex and diverse than in non-primates. [1]

Human milk oligosaccharides (HMOs) form the third most abundant solid component (dissolved or emulsified or suspended in water) of human milk, after lactose and fat. [9] HMOs are present in a concentration of 11.3 – 17.7 g/L (1.5 oz/gal – 2.36 oz/gal) in human milk, depending on lactation stages. [10] Approximately 200 structurally different human milk oligosaccharides are known, and they can be categorized into fucosylated, sialylated and neutral core HMOs. The composition of human milk oligosaccharides in breast milk is individual to each mother and varies over the period of lactation. The dominant oligosaccharide in 80% of all women is 2′-fucosyllactose, which is present in human breast milk at a concentration of approximately 2.5 g/L; [4] other abundant oligosacchadies include lacto-N-tetraose, lacto-N-neotetraose, and lacto-N-fucopentaose. [11] It has been found by numerous studies that the concentration of each individual human milk oligosaccharide changes throughout the different periods of lactation (colostrum, transitional, mature and late milk) and depend on various factors such as the mother's genetic secretor status and length of gestation. [10]

Mean concentrations of the most abundant HMOs by lactation stage in [g/L] (pooled HMO means from 31 countries) [10]
AbbreviationNameColostrum (0–5 days)Transitional (6–14 days)Mature (15–90 days)Late (>90 days)
2'FL2'-Fucosyllactose3.182.072.281.65
LNDFH-ILacto-N-difucohexaose I1.031.061.100.87
LNFP-ILacto-N-fucopentaose I0.831.110.830.41
LNFP-IILacto-N-fucopentaose II0.780.330.780.27
LNTLacto-N-tetraose0.731.070.740.64
3-FL3-Fucosyllactose0.720.590.720.92
6'-SL6'-Sialyllactose0.400.710.400.30
DSLNTDisialyllacto-N-tetraose0.380.670.380.22
LNnTLacto-N-neotetraose0.370.470.370.19
DFLDifucosyllactose0.290.560.290.27
FDS-LNHFucosyldisialyllacto-N-hexaose I0.28N/A0.290.12
LNFP-IIILacto-N-fucopentaose III0.260.370.260.23
3'SL3'-Sialyllactose0.190.130.190.13

Applications

Synthesis

Biosynthesis in humans

All HMOs derive from lactose, which can be decorated by four monosaccharides (N-acetyl-D-glucosamine, D-galactose, sialic acid and/or L-fucose) to form an oligosaccharide. [10] The HMO variability in human mothers depend on two specific enzymes, the α1-2-fucosyltransferase (FUT2) and the α1-3/4-fucosyltransferase (FUT3). [16] The milk of mothers with inactivated FUT2 enzyme do not contain α1-2-fucosylated HMOs, and likewise with inactivated FUT3 enzyme there can be almost no α1-4-fucasylated HMOs found. Typically 20% of the global population of mothers do not have active FUT2 enzyme, but still have an active FUT3 enzyme, whereas 1% of mothers express neither FUT2 nor FUT3 enzymes. [17]

Milk groups according to Lewis and Secretor status [17]
Milk groupGenetic classificationLewis status (FUT3 enzyme presence)Secretor status (FUT2 enzyme presence)Main HMOs secretedEstimated global frequency
1Lewis positive, SecretorYesYes2'FL, 3-FL, DFL, LNT, LNnT, LNFP-I, LNFP-II, LNDFH-I, LNDFH-II70%
2Lewis positive, Non-secretorYesNo3-FL, LNT, LNnT, LNFP-II, LNFP-III, LNDFH-II20%
3Lewis negative, SecretorNoYes2'FL, 3-FL, DFL, LNT, LNnT, LNFP-I, LNFP-III9%
4Lewis negative, Non-secretorNoNo3-FL, LNT, LNnT, LNFP-III, LNFP-V1%

Industrial large-scale synthesis

Human milk oligosaccharides can be synthesized in large quantities using precision industrial fermentation methods e.g. by the commonly used, non-pathogenic bacteria Escherichia coli . [18] During the fermentation process the bacteria are fed with a carbon-source (e.g. glucose), salts, minerals and trace elements under aseptic conditions in a stainless steel bioreactor, while lactose is added to the process as precursor molecule. Bacteria are then converting the lactose into human milk oligosaccharides by decorating it with other sugar monomers. After the fermentation process the HMOs are completely separated from the bacteria, proteins and DNA using different filtration techniques. [18] Subsequently the HMOs are purified, crystallized, dried, packaged and delivered to infant formula manufacturers where they are mixed with other components of infant formula. [18]

Enzymatic synthesis

Enzymatic synthesis of HMOs through transgalactosylation is an efficient way for production. Various donors, including p-nitrophenyl-β-galactopyranoside, uridine diphosphate galactose and lactose, can be used in transgalactosylation. In particular, lactose may act as either a donor or an acceptor in a variety of enzymatic reactions and is available in large quantities from the whey produced as a co-processing product from cheese production. There is a lack of published data, however, describing the large-scale production of such galacto-oligosaccharides. [19]

Related Research Articles

<span class="mw-page-title-main">Flatulence</span> Bodily function of expelling intestinal gas from the anus

Flatulence, in humans, is the expulsion of gas from the intestines via the anus, commonly referred to as farting, tooting, or passing gas. "Flatus" is the medical word for gas generated in the stomach or bowels. A proportion of intestinal gas may be swallowed environmental air, and hence flatus is not entirely generated in the stomach or bowels. The scientific study of this area of medicine is termed flatology.

<span class="mw-page-title-main">Lactase</span> Mammalian protein found in Homo sapiens

Lactase is an enzyme produced by many organisms. It is located in the brush border of the small intestine of humans and other mammals. It is essential to the complete digestion of whole milk; it breaks down lactose, a sugar which gives milk its sweetness. People who have deficiency of lactase, and consume dairy products, may experience the symptoms of lactose intolerance. Lactase can be purchased as a food supplement, and is added to milk to produce "lactose-free" milk products.

<span class="mw-page-title-main">Infant formula</span> Manufactured food designed for feeding infants

Infant formula, also called baby formula, simply formula, baby milk or infant milk, is a manufactured food designed and marketed for feeding to babies and infants under 12 months of age, usually prepared for bottle-feeding or cup-feeding from powder or liquid. The U.S. Federal Food, Drug, and Cosmetic Act (FFDCA) defines infant formula as "a food which purports to be or is represented for special dietary use solely as a food for infants by reason of its simulation of human milk or its suitability as a complete or partial substitute for human milk".

An oligosaccharide is a saccharide polymer containing a small number of monosaccharides. Oligosaccharides can have many functions including cell recognition and cell adhesion.

<span class="mw-page-title-main">Breast milk</span> Milk produced by the mammary glands in the breast of a human female

Breast milk or mother's milk is milk produced by mammary glands located in the breast of a human female. Breast milk is the primary source of nutrition for newborns, containing fat, protein, carbohydrates and variable minerals and vitamins. Breast milk also contains substances that help protect an infant against infection and inflammation, whilst also contributing to healthy development of the immune system and gut microbiome.

Prebiotics are compounds in food that foster growth or activity of beneficial microorganisms such as bacteria and fungi. The most common environment considered is the gastrointestinal tract, where prebiotics can alter the composition of organisms in the gut microbiome.

<span class="mw-page-title-main">Gut microbiota</span> Community of microorganisms in the gut

Gut microbiota, gut microbiome, or gut flora, are the microorganisms, including bacteria, archaea, fungi, and viruses, that live in the digestive tracts of animals. The gastrointestinal metagenome is the aggregate of all the genomes of the gut microbiota. The gut is the main location of the human microbiome. The gut microbiota has broad impacts, including effects on colonization, resistance to pathogens, maintaining the intestinal epithelium, metabolizing dietary and pharmaceutical compounds, controlling immune function, and even behavior through the gut–brain axis.

A bifidus factor is a compound that specifically enhances the growth of bifidobacteria in either a product or in the intestines of humans and/or animals. Several products have been marketed as bifidogenic factors, such as several prebiotics and methyl-N-acetyl D-glucosamine in human milk.

Faecalibacterium is a genus of bacteria. Its sole known species, Faecalibacterium prausnitzii is gram-positive, mesophilic, rod-shaped, and anaerobic, and is one of the most abundant and important commensal bacteria of the human gut microbiota. It is non-spore forming and non-motile. These bacteria produce butyrate and other short-chain fatty acids through the fermentation of dietary fiber. The production of butyrate makes them an important member of the gut microbiota, fighting against inflammation.

<span class="mw-page-title-main">Galactooligosaccharide</span> Class of prebiotics

Galactooligosaccharides (GOS), also known as oligogalactosyllactose, oligogalactose, oligolactose or transgalactooligosaccharides (TOS), belong to the group of prebiotics. Prebiotics are defined as non-digestible food ingredients that beneficially affect the host by stimulating the growth and/or activity of beneficial bacteria in the colon. GOS occurs in commercially available products such as food for both infants and adults.

<i>Bifidobacterium</i> Genus of bacteria

Bifidobacterium is a genus of gram-positive, nonmotile, often branched anaerobic bacteria. They are ubiquitous inhabitants of the gastrointestinal tract though strains have been isolated from the vagina and mouth of mammals, including humans. Bifidobacteria are one of the major genera of bacteria that make up the gastrointestinal tract microbiota in mammals. Some bifidobacteria are used as probiotics.

FODMAPs or fermentable oligosaccharides, disaccharides, monosaccharides, and polyols are short-chain carbohydrates that are poorly absorbed in the small intestine and are prone to absorb water and ferment in the colon. They include short-chain oligosaccharide polymers of fructose (fructans) and galactooligosaccharides, disaccharides (lactose), monosaccharides (fructose), and sugar alcohols (polyols), such as sorbitol, mannitol, xylitol, and maltitol. Most FODMAPs are naturally present in food and the human diet, but the polyols may be added artificially in commercially prepared foods and beverages.

<span class="mw-page-title-main">2'-Fucosyllactose</span> Chemical compound

2′-Fucosyllactose (2′-FL) is an oligosaccharide, more precisely, fucosylated, neutral trisaccharide composed of L-fucose, D-galactose, and D-glucose units. It is the most prevalent human milk oligosaccharide (HMO) naturally present in human breast milk, making up about 30% of all of HMOs. It was first discovered in the 1950s in human milk. The oligosaccharide's primary isolation technique has been in use since 1972.

<i>Bifidobacterium bifidum</i> Species of bacterium

Bifidobacterium bifidum is a bacterial species of the genus Bifidobacterium. B. bifidum is one of the most common probiotic bacteria that can be found in the body of mammals, including humans.

Microbiota-accessible carbohydrates (MACs) are carbohydrates that are resistant to digestion by a host's metabolism, and are made available for gut microbes, as prebiotics, to ferment or metabolize into beneficial compounds, such as short chain fatty acids. The term, ‘‘microbiota-accessible carbohydrate’’ contributes to a conceptual framework for investigating and discussing the amount of metabolic activity that a specific food or carbohydrate can contribute to a host's microbiota.

<span class="mw-page-title-main">Human milk microbiome</span> Community of microorganisms in human milk

The human milk microbiota, also known as human milk probiotics (HMP), refers to the microbiota (community of microorganisms) residing in the human mammary glands and breast milk. Human breast milk has been traditionally assumed to be sterile, but more recently both microbial culture and culture-independent techniques have confirmed that human milk contains diverse communities of bacteria which are distinct from other microbial communities inhabiting the human body.

<span class="mw-page-title-main">Human milk immunity</span> Protection provided to immune system via human milk

Human milk immunity is the protection provided to the immune system of an infant via the biologically active components in human milk. Human milk was previously thought to only provide passive immunity primarily through Secretory IgA, but advances in technology have led to the identification of various immune-modulating components. Human milk constituents provide nutrition and protect the immunologically naive infant as well as regulate the infant's own immune development and growth.

A low-FODMAP diet is a person's global restriction of consumption of all fermentable carbohydrates (FODMAPs), recommended only for a short time. A low-FODMAP diet is recommended for managing patients with irritable bowel syndrome (IBS) and can reduce digestive symptoms of IBS including bloating and flatulence.

Lacto-<i>N</i>-tetraose Chemical compound

Lacto-N-tetraose is a complex sugar found in human milk. It is one of the few characterized human milk oligosaccharides (HMOs) and is enzymatically synthesized from the substrate lactose. It is biologically relevant in the early development of the infant gut flora.

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