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母乳微生物群：修订间差异

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在母乳中，可以分離出三種有益生功效的乳桿菌種，分別是{{link-en|發酵乳桿菌|L. fermentum}} CECT5716、{{link-en|加氏乳桿菌|L. gasseri}} CECT5714及{{link-en|唾液乳桿菌|L. salivarius}} CECT5713<ref name="Lara-Villoslada_2007">{{cite journal | vauthors = Lara-Villoslada F, Olivares M, Sierra S, Rodríguez JM, Boza J, Xaus J | title = Beneficial effects of probiotic bacteria isolated from breast milk | journal = The British Journal of Nutrition | volume = 98 Suppl 1 | issue = | pages = S96-100 | date = October 2007 | pmid = 17922969 | doi = 10.1017/S0007114507832910 }}</ref>，其中發酵乳桿菌是最常見的菌種<ref name="Soto_2014" />。早期有在[[配方奶粉]]中加入發酵乳桿菌，宣稱安全，適合一到六個月的嬰兒<ref name="Maldonado_2012">{{cite journal | vauthors = Maldonado J, Cañabate F, Sempere L, Vela F, Sánchez AR, Narbona E, López-Huertas E, Geerlings A, Valero AD, Olivares M, Lara-Villoslada F | display-authors = 6 | title = Human milk probiotic Lactobacillus fermentum CECT5716 reduces the incidence of gastrointestinal and upper respiratory tract infections in infants | journal = Journal of Pediatric Gastroenterology and Nutrition | volume = 54 | issue = 1 | pages = 55–61 | date = January 2012 | pmid = 21873895 | doi = 10.1097/MPG.0b013e3182333f18 }}</ref>，且適合長期使用<ref name="pmid22155106">{{cite journal | vauthors = Gil-Campos M, López MÁ, Rodriguez-Benítez MV, Romero J, Roncero I, Linares MD, Maldonado J, López-Huertas E, Berwind R, Ritzenthaler KL, Navas V, Sierra C, Sempere L, Geerlings A, Maldonado-Lobón JA, Valero AD, Lara-Villoslada F, Olivares M | display-authors = 6 | title = Lactobacillus fermentum CECT 5716 is safe and well tolerated in infants of 1-6 months of age: a randomized controlled trial | journal = Pharmacological Research | volume = 65 | issue = 2 | pages = 231–8 | date = February 2012 | pmid = 22155106 | doi = 10.1016/j.phrs.2011.11.016 }}</ref>。
在母乳中，可以分離出三種有益生功效的乳桿菌種，分別是{{link-en|發酵乳桿菌|L. fermentum}} CECT5716、{{link-en|加氏乳桿菌|L. gasseri}} CECT5714及{{link-en|唾液乳桿菌|L. salivarius}} CECT5713<ref name="Lara-Villoslada_2007">{{cite journal | vauthors = Lara-Villoslada F, Olivares M, Sierra S, Rodríguez JM, Boza J, Xaus J | title = Beneficial effects of probiotic bacteria isolated from breast milk | journal = The British Journal of Nutrition | volume = 98 Suppl 1 | issue = | pages = S96-100 | date = October 2007 | pmid = 17922969 | doi = 10.1017/S0007114507832910 }}</ref>，其中發酵乳桿菌是最常見的菌種<ref name="Soto_2014" />。早期有在[[配方奶粉]]中加入發酵乳桿菌，宣稱安全，適合一到六個月的嬰兒<ref name="Maldonado_2012">{{cite journal | vauthors = Maldonado J, Cañabate F, Sempere L, Vela F, Sánchez AR, Narbona E, López-Huertas E, Geerlings A, Valero AD, Olivares M, Lara-Villoslada F | display-authors = 6 | title = Human milk probiotic Lactobacillus fermentum CECT5716 reduces the incidence of gastrointestinal and upper respiratory tract infections in infants | journal = Journal of Pediatric Gastroenterology and Nutrition | volume = 54 | issue = 1 | pages = 55–61 | date = January 2012 | pmid = 21873895 | doi = 10.1097/MPG.0b013e3182333f18 }}</ref>，且適合長期使用<ref name="pmid22155106">{{cite journal | vauthors = Gil-Campos M, López MÁ, Rodriguez-Benítez MV, Romero J, Roncero I, Linares MD, Maldonado J, López-Huertas E, Berwind R, Ritzenthaler KL, Navas V, Sierra C, Sempere L, Geerlings A, Maldonado-Lobón JA, Valero AD, Lara-Villoslada F, Olivares M | display-authors = 6 | title = Lactobacillus fermentum CECT 5716 is safe and well tolerated in infants of 1-6 months of age: a randomized controlled trial | journal = Pharmacological Research | volume = 65 | issue = 2 | pages = 231–8 | date = February 2012 | pmid = 22155106 | doi = 10.1016/j.phrs.2011.11.016 }}</ref>。


