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Pre- and postnatal supplementation with Limosilactobacillus reuteri and ω-3 fatty acids for prevention of childhood allergies: Exploring potential breast milk mediated mechanisms of action
Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Avdelningen för inflammation och infektion. Linköpings universitet, Medicinska fakulteten.ORCID-id: 0000-0002-7119-6114
2026 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Allergic disease often begins in early life, and the increased prevalence has been linked to reduced microbial exposure and dietary changes associated with modern lifestyle. These changes in environmental stimuli are thought to negatively influence immune maturation and thereby increase the risk of allergic sensitization. Supplementation with probiotics and ω-3 polyunsaturated fatty acids (PUFAs), have been proposed as strategies to mitigate the lack of stimuli, promoting immune tolerance and preventing subsequent allergic disease in the infant. Human breast milk contains several immune relevant components, including extracellular vesicles (EVs) and microRNAs (miRNAs), which may mediate vertical immune signaling from the mother to baby, contributing to infant immune maturation.

This thesis is based on a randomized placebo-controlled study, where pre- and postnatal supplementation with the probiotic bacteria Limosilactobacillus (L) reuteri and/or ω-3 PUFAs was given from gestational week 20 until delivery (L. reuteri) and ω-3 three months postpartum. After birth, the child continued with L. reuteri for a year and was exposed to ω- 3 through breastfeeding. The overall aim was to study human milk-derived EVs and miRNAs in relation to infant immune maturation, and to investigate how the supplementations modulate these breast milk components.

In Paper I, we show that several breast milk miRNAs moderately correlate with the proportions of resting and activated regulatory T cells in infants at 6 and 24 months of age, suggesting a potential role for milk-derived miRNAs in tolerance development. However, maternal supplementation did not alter the relative expression of 24 immune-related miRNAs in colostrum or in mature milk.

Following this, we evaluated the impact of milk sample handling on EVs and their miRNA cargo. In Paper II, Frozen milk samples had comparable EV characteristics and miRNA expression as fresh samples, supporting their use in large-scale studies with biobank materials. However, casein removal with sodium citrate seem to affect some EV characteristics between fresh and frozen samples, highlighting the importance of methodological considerations in EV research.

In Paper III, we demonstrate that there are effects of maternal supplementation on expression of EV-associated miRNAs in breast milk, but these effects seem to depend on the maternal allergy status. Also, miR-223-3p was higher in milk-EVs from allergic compared to non-allergic mothers, without any supplemental interactions. Thus, both maternal allergy and dietary interventions might shape aspects of the miRNA composition in milk-derived EVs, potentially influencing infant immune maturation and allergy risk.

Finally, in Paper IV, we provided an in-depth proteomic characterization of milk-derived EVs, revealing that surface-associated proteins were enriched in immune-related functions, whereas luminal cargo proteins were primarily associated with intracellular processes and exosome biogenesis. The results suggest that milk-derived EVs originate from multiple cellular sources, both the mammary gland and immune cells, and that EV surface proteins may play key roles in vertical immune communication.

Together, these findings support the concept where human milk-derived EVs and their miRNA cargo are influenced both by maternal allergy status and dietary interventions. Furthermore, milk EVs and their cargo may contribute to early-life immune programming, potentially affecting tolerance development and allergy risk in the infant.

Ort, förlag, år, upplaga, sidor
Linköping: Linköping University Electronic Press, 2026. , s. 68
Serie
Linköping University Medical Dissertations, ISSN 0345-0082 ; 2038
Nyckelord [en]
Extracellular vesicles, MicroRNA, Allergy, Limosilactobacillus reuteri, ω-3 polyunsaturated fatty acids, Breast milk
Nationell ämneskategori
Immunologi inom det medicinska området
Identifikatorer
URN: urn:nbn:se:liu:diva-223258DOI: 10.3384/9789181185102ISBN: 9789181185096 (tryckt)ISBN: 9789181185102 (digital)OAI: oai:DiVA.org:liu-223258DiVA, id: diva2:2055429
Disputation
2026-05-28, Belladonna, Building 511, Campus US, Linköping, 09:00 (Engelska)
Opponent
Handledare
Anmärkning

Funding agencies: The Swedish Heart and Lung Foundation, the Ellen, Walter & Lennart Hesselman foundation, the Medical Research Council for South-East Sweden, the Swedish Asthma and Allergy Association, Lion's Research Foundation for Public Diseases, the Faculty of Medicine at Linköping University, the Swedish Research Council, the Joanna Cocozza Foundation for Pediatric Research, and the Cancer and Allergy Foundation

Tillgänglig från: 2026-04-24 Skapad: 2026-04-24 Senast uppdaterad: 2026-04-28Bibliografiskt granskad
Delarbeten
1. Immune-related microRNAs in breast milk and their relation to regulatory T cells in breastfed children
Öppna denna publikation i ny flik eller fönster >>Immune-related microRNAs in breast milk and their relation to regulatory T cells in breastfed children
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2023 (Engelska)Ingår i: Pediatric Allergy and Immunology, ISSN 0905-6157, E-ISSN 1399-3038, Vol. 34, nr 4, artikel-id e13952Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BackgroundThe immunomodulatory capacity of breast milk may partially be mediated by microRNAs (miRNA), small RNA molecules that regulate gene expression on a post-transcriptional level and are hypothesized to be involved in modulation of immunological pathways. Here, we evaluate the expression of immune-related miRNAs in breast milk after pre- and postnatal supplementation with Limosilactobacillus reuteri and omega-3 (omega-3) polyunsaturated fatty acids (PUFAs), and the association to infant regulatory T cell (Treg) frequencies. MethodsOne-hundred and twenty women included in a double-blind, randomized, placebo-controlled allergy intervention trial received L. reuteri and/or omega-3 PUFAs daily from gestational week 20. Using Taqman qPCR, 24 miRNAs were analyzed from breast milk obtained at birth (colostrum) and after 3 months (mature milk) of lactation. The proportion of activated and resting Treg cells were analyzed in infant blood using flow cytometry at 6, 12, and 24 months. ResultsRelative expression changed significantly over the lactation period for most of the miRNAs; however, the expression was not significantly influenced by any of the supplements. Colostrum miR-181a-3p correlated with resting Treg cell frequencies at 6 months. Colostrum miR-148a-3p and let-7d-3p correlated with the frequencies of activated Treg cells at 24 months, as did mature milk miR-181a-3p and miR-181c-3p. ConclusionMaternal supplementation with L. reuteri and omega-3 PUFAs did not significantly affect the relative miRNA expression in breast milk. Interestingly, some of the miRNAs correlate with Treg subpopulations in the breastfed children, supporting the hypothesis that breast milk miRNAs could be important in infant immune regulation. Trial registrationClinicalTrials.gov-ID: NCT01542970.

Ort, förlag, år, upplaga, sidor
WILEY, 2023
Nyckelord
breast milk; Limosilactobacillus reuteri; microRNA; omega-3 polyunsaturated fatty acids; randomized placebo-controlled trial; regