[Contamination of human milk with aerobic flora: Evaluation of losses for a human milk bank]. / Contamination du lait maternel par une flore aérobie : évaluation des pertes pour un lactarium.

INTRODUCTION: In France, human milk banks pasteurize milk for the mother's own hospitalized baby (personalized milk) and for donation. There is specific legislation regulating the activity of human milk banks with bacterial screening of donor milk before and after pasteurization. Milk should be tested for Staphylococcus aureus and total aerobic flora. Any sample of milk positive for aerobic flora and/or S. aureus before and/or after pasteurization should be discarded. The real pathogenicity of the total aerobic flora is actually debated as well as the usefulness of systematic postpasteurization screening. The aim of this study was to quantify milk losses related to prepasteurization contamination by total aerobic flora in a regional milk bank, to identify losses due to contamination with S. aureus or aerobic flora, and to analyze differences between centers. METHODS: This was a prospective observational study conducted in the regional human milk bank of the Nord-Pas-de-Calais area in France. Data were collected from six major centers providing 80% of the milk collected between June 2011 and June 2012. Variables were the volumes of personalized milk collected by each center, volumes of contaminated milk, and the type of bacteria identified. RESULTS: During the study period, the regional human milk bank treated 4715 L (liters) of personalized milk and 508 L (10.8%) were discarded due to bacteriological screening. Among these 508 L, 43% were discarded because of a prepasteurization contamination with aerobic flora, 55% because of a prepasteurization contamination with S. aureus, and 2% because of other pathogenic bacteria. Postpasteurization tests were positive in 25 samples (0.5%). Only five of these 25 samples were positive before pasteurization and in all cases with S. aureus. A total of 218 L were destroyed because of prepasteurization contamination with total aerobic flora, while the postpasteurization culture was sterile. There was a great difference between centers in the percentage of discarded milk and the type of contamination. The percentage of discarded milk varied from 4 to 16% (P<0.001) and the percentage of prepasteurization positive samples with aerobic flora from 0 to 70% (P<0.001). Costing 80 €/L in France, this represented an economic loss of €17,440. CONCLUSION: A significant volume of milk is discarded because of contamination with total aerobic flora found only in prepasteurization tests. Reassessment of the French regulations with regard to microbiological safety could save human milk to cover the needs of a larger group of preterm babies.

Human milk can neutralize Coxsackievirus B4 in vitro.

The role of enteroviruses in type 1 diabetes has long been suspected. A lower risk of type 1 diabetes is associated with breastfeeding, which could be due to a protective effect against enteroviruses. The neutralizing activity of breast milk against CVB4, a representative of enteroviruses was investigated in this study in vitro. Breast milk was cytotoxic to Hep-2 cells up to a dilution of 1/32, whereas the aqueous fraction obtained after centrifugation was not cytotoxic; although it inhibited the cytopathic effect of CVB4 on Hep-2 cell monolayers. The anti-CVB4 neutralizing activity of aqueous fractions of breast milk from 49 donors living in Northern France and 15 donors living in Congo, where enteroviral infections are more prevalent, were determined. The levels of colostrum activity expressed as titre ranged from <2 to 32 in 36% of the donors from France whereas they were >128 in every donor from Congo. Pasteurized colostrum had a lower anti-CVB4 activity compared to fresh samples (P < 0.0001, n = 49). The treatment of colostrum samples with jacalin-coated beads that bind specifically to human IgA, showed that IgA plays a role in anti-CVB4 activity. There was no correlation between the neutralizing activities of breast milk and serum (P = 0.37, n = 25). The current study showed that the variations in anti-CVB4 activity in breast milk can be attributed to environmental and living conditions. Whether a low protective activity of breast milk against enteroviruses expose newborns to a higher risk of type 1 diabetes deserves further investigation.

Identification of neurotensin-related peptides in human thymic epithelial cell membranes and relationship with major histocompatibility complex class I molecules.

This study shows the expression at the cell surface of human thymic epithelial cells (TEC) of a neurotensin (NT)-like immunoreactivity. NT radio-immunoassay (RIA) revealed that cultured human TEC contain +/-5 ng immunoreactive (ir) NT/10(6) cells, of which 5% is associated with plasma cell membranes. HPLC analysis of NT-ir present in human TEC showed a major peak of NT-ir corresponding to NT1-13. NT-ir was not detected in the supernatant of human TEC cultures. Using an affinity column prepared with a anti-MHC class I monoclonal antibody, NT-ir-related peptides were retained on the column and eluted together with MHC class I-related proteins. According to the elution time on HPLC of these peptides, they correspond to intact NT1-13, as well as to smaller fragments of NT1-13.

Cytokine production by human thymic epithelial cells: control by the immune recognition of the neurohypophysial self-antigen.

