Microbiota in human breast milk: Noninfectious mastitis versus without mastitis.

BACKGROUND: Long-term breastfeeding is beneficial for both mothers and infants and mastitis is associated with the premature interruption of breastfeeding. Mastitis can be infectious or noninfectious. However, the effect of noninfectious mastitis on milk microbiota is not well-understood. In this study, we aimed to clarify the relationship between noninfectious mastitis and the microbiota by conducting breast milk culture tests. METHODS: We compared the milk microbiota between women with noninfectious mastitis and without mastitis. Bacterial cultures were compared in 143 milk samples from January to November 2022, and bacterial diversity was evaluated based on the total number of bacterial species and bacterial species found per specimen. RESULTS: Women with noninfectious mastitis provided samples at a significantly later stage postpartum (p < 0.01). The total bacterial count was significantly lower in samples from participants with noninfectious mastitis (p < 0.01). The bacterial diversity of milk from participants with noninfectious mastitis was lower than that without mastitis: nine bacterial species identified in the former and 21 in the latter. The number of Rothia spp. was significantly higher, whereas the number of Staphylococcus aureus, Staphylococcus epidermidis and Pseudomonas fluorescens was significantly lower in samples from women with mastitis. There was no correlation between postpartum week and the number of bacterial species or presence of Rothia spp. CONCLUSIONS: Noninfectious mastitis is associated with a decrease in the diversity of human milk microbiota, indicating impaired immune, metabolic, and neuroendocrine development functions in infants. Rothia spp. may also be associated with noninfectious mastitis, suggesting a possible target for future research.

Comprehensive Analysis of Lipid Composition in Human Foremilk and Hindmilk.

Precision nutrition, also referred to as personalized nutrition, focuses on the individual to determine the individual's most effective eating plan to prevent or treat disease. A precision nutrition for infants requires the determination of the profile of human milk. We compared the lipid profiles of the foremilk (i.e., the initial milk of a breastfeed) and hindmilk (the last milk) of six Japanese subjects and evaluated whether a human milk lipid profile is useful for precision nutrition even though the fat concentration fluctuates during lactation. We detected and quantified 527 species with a lipidome analysis by liquid chromatography-tandem mass spectrometry. The fat concentration in hindmilk (120.6 ± 66.7 µmol/mL) was significantly higher than that in foremilk (68.6 ± 33.3 µmol/mL). While the total carbon number of fatty acids in triglyceride (TG) was highest in C52 for all subjects, the second or third number differed among the subjects. Both the distribution of total carbon number of fatty acids included in TG and the distribution of fatty acids in TG classified by the number of double bonds were almost the same in the foremilk and hindmilk in each subject. The lipids levels containing docosahexaenoic acid and arachidonic acid in total lipids of the foremilk and the hindmilk were almost the same in each subject. Among the sphingolipids and glycerophospholipids, the level of sphingomyelin was the highest in four subjects' milk, and phosphatidylcholine was the highest in the other two subjects' milk. The order of their major species was the same in each foremilk and hindmilk. A clustering heatmap revealed the differences between foremilk and hindmilk in the same subject were smaller than the differences among individuals. Our analyses indicate that a human-milk lipid profile reflects individual characteristics and is a worthwhile focus for precision nutrition.

Reliability of an Ion-Selective Electrode as a Simple Diagnostic Tool for Mastitis.

BACKGROUND: Developing a simple quantitative tool for mastitis diagnosis is essential. The Ion-Selective Electrode for sodium has been reported to reliably measure sodium concentrations in human milk. RESEARCH AIM: To determine whether an Ion-Selective Electrode measurement of sodium:potassium ratios could serve as a diagnostic tool for mastitis and, if so, to determine the diagnostic cut-off value. METHODS: A total of 107 milk samples, including 55 from milk bank donors and 52 from participants with mastitis, were studied. The sodium:potassium ratios were determined in 33 samples (without mastitis n = 15; with mastitis n = 18) by the Ion-Selective Electrode and ion chromatography. The remaining 74 samples (donor milk n = 40; participants with mastitis n = 34) were analyzed by Ion-Selective Electrode only. Values were averaged over three measurements for each method. RESULTS: The median postpartum months of donors and participants with mastitis were 2 and 3 months, respectively. The mean (SD) sodium:potassium ratios without and with mastitis were 0.5 (0.1) and 1.7 (1.2), respectively. A positive correlation existed between sodium:potassium ratios obtained from the two methods (r = 0.98). Area under the curve values were 0.951 (95% CI [0.904, 0.986]) for the Ion-Selective Electrode (N = 107) and 0.978 (95% CI [0.926, 1.000]) for the ion chromatography (n = 33) methods. The optimal cut-off value for the Ion-Selective Electrode method was 0.60, with 86.5% sensitivity and 92.7% specificity. CONCLUSIONS: The Ion-Selective Electrode was sufficiently accurate for the diagnosis of mastitis. Cohort studies are needed to explore the relationship between sodium:potassium ratios and clinical outcomes.

Accuracy of carbohydrate-deficient transferrin as a biomarker of chronic alcohol abuse during treatment for alcoholism.

AIM: Clinical evaluations are generally used to verify the effectiveness of detoxification treatments for alcohol dependence, but new objective biomarkers are essential for accurate diagnosis. We aim to assess the accuracy of carbohydrate-deficient transferrin (%CDT) in a cohort of Japanese patients admitted to a psychiatric hospital specializing in alcohol dependence. In addition, we investigated the kinetics of %CDT during alcohol moderation or cessation. METHODS: The study cohort consisted of 126 alcohol-dependent patients. The levels of serum %CDT were assessed by the N Latex CDT direct immunonephelometric assay. RESULTS: Alcohol consumption was significantly correlated with %CDT. The only independent predictive factor of alcohol consumption was %CDT, with glutamyltranspeptidase (GGT) and albumin-bilirubin score proving insufficient. The cut-off value of %CDT was 1.9% with high sensitivity and specificity in detecting alcohol abstinence beyond 30 days (68.6% sensitivity, 91.8% specificity) and excessive alcohol drinking (77.9% sensitivity, 77.1% specificity). The %CDT levels were significantly decreased at 30 days of abstinence when compared with baseline. Notably, %CDT values were significantly changed even in the light alcohol drinking cohort (p = 0.0009), whereas GGT levels were not significantly changed. CONCLUSIONS: Our results indicate that %CDT is an accurate and specific biomarker of alcohol consumption and is useful in detecting alcohol abstinence even in a low alcohol intake patient cohort. These results suggest that %CDT could be a useful objective biomarker of chronic alcohol abuse during clinical treatment for alcoholism.

Qualitative and Quantitative Analyses of Glycogen in Human Milk.

Identification as well as a detailed analysis of glycogen in human milk has not been shown yet. The present study confirmed that glycogen is contained in human milk by qualitative and quantitative analyses. High-performance anion exchange chromatography (HPAEC) and high-performance size exclusion chromatography with a multiangle laser light scattering detector (HPSEC-MALLS) were used for qualitative analysis of glycogen in human milk. Quantitative analysis was carried out by using samples obtained from the individual milks. The result revealed that the concentration of human milk glycogen varied depending on the mother's condition-such as the period postpartum and inflammation. The amounts of glycogen in human milk collected at 0 and 1-2 months postpartum were higher than in milk collected at 3-14 months postpartum. In the milk from mothers with severe mastitis, the concentration of glycogen was about 40 times higher than that in normal milk.

Regression of a primary pulmonary adenocarcinoma after zoledronic acid monotherapy.

Bisphosphonates are widely used for the treatment of metastatic skeletal tumors and hypercalcemia resulting from malignant tumors. Zoledronic acid (ZOL), a third-generation bisphosphonate agent, was recently demonstrated to show synergistic antitumor activity of ZOL when combined with chemotherapy in lung cancer patients. However, whether ZOL exerts direct antitumor activity on lung cancer remains unclear. Here, we report an atypical case encountered while treating a 57-year-old woman with pulmonary adenocarcinoma and multiple metastases of the liver, left adrenal gland, and bone. The nonskeletal lesions, consisting of the primary lesion and hepatic metastasis, regressed after treatment with ZOL alone. We believe this case demonstrates a possible antitumor effect of ZOL against lung cancer.

A fatal case of acute hepatitis B developed in a toluene abuser.

Liver dysfunction involving toluene intoxicity includes elevation of transaminase level and delayed complications of liver failure, but its effect on hepatitis B virus (HBV) infection is as yet unknown. Here, we report a case of fulminant hepatitis B developed in a toluene abuser. A 23-year-old female toluene abuser was admitted to a local clinic because of nausea, vomiting, and dizziness, and a mild elevation of serum transaminase level was identified. She was treated as an outpatient, but continued toluene inhalation during follow-up. Five days later, she was found in a drowsy state of consciousness and taken to the emergency unit of our institution. Laboratory findings showed an alanine aminotransferase level of 4,659 IU, a remarkably prolonged prothrombin time, and she was diagnosed with fulminant hepatitis B. Intensive care was carried out, but she died the next day. Molecular analysis revealed that the HBV isolate was classified as genotype C, and nucleotide positions that are prone to fulminant hepatitis were A at 1,762 and G at 1,764 in the core promoter region, and G at 1,896 in codon 28 in the precore region. The long-term toluene inhalation could have contributed to drastic clinical course of acute hepatitis B in this patient.