Mother’s milk, microbiome influence rotavirus infection in babies

Rotavirus infection is one of the leading causes of gastroenteritis in children under five years By studying the complex interplay between the sugars and microbes in mother’s milk and the baby’s gut microbes, an international team of researchers has tried to understand neonatal rotavirus infection. Rotavirus infection is one of the leading causes of gastroenteritis in children under five years worldwide. Babies in 10 Indian states are immunised against rotavirus. Monkey kidney cells The researchers first investigated whether human milk oligosaccharides (specific sugars in milk) can inhibit infection by a particular strain (G10P11) of rotavirus. In vitro studies were carried out on monkey kidney epithelial cells (MA104 cells). Though mother’s milk sugars should be ideally killing the virus, the researchers found that the oligosaccharides enhanced the infection of cells with this strain of rotavirus. “We found that specific human milk oligosaccharides also improved the replication of the vaccine [used in the immunisation programme in India] in vitro . At this point, we don’t have a clear understanding of the mechanism by which this happens…It is possible that the oligosaccharides confer some kind of structural stability to the virus and improve the efficiency of uptake by cells,” explains Dr. Sasirekha Ramani from Baylor College of Medicine in Houston, U.S., in an email to The Hindu. She is the first author of the paper published in Nature Communications. This enhanced viral replication could further boost the immune response of the baby against the virus, which could mean better protection for the infant. Validation The researchers then repeated the study in a neonatal nursery to validate their lab results. A study group of 181 mother–infant pairs were selected from the Christian Medical College (CMC), Vellore. The sugars and microbiome of breast milk, and baby’s gut microbiome were characterised. They found that oligosaccharides responsible for increased infectivity were “significantly higher” in breast milk where the babies had symptomatic infection. There were also specific differences in the milk microbiome. “An association between oligosaccharides profile of milk, microbiome of milk and rotavirus infection in babies has been found. At this point, our understanding of the mechanisms by which the milk microbiome impact neonatal rotavirus infection is very preliminary. We need field studies to understand the impact of these results in the context of vaccine response and immunity,” adds Dr. Ramani. “Why neonatal rotavirus infections are neonatal is a question that has fascinated me. While we have not yet answered that question, we have advanced our understanding of factors that influence rotavirus infection, particularly the role of breast milk. Understanding multiple aspects of breast milk — microbiome and its composition including sugars — is critical for us to think about how to improve breast milk quality and its beneficial impact on children,” Prof. Gagandeep Kang, now at the Translational Health Science and Technology Institute, Faridabad, and previously at CMC, Vellore says in an email to The Hindu.

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