Oxytocin (OT) has been shown to be the dominant peptide of the neurohypophysial family expressed by thymic epithelial and nurse cells (TEC/TNC) in various species. Thymic OT is not secreted but, after translocation of a hybrid neurophysin/MHC class I protein, is integrated within the plasma membrane of TEC, thus allowing its presentation to pre-T cells. In order to further demonstrate that thymic OT behaves like a membrane antigen, we assessed the effect of mAbs to OT on cytokine productions by cultures enriched in human TEC. 75-85% pure TEC cultures were prepared from human thymic fragments. Using immunofluorescence and confocal microscopy, ir-OT, ir-interleukin-1 beta (IL-1 beta), ir-interleukin-6 (IL-6) and ir-leukemia inhibitory factor (LIF) could be detected in these TEC cultures. ir-OT was restricted to TEC, while some ir-IL-6 and ir-LIF were also seen in occasional fibroblasts. In basal conditions, ir-IL-6 and ir-LIF (but not ir-OT and ir-IL-1 beta) were detected in the supernatants of human TEC cultures. MAbs to OT induced a marked increase of ir-IL-6 and ir-LIF secretion in TEC cultures. No significant effect was observed using mAbs against vasopressin, mouse immunoglobulins, or control ascitic fluid controls. These data show that OT is fully processed and recognized by specific mAbs at the outer surface of TEC plasma membrane. They further support that thymic OT behaves as the self-antigen of the neurohypophysial family.

Tumor necrosis factor-alpha antagonizes follicle-stimulating hormone action in cultured Sertoli cells.

In the present study, we have tested the effect of tumor necrosis factor-alpha (TNF alpha) on FSH action in cultured purified Sertoli cells isolated from immature porcine testes. FSH action was evaluated through three different parameters (aromatase activity, lactate production, and alpha-inhibin production). TNF alpha was shown to reduce (about 40-60% decrease) FSH-stimulated but not basal aromatase activity (evaluated through the conversion of testosterone into estradiol) in a dose- and time-dependent manner. The maximal and half-maximal (IC50) effects were observed with 6 ng/ml (3.5 x 10(-10) M) and 0.6 ng/ml (3.5 x 10(-11) M), respectively, after a long-term (72 h) treatment. TNF alpha (20 ng/ml) also inhibited Sertoli cell aromatase activity when stimulated with 8-bromo-cAMP (0.01-3 mM, 72 h) instead of FSH, suggesting that the antigonadotropin action of the cytokine is probably exerted at a step located beyond cAMP formation. The inhibitory effect of TNF alpha was not limited to the action of FSH on aromatase activity but also extended to the gonadotropin action on lactate and inhibin-alpha chain production in Sertoli cells. As for FSH-induced aromatase activity, TNF alpha reduced FSH-stimulated lactate accumulation with an IC50 of 0.6 ng/ml, after a long-term (72 h) treatment. Again, the cytokine reduced lactate production stimulated by 8-bromo-cAMP, suggesting that TNF alpha antagonistic action against FSH is exerted at post-cAMP levels. Finally, TNF alpha exerted a more pronounced inhibitory effect (> 90% inhibition) on alpha-inhibin than on inhibin heterodimer production. These inhibitory effects of TNF alpha on the gonadotropin action are probably exerted directly on Sertoli cells, since TNF alpha high affinity binding sites (dissociation constant approximately 5.3 x 10(-10) M) are present in primary cultures of purified porcine Sertoli cells. Altogether, the present findings show that TNF alpha antagonizes FSH action on Sertoli cell functions such as aromatase activity and lactate and alpha-inhibin production. Such an inhibitory effect is probably exerted at a biochemical step(s) located beyond cAMP generation.

[Effects of naproxen (naprosyne) on the metabolism of arthrotic cartilage in man in vivo]. / Effets du naproxène (Naprosyne) sur le métabolisme du cartilage arthrosique chez l'homme in vivo.

Degradative enzyme (proteoglycanase and collagenase) as well as proteoglycan synthesis enzyme (glycosyl-transferase) activity was studied in osteoarthritic fibrillated cartilage. Proteoglycanase activity was significantly lower in 10 patients with hip osteoarthritis treated with Naproxen (1 g/daily for 4 weeks) than in 10 patients treated with acetaminophen. Synthesis enzyme activity was similar in both groups. The results which confirm in vitro studies suggest that naproxen has not toxic effect on human osteoarthritic cartilage and could rather be beneficial.

[Endocrine, paracrine and autocrine mechanisms of aromatase activity]. / Mécanismes endocrines, paracrines et autocrines de l'activité aromatasique.

The endocrine, paracrine and autocrine mechanisms involved in aromatase activity. Development of a single follicle during the menstrual cycle is under control of hormones stimulating follicular maturation, ovulation and luteogenesis. Several factors intervene locally to avoid other follicles developing at the same time as the dominant follicle. These other follicles remain quiescent or go on to atresia. Atresia results from the action of several endocrine, paracrine and autocrine mechanisms which synergistically inhibit aromatase activity. The subsequent lack of estrogens reduces granulosa cell multiplication.