== 起源 ==
有關母乳微生物群的啟源還不完全清楚<ref name="Gomez-Gallego_2016" />，目前有許多相關的假說。母乳中的微生物群可能是源自乳房的{{link-en|皮膚微生物群|skin flora}}<ref>{{cite journal | vauthors = West PA, Hewitt JH, Murphy OM | title = Influence of methods of collection and storage on the bacteriology of human milk | journal = The Journal of Applied Bacteriology | volume = 46 | issue = 2 | pages = 269–77 | date = April 1979 | pmid = 572360 | doi = 10.1111/j.1365-2672.1979.tb00820.x }}</ref><ref>{{cite journal | vauthors = Grice EA, Kong HH, Conlan S, Deming CB, Davis J, Young AC, Bouffard GG, Blakesley RW, Murray PR, Green ED, Turner ML, Segre JA | display-authors = 6 | title = Topographical and temporal diversity of the human skin microbiome | journal = Science | volume = 324 | issue = 5931 | pages = 1190–2 | date = May 2009 | pmid = 19478181 | pmc = 2805064 | doi = 10.1126/science.1171700 }}</ref>，或是嬰兒的{{link-en|口腔微生物學|Oral microbiology|口腔微生物群}}<ref name="Hunt_2011" /><ref name="Jiménez_2015" /><ref>{{cite journal | vauthors = Cephas KD, Kim J, Mathai RA, Barry KA, Dowd SE, Meline BS, Swanson KS | title = Comparative analysis of salivary bacterial microbiome diversity in edentulous infants and their mothers or primary care givers using pyrosequencing | journal = PLOS ONE | volume = 6 | issue = 8 | pages = e23503 | date = August 2011 | pmid = 21853142 | doi = 10.1371/journal.pone.0023503 }}</ref><ref>{{cite journal | vauthors = Nasidze I, Li J, Quinque D, Tang K, Stoneking M | title = Global diversity in the human salivary microbiome | journal = Genome Research | volume = 19 | issue = 4 | pages = 636–43 | date = April 2009 | pmid = 19251737 | doi = 10.1101/gr.084616.108 }}</ref>。在哺乳或是嬰兒吸吮乳頭時的母乳倒流也可能導致乳腺中的細菌形成<ref>{{cite journal | vauthors = Rodríguez JM | title = The origin of human milk bacteria: is there a bacterial entero-mammary pathway during late pregnancy and lactation? | journal = Advances in Nutrition | volume = 5 | issue = 6 | pages = 779–84 | date = November 2014 | pmid = 25398740 | doi = 10.3945/an.114.007229 }}</ref>，透過{{link-en|紅外線攝影|infrared photography|infrared photography}}發現在哺乳時有一定程度的母乳倒流<ref>{{cite journal | vauthors = Ramsay DT, Kent JC, Owens RA, Hartmann PE | title = Ultrasound imaging of milk ejection in the breast of lactating women | journal = Pediatrics | volume = 113 | issue = 2 | pages = 361–7 | date = February 2004 | pmid = 14754950 | doi = 10.1542/peds.113.2.361 }}</ref>。另外，微生物群也可能從母親的[[消化道]]，透過[[樹突狀細胞]]產生的{{le|entero-mammary pathway|腸-乳途徑}}進入乳腺<ref name="Fernández_2013" /><ref name="Martín_2009" /><ref>{{cite journal | vauthors = Jeurink PV, van Bergenhenegouwen J, Jiménez E, Knippels LM, Fernández L, Garssen J, Knol J, Rodríguez JM, Martín R | display-authors = 6 | title = Human milk: a source of more life than we imagine | journal = Beneficial Microbes | volume = 4 | issue = 1 | pages = 17–30 | date = March 2013 | pmid = 23271066 | doi = 10.3920/bm2012.0040 }}</ref>。
== 特點 ==
== 特點 ==
人體母乳益生菌會收到不同因素的影響，例如母親自身的BMI、嬰兒性別、生產方式及母乳喂哺模式等等。<ref>[7]Munblit D, Peroni DG, Boix-Amoros A, Hsu PS, Van't Land B, Gay MCL, et al. Human milk and allergic diseases: an unsolved puzzle. Nutrients (2017) 9: E894. 10.3390/nu9080894 </ref><ref>[8]Moossavi S, Khafipour E, Sepehri S, Robertson B, Bode L, Becker AB, et al. Maternal and early life factors influencing the human milk microbiota in the child cohort. In: Poster Session Presented at: Canadian Society of Microbiololists. Waterloo, ON: (2017)</ref> 有研究表明，在懷孕和哺乳期間未接受任何抗生素治療的婦女的母乳中有更多的乳酸桿菌和雙歧桿菌含量。[5]
人體母乳益生菌會收到不同因素的影響，例如母親自身的BMI、嬰兒性別、生產方式及母乳喂哺模式等等。<ref>[7]Munblit D, Peroni DG, Boix-Amoros A, Hsu PS, Van't Land B, Gay MCL, et al. Human milk and allergic diseases: an unsolved puzzle. Nutrients (2017) 9: E894. 10.3390/nu9080894 </ref><ref>[8]Moossavi S, Khafipour E, Sepehri S, Robertson B, Bode L, Becker AB, et al. Maternal and early life factors influencing the human milk microbiota in the child cohort. In: Poster Session Presented at: Canadian Society of Microbiololists. Waterloo, ON: (2017)</ref> 有研究表明，在懷孕和哺乳期間未接受任何抗生素治療的婦女的母乳中有更多的乳酸桿菌和雙歧桿菌含量。[5]

