Wednesday, June 29, 2022

2022 News – New research suggests mothers’ HIV status, breastfeeding and infant gut microbiome may have long-term effects on infant health

Research by UM School of Medicine could lead to new treatments

According to a new study by researchers, babies born to women with HIV often have poorer health and less developed development in the early months of life than babies born to women without the infection – even if they are stillborn. Do not get infected with HIV during Institute for Genome Sciences (IGS) of the University of Maryland School of Medicine (UMSOM). The study also provides new insight into why these health problems often persist throughout babies’ lives.

Claire Fraser, PhDScience has come a long way in preventing mother-to-child HIV transmission due to the standard use of antiretroviral therapy (ART) for HIV-positive pregnant women. However, children of HIV-positive mothers still struggle with slow growth and adverse health outcomes.

In the study published online in April microbiomeScientists from the Institute for Genome Sciences (IGS) and the Institute for Human Virology, both UMSOM, found a complex interaction of factors shaping the growth and health of infants. These included maternal HIV status, gut microbiota of infants, duration of breastfeeding by mothers, and composition of breast milk.

For 18 months, study leaders Claire Fraser, PHDEndowed Professor, Dean of Medicine at UMSOM and Director of IGS, and Man Charut, PhD, MHS, Professor of Medicine at UMSOM and Division Director of Epidemiology and Prevention at UMSOM’s Institute of Human Virology, along with colleagues, followed a group of 272 Nigerian children who were born to mothers with and without HIV. All mothers with HIV in this study were being treated with ART, and none transmitted the virus to their newborns.

Surprisingly, the researchers found no significant difference between the gut and vaginal microbiomes of mothers with and without HIV, as well as no difference in the gut microbiomes of infants at birth. Babies born to mothers with HIV displayed lower birth weight-to-age Z-scores (WAZs) than babies born to uninfected mothers. The Z-score measures the distance from a particular data point. These differences persisted throughout the 18-month study and increased further in infants who were not breastfed.

The World Health Organization recommends that HIV-positive mothers be exclusively breastfed for six months and fed milk with solid food for two years. The Fraser/Charurat team found that by six months, 99 percent of mothers without HIV were still breastfeeding, but only 39 percent of mothers with HIV were still breastfeeding. At nine months the numbers became even more discrepant: 95% of mothers without HIV still breastfed their babies, and only 17% of mothers with HIV were still breastfeeding.

“We have known for a long time that the composition of the gut microbiome in infants affects their overall health, growth and development. This composition is greatly influenced by what babies eat early in life.” Dr Fraser said.

Scientists know the gastrointestinal tract of healthy breastfed babies is full of bacteria Bifidobacterium. Its loss — or invasion of other types of bacteria — can predispose an infant to metabolic and autoimmune diseases throughout life.

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    Mann E. Charurat, PhD, MHS“We wondered whether lack of breastfeeding in infants of HIV-positive mothers during the first weeks and months was associated with lower abundance postpartum bifidobacteria And, in fact, we found significantly less of that genus in non-breastfed babies.” Dr Fraser explained. “We also thought that low amounts might affect a child’s weight, and, again, low bifidobacteria Due to which the baby’s weight decreased.

Is it how long a baby gets breast milk or is it the ingredients that matter?

“Looks like it’s both,” Dr Fraser said. “There is a difference in growth between babies of mothers with HIV who were breastfed longer and those who weaned early. We found that the presence of ART in breastmilk correlated with lower abundance bifidobacteria Even in the infant gut microbiome.”

Researchers don’t know whether ART drug metabolites directly exert effect bifidobacteria Level.

“It seems that breastfeeding helps bridge the gap between children in the two different groups,” Dr Fraser explained. ,This could mean that breastmilk containing ART metabolites may be less than ideal – perhaps ART is directly toxic to certain gut microbes.”

Dr. Fraser said, using Bifidobacterium In babies born to mothers with HIV – probiotic supplementation may be one way to help strengthen the gut – and ultimately reduce disease. A stronger gut, then, can reduce the ongoing poor growth and mortality in those babies.

E. Albert Rees, MD, PhD, MBA“We believe that there are other confounding factors, such as food choices available in poorer areas, that may play a role in this complex interaction between mothers with HIV and the health of their newborns,” Dr. Charurat added. “We will dive deeper into this research.”

Albert Rees, MD, PhD, MBAExecutive Vice President of Medical Affairs, UM, Baltimore, John Z. and Akiko K. Bowers Distinguished Professor, and Dean at the University of Maryland School of Medicine, said, “This research is important for allowing children born to mothers with HIV to grow up with their peers whose mothers have not contracted HIV.”

The research reported in this publication was supported by the National Institute of Dental and Craniofacial Research of the National Institutes of Health under award number R01DE025174. Additional support was provided by the Dean’s Ended Professorship to Claire M. Fraser, PhD (University of Maryland School of Medicine). Olivia A. Martin is a TL1 Post-doctoral Fellow supported by 1TL1TR003100-01, 1UL1TR003098-01, and the University of Maryland, Baltimore, Institute for Clinical and Translational Research.

The authors have no conflicts of interest.

About the University of Maryland School of Medicine

Now in its third century, the University of Maryland School of Medicine was chartered in 1807 as the first public medical school in the United States. It continues to this day as one of the fastest growing, top-tier biomedical research enterprises in the world – with 46 academic departments, centers, institutions and programs, and a network of more than 3,000 physicians, scientists and allied health professionals. With faculty, which includes members of the National Academy of Medicine and the National Academy of Sciences, and Albert E. Two-time coveted winner of the Lasker Award. With an operating budget of more than $1.3 billion, the School of Medicine works closely with the University of Maryland Medical Center and the Medical System to provide research-intensive, academic and clinical-based care for approximately 2 million patients each year. can be provided. The School of Medicine has approximately $600 million in extramural funding, with most of its academic departments ranked highest among all medical schools in the country in research funding. As one of seven professional schools that make up the University of Maryland, Baltimore campus, the School of Medicine has a total population of approximately 9,000 faculty and staff, including 2,500 students, interns, residents, and fellows. The combined School of Medicine and Medical System (“University of Maryland Medicine”) has an annual budget of more than $6 billion and an economic impact of approximately $20 billion on the state and local community. The School of Medicine, which ranks 8th among public medical schools in research productivity (according to the Association of American Medical College Profile) is an innovator in translational medicine with 606 active patents and 52 start-up companies., in the latest US news and world report Ranking of the best medical schools, published in 2021, ranks the UM School of Medicine #9 of 92 public medical schools in the US, and in the top 15 percent (#27) Out of all 192 public and private US medical schools. The School of Medicine works with research and treatment facilities locally, nationally and globally 36 countries Worldwide. meeting medschool.umaryland.edu

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About the Institute of Genome Sciences

Institute of Genome Sciences (IGS) The University of Maryland School of Medicine has revolutionized genomic discoveries in medicine, agriculture, environmental science and biodefense since its founding in 2007. IGS investigators research the areas of genomics and the microbiome, including treatment, cure, and prevention, to better understand health and disease. IGS investigators also lead the development of the new field of microbial forensics. IGS is a major center for major organic initiatives that are currently NIH-funded . running with Human Microbiome Project (HMP) and NIAID-sponsored Genomic Sequencing Center for Infectious Diseases (GSCID), Follow us on Twitter @GenomeScience.

About the Institute of Human Virology

Established in 1996 as a partnership between the State of Maryland, the City of Baltimore, the University System of Maryland and the University of Maryland Medical System, IHV is an institution of the University of Maryland School of Medicine and is home to a few. Globally recognized and world renowned expert in all virology. IHV combines the disciplines of basic research, epidemiology and clinical research to accelerate the discovery of diagnostics and therapeutics for a variety of chronic and fatal viral and immune disorders, particularly HIV, the virus that causes AIDS. A concerted effort can be made for For more information, visit ihv.org and follow us on Twitter @IHVmaryland.

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