DOI:https://doi.org/10.1093/glycob/cwh020Background: To test the hypothesis that human milk fucosyloligosaccharides are part of an innate immune system, we addressed whether their expression (1) depends on maternal genotype and (2) protects breastfed infants from pathogens. Objective and Methods: Thus the relationship between maternal Lewis blood group type and milk oligosaccharide expression and between variable oligosaccharide expression and risk of diarrhea in their infants was studied in a cohort of 93 Mexican breastfeeding mother–infant pairs. Milk of the 67 Lea–b+ mothers contained more LNF-II (Lea) and 3-FL (Lex) (oligosaccharides whose fucose is exclusively α1,3- or α1,4-linked) than milk from the 24 Lea−b− mothers; milk from Lea−b− mothers contained more LNF-I (H-1) and 2′FL (H-2), whose fucose is exclusively α1,2-linked. Results: The pattern of oligosaccharides varied among milk samples; in each milk sample, the pattern was summarized as a ratio of 2-linked to non-2-linked fucosyloligosaccharides. Milks with the highest ratios were produced primarily by Lea−b− mothers; those with the lowest ratios were produced exclusively by Lea–b+ mothers (P<.001). Thus, maternal genetic polymorphisms expressed as Lewis blood group types are expressed in milk as varied fucosyloligosaccharide ratios. The four infants who developed diarrhoea associated with stable toxin of Escherichia coli were consuming milk with lower ratios (4.4 ± 0.8 [SE]) than the remaining infants (8.5 ± 0.8; P<.001). Furthermore, the 27 infants who developed moderate to severe diarrhoea of any cause were consuming milk with lower ratios (6.1 ± 0.9) than the 26 who remained healthy (10.5 ± 1.9; P=.042). Conclusion: Thus, milk with higher 2-linked to non-2-linked fucosyloligosaccharide ratios affords greater protection against infant diarrhoea. We conclude that specific oligosaccharides constitute a major element of an innate immune system of human milk. Read More
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