2019年10月28日 (一) 14:16的版本

母乳樣本中的微生物

母乳微生物群（human milk microbiota）也稱為母乳益生菌，是在人類母乳及乳腺中的微生物群（英语：Microbiota）[1]。以往曾認為母乳無菌（英语：Asepsis）[1][2]，不過近來不論透過微生物培養（英语：microbial culture），或是其他的技術，都已確定母乳中含有許多和人類微生物群系不同的细菌群[3][4][5]。

母乳微生物群可能是嬰兒體內，偏利共生、互利共生，或潛在益生菌之腸道菌群的來源[2]。世界卫生组织（WHO）對益生菌的定義是：「當達到足夠數量時，能對宿主的健康有益的微生物。」[6]。

來源

母乳中的微生物群，以及十種最常見的菌種

母乳是乳酸菌的自然來源，初生嬰兒透過母乳餵養可以獲取乳酸菌，母乳也可視為是共生食物[7]。健康母親的母乳中，正常細菌含量約為每毫升103菌落形成單位（CFU）[8]。母乳中的菌種非常複雜[8]。在所有母乳樣本中可檢測的超過100種可操作的分類單位（英语：Taxonomy (biology)）中，只有9種菌類是所有樣本共有的（鏈球菌，葡萄球菌，沙雷氏菌（英语：Serratia），假單胞菌，棒狀桿菌（英语：Corynebacterium），羅爾斯頓菌（英语：Ralstonia），丙酸桿菌，鞘氨醇單胞菌（英语：Sphingomonas）和慢生根瘤菌科），但個別母體裏的母乳細菌群落多半都是穩定的[9]。母乳是嬰兒腸道中葡萄球菌、鏈球菌、乳酸菌、雙歧桿菌（英语：Bifidobacterium）、丙酸桿菌、棒狀桿菌和其他相關革蘭氏陽性菌的來源[2]。

成份

以前科學界都認為母乳是無菌的，後來才從健康女性身上，以衛生方式採集的母乳中發現了乳桿菌[7]。研究指出母乳中的多個菌類，包括乳桿菌屬，葡萄球菌屬，腸球菌屬和雙歧桿菌屬的細菌菌株，會透過母乳喂哺傳到嬰兒體内，因此由母乳喂哺的嬰兒的腸道微生物群成分與其母親的母乳成分相近似.[2]。研究亦指出母乳微生物群及嬰兒腸道微生物群具有相似性，因此認為飲食攝取（包括母乳益生菌）可以幫助建立嬰兒腸道微生物群，也對其免疫發展有益[10]。

母乳樣本中常見的菌種有雙歧桿菌屬（英语：Bifidobacterium）、乳桿菌屬、葡萄球菌属、鏈球菌屬、擬桿菌屬、梭菌屬、微球菌屬（英语：Micrococcus）、肠球菌及埃希氏菌屬（英语：Escherichia）[3][3][5]。有關母乳的元基因組學分析發現其中主要以葡萄球菌属、擬桿菌屬及缓慢爱德华氏菌（英语：Edwardsiella）為主[11][12]。母乳微生物群會隨族群及女性的個體差異而不同[13]，不過在一個以美國女性為基礎的研究中，觀察到在其研究樣本中有相同的九種菌種，因此認為在母乳微生物群中有主要菌種，至少在美國是這樣的情形[8]。人類初乳中的菌種比一般母乳的更加分散[1][14]。

在母乳中，可以分離出三種有益生功效的乳桿菌種，分別是發酵乳桿菌（英语：L. fermentum） CECT5716、加氏乳桿菌（英语：L. gasseri） CECT5714及唾液乳桿菌（英语：L. salivarius） CECT5713[15]，其中發酵乳桿菌是最常見的菌種[9]。早期有在配方奶粉中加入發酵乳桿菌，宣稱安全，適合一到六個月的嬰兒[16]，且適合長期使用[17]。

起源

有關母乳微生物群的啟源還不完全清楚[1]，目前有許多相關的假說。母乳中的微生物群可能是源自乳房的皮膚微生物群（英语：skin flora）[18][19]，或是嬰兒的口腔微生物群（英语：Oral microbiology）[8][12][20][21]。在哺乳或是嬰兒吸吮乳頭時的母乳倒流也可能導致乳腺中的細菌形成[22]，透過infrared photography（英语：infrared photography）發現在哺乳時有一定程度的母乳倒流[23]。另外，微生物群也可能從母親的消化道，透過樹突狀細胞產生的entero-mammary pathway（英语：腸-乳途徑）進入乳腺[2][3][24]。

特點

人體母乳益生菌會收到不同因素的影響，例如母親自身的BMI、嬰兒性別、生產方式及母乳喂哺模式等等。[25][26] 有研究表明，在懷孕和哺乳期間未接受任何抗生素治療的婦女的母乳中有更多的乳酸桿菌和雙歧桿菌含量。[5]

發酵乳桿菌是人類母乳中最常見的菌類之一[5]，它是在1994年從人類糞便樣本分析中發現的，對消化道酸鹼度及膽汁具有極高的耐受性，對於其益生菌作用極爲明顯。[27] 由於其免疫增強和抗微生物能力，發酵乳桿菌的抗感染特性亦見顯赫。[28]

乳腺炎是與哺乳有關的常見炎症性疾病。 兩項不同的研究表明，發酵乳桿菌可以通過減少被認爲是致病因素的鏈球菌屬數量來改善乳腺炎狀況。[11] 發酵乳桿菌除了對孕婦及哺乳中的婦女有益處外，亦可以有助減低嬰兒腸道及上呼吸道感染風險。[5]

唾液乳桿菌CECT5713源於一個月大由母乳喂哺嬰孩的糞便樣本中抽取而來，研究指出由母乳喂哺的嬰孩的腸道微生物群反映了其母親的乳汁細菌成分。經過RAPD和PFGE 分析顯示唾液乳桿菌CECT5713存在於天然母乳中。唾液乳桿菌CECT5713會生產乙酸鹽，L-乳酸鹽和過氧化氫，或有助解釋其在研究中對大部分標記生物的抗菌活性功效。再者，唾液乳桿菌CECT5713在模擬腸道極端環境下仍有高存活率。[29]

加氏乳桿菌 CECT5714是從腸道樣本中抽取而來，屬於嗜酸乳桿菌複合物的一種，被廣泛運用於不同的乳製品中，例如乳酪。一個雙盲隨機對照研究發現加氏乳桿菌 CECT5714對過敏反應中涉及的免疫參數有其影響，例如減少血漿中IgE的數量和增加調節性T細胞。含有加氏乳桿菌CECT5714的益生菌產品還增強了先天性和特異性免疫參數，可以改善普遍兒童的健康狀況。[30]

相關條目

參考資料

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