ANNE SÜTÜ VE ENZİMLERİNİN SİNDİRİM SİSTEMİNDEKİ ROLÜ

Yıl 2019, Cilt: 4 Sayı: 2, 1 - 8, 27.12.2019

Seda Özarslan

Öz

Anne sütü, yenidoğanlar için içerdiği biyoaktif bileşenler ve besinler bakımından eşsiz bir besindir. Anne sütünde bulunan proteinler, karmaşık ve çeşitli biyolojik aktivitelere sahiptir. Anne sütünün çeşitli proteazlar içerdiği bilinmektedir, ancak bu enzimlerin aktif olup olmadığı, hangi proteinleri parçaladıkları ve bunların in vivo olarak süt proteininin sindirimine nasıl bir katkı sağladığı hakkında çok az şey bilinmektedir. Yapılan çalışmalar incelendiğinde anne sütünde bulunan fonksiyonel peptitlerin salınımının ilk olarak meme bezinde salgılandığını ve anne sütünde üretilen karmaşık bir proteaz dizisinin, anne sütünde aktif olduğu ve bu peptitleri serbest bıraktığını göstermektedir. Ayrıca süt proteazlarının, bebeğin midesinde süt proteinlerini sindirmeye devam ettiğini göstermektedir. Bunun yanında yenidoğanda gastrik ve intestinal proteazlar, lipazlar ve karboksipeptidazların beslenmeden sonra uygun koşullarda aktif olduğu yapılan araştırmalarda görülmüştür. Sütün, dinamik doğası, çeşitliliği ve etkinliği açısından anlaşılması gerekmektedir. Spesifik peptitler, belirli zamanlarda, meme bezi ve bebeğin bağırsak yolu boyunca spesifik bölgelere salınmaktadır. Bu durum ise, sütteki protein yapıları, mevcut enzimler ve bebeğin belirli yerlerde ve zamanlarda bu enzimleri aktive etme yeteneği sayesinde mümkün olmaktadır. Bilimsel çalışmalar, sütün biyolojik açıdan dinamik ve aktif bir sıvı olarak karmaşık özelliklerini ortaya koymuştur. Bu bağlamada gelecekte yapılacak çalışmaların anne-bebek ikilisini bir beslenme sistemi olarak görmesi gerekmektedir. Bu makalede; anne sütü ve enzimlerinin bebeğin sindirim sistemindeki rolü ile ilgili yapılan çalışmalar derlenmiştir.

Anahtar Kelimeler

Anne sütü, bebek, enzim, gastrik ve intestinal sistem

Kaynakça

• KAYNAKLAR 1. Spear HJ. Breastfeeding support. AWHONN Lifelines 2005;9: 181-3. 2. Preuffer M, Schrezenmeir J. Bioactive Substances in milk with properties decreasing risk of cardiovascular Disease. The British Journal of Nutrition 2000; 84(1): 155-159. 3. Dallas D, Guerrero A, Khaldi N, Castillo PA, Martin WF, Smilowitz JT, Bevins CL, Barile D, German JB, Lebrilla CB. Extensive in vivo human milk peptidomics reveals specific proteolysis yielding protective antimicrobial peptides. Journal of Proteome Research 2013;12(5):2295-2304. 4. Dallas DC, Guerrero A. Khaldi N, Borghese R, Bhandari A, Underwood MA, Lebrilla CB, German JB, Barile D.A. Peptidomic analysis of human milk digestion in the infant stomach reveals protein-specific degradation patterns. Journal of Nutrition 2014;144(6):815–820. 5. Wickramasinghe S, Rincon G, Islas-Trejo A, Medrano JF. Transcriptional profiling of bovine milk using RNA sequencing. BMC Genomics 2012; 13(1):45-58. 6. Dallas DC, Murray NM, Gan J. Proteolytic Systems in Milk: Perspectives on the Evolutionary Function within the Mammary Gland and the Infant. Journal of mammary gland biology and neoplasia 2015;20(3-4):1-15. 7. Arvedson JC, Brodsky L.. Pediatric swallowing and feeding: Assessment andmanagement. 2nd edition. Cengage Learning 2002. 8. Bourlieu C, Menard O, Bouzerzour K, Mandalari G, Macierzanka A, Mackie AR, Dupont D. Specificity of infant digestive conditions: Some clues for developing relevant in vitro models. Critical Reviews in Food Science and Nutrition 2014;54(11), 1427-1457. 9. Nagita A, Amemoto K, Yoden A, Aoki S, Sakaguchi M, Ashida K, Mino M. Diurnal variation in intragastric pH in children with and without peptic ulcers. Pediatric Research 1996;40(4), 528-532. 10. Roman C, Carriere F, Villeneuve P, Pina M, Millet V, Simeoni U. et al. Quantitative and qualitative study of gastric lipolysis in premature infants: Do MCT-enriched infant formulas improve fat digestion? Pediatric Research 2007;61(1), 83-88. 11. Mason S. Some aspects of gastric function in the newborn. Archives of Disease in Childhood 1962; 37(194), 387-391. 12. Khaldi N, Vijayakumar V, Dallas DC, Guerrero A, Wickramasinghe S, Smilowitz JT, Medrano JF et al. Predicting the important enzymes in human breast milk digestion. J Agric Food Chem 2014; 62(29):7225-32. 13. Demers-Mathieu V, Nielsen SD, Underwoodi MA. Borghese R, Dallas DC. Changes in Proteases, Antiproteases, and Bioactive Proteins From Mother's Breast Milk to the Premature Infant Stomach. J Pediatr Gastroenterol Nutr. 2018;66(2): 318-324. 14. Dallas DC, Underwood MA, Zivkovic AM, German JB. Digestion of protein in premature and term infants. Journal of Nutritional Disorders & Therapy 2012;2(3), 1-9. 15. Hamosh M. Digestion in the newborn. Clinics in Perinatology 1996;23(2), 191-209. 16. Agunod M, Yamaguchi N, Lopez R, Glass GBJ. Correlative study of hydrochloric acid, pepsin, and intrinsic factor secretion in newborns and infants. The American Journal of Digestive Diseases 1969;14(6), 400-414. 17. Henschel MJ, Newport MJ, Parmar V. Gastric proteases in the human infant. Neonatology 1987;52(5), 268-272. 18. Holton TA, Vijayakumar V, Dallas DC, Guerrero A, Borghese RA, Lebrilla CB, German JB et al. Following the digestion of milk proteins from mother to baby. J Proteome Res 2014;3(12):5777-83. 19. Lebenthal E, Lee P. Development of functional response in human exocrine pancreas. Pediatrics 1980a;66(4), 556-560. 20. Auricchio S, Stellato A, De Vizia, B. Development of brush border peptidases in human and rat small intestine during fetal and neonatal life. Pediatric Research 1981;15(7), 991-995. 21. Lebenthal E, Lee P, Heitlinger, LA. Impact of development of the gastrointestinal tract on infant feeding. The Journal of Pediatrics 1983; 102(1), 1-9. 22. Hirata Y, Matsuo T, Kokubu H. Digestion and absorption of milk protein in infants' intestine. Kobe Journal of Medical Sciences 1965;11, 103. 23. Hermoso M, Tabacchi G. Iglesia-Altaba I, Bel-Serrat S, Moreno-Aznar LA, García-Santos Y, et al. The nutritional requirements of infants. Towards EU alignment of reference values: The EURRECA network. Maternal & Child Nutrition 2010;6, 55-83. 24. Joeckel RJ, Phillips SK. Overview of infant and pediatric formulas. Nutrition in Clinical Practice 2009; 24(3), 356-362. 25. Andersson EL, Hernell O, Bläckberg L, Falt H, Lindquist S. BSSL and PLRP2:Key enzymes for lipid digestion in the newborn examined using the Caco-2 cell line. Journal of Lipid Research 2011;52(11), 1949-1956. 26. Hamosh M. Lingual and gastric lipases: Their role in fat digestion. CRC Press, Inc. Division of Developmental Biology and Nutrition, Department of Pediatrics, Georgetown University Medical Center, Washington, DC, USA. 1990. 239pp. 27. Hamosh M. Gastric and lingual lipases. Physiology of the Gastrointestinal Tract, 3. 1994. pp. 1239-1253. 28. Nguyen TTP, Bhandari B, Cichero J, Prakash S. A comprehensive review on in vitro digestion of infant formula. Food Research International 2015;(76), 373-386. 29. Roman C, Carriere F, Villeneuve P, Pina M, Millet V, Simeoni U, Jacques Sarles. Quantitative and qualitative study of gastric lipolysis in premature infants: Do MCT-enriched infant formulas improve fat digestion? Pediatric Research 2007; 61(1), 83-88. 30. Cohen M, Morgan RG, Hofmann AF. Lipolytic activity of human gastric and duodenal juice againstmediumand long chain triglycerides. Gastroenterology 1971;60(1), 1-15. 31. Sarles J, Moreau H, Verger R. Human gastric lipase: ontogeny and variations in children. Acta Paediatrica 1992;81(6-7), 511-513. 32. Commare CE, Tappenden KA. Development of the infant intestine: Implications for nutrition support. Nutrition in Clinical Practice 2007; 22(2), 159-173. 33. Armand M, Hamosh M, Mehta NR, Angelus PA, Philpott JR, Henderson TR, Dewyer NC, et al. Effect of human milk or formula on gastric function and fat digestion in the premature infant. Pediatric Research 1996;40(3), 429-437. 34. DiPalma J, Kirk CL, Hamosh M, Colon AR, Benjamin SB, Hamosh P. Lipase and pepsin activity in the gastric mucosa of infants, children, and adults. Gastroenterology 1991; 101(1), 116-121. 35. Hamosh M. Enteral lipid digestion and absorption. In W.H. William (Ed.), Neonatal nutrition and metabolism Cambridge: Cambridge University Press. 2006. pp. 350-368. 36. Bourlieu C, Ménard O, De La Chevasnerie A, Sams L, Rousseau F, Madec MN, Robert B, et al. The structure of infant formulas impacts their lipolysis, proteolysis and disintegration during in vitro gastric digestion. Food Chemistry 2015;182, 224-235. 37. Hamosh M. Digestion in the newborn. Clinics in Perinatology, 1996;23(2), 191-209. 38. Bernback S. Blackberg L, Hernell O. The complete digestion of human milk triacylglycerol in vitro requires gastric lipase, pancreatic colipase-dependent lipase, and bile salt-stimulated lipase. Journal of Clinical Investigation 1990;85(4), 1221. 39. Berton A, Sebban‐Kreuzer C, Rouvellac S, Lopez C, Crenon I. Individual and combined action of pancreatic lipase and pancreatic lipase‐related proteins 1 and 2 on native versus homogenized milk fat globules. Molecular Nutrition & Food Research 2009; 53(12), 1592-1602. 40. Roussel A, de Caro J, Bezzine S, Gastinel L, de Caro A, Carriere F, et al. Reactivation of the totally inactive pancreatic lipase RP1 by structure-predicted point mutations. Proteins: Structure, Function, and Bioinformatics 1998; 32(4), 523-531. 41. Lindquist S, Hernell O. Lipid digestion and absorption in early life: An update. Current Opinion in Clinical Nutrition and Metabolic Care 2010; 13(3), 314-320. 42. Hernell O, Blackberg L, Bernback S. In Herausgegeben von, & B. S. Lindblad (Eds.), Digestion and absorption of human milk lipids. Perinatal Nutrition, BristolMyers Nutrition Symposia, San Diego: Academic Press. 1998. 6. pp. 259-272. 43. Lebenthal E, Lee P, Heitlinger LA. Impact of development of the gastrointestinal tract on infant feeding. The Journal of Pediatrics 1983; 102(1), 1-9. 44. Andersson EL, Hernell O, Blackberg L, Falt H, Lindquist S. BSSL and PLRP2: Key enzymes for lipid digestion in the newborn examined using the Caco-2 cell line. Journal of Lipid Research 2011;52(11), 1949-1956. 45. Cichero JA, Nicholson TM, September C. Thickened milk for the management of feeding and swallowing issues in infants: A call for interdisciplinary professional guidelines. Journal of Human Lactation 2013;29(2), 132-135. 46. Patole S. Developmental physiology of the gastrointestinal tract and feed intolerance in preterm neonates. In S. Patole (Ed.), Nutrition for the preterm neonate. Netherlands: Springer. 2013. 3-23pp. 47. Sibley E. Carbohydrate digestion and absorption. In L.R. Johnson (Ed.), Encyclopedia of gastroenterology. New York: Elsevier. 2004. pp. 275-278. 48. Dewit O, Dibba B, Prentice A. Breast-milk amylase activity in English and Gambian mothers: Effects of prolonged lactation, maternal parity, and individual variations. Pediatric Research 1190;28(5), 502-506. 49. Lebenthal E, Lee P. Glucoamylase and disaccharidase activities in normal subjects and in patients with mucosal injury of the small intestine. The Journal of Pediatrics 1980b; 97(3), 389-393. 50. Lee P, Werlin S, Trost B, Struve M. Glucoamylase activity in infants and children: Normal values and relationship to symptoms and histological findings. Journal of Pediatric Gastroenterology and Nutrition 2004;39(2), 161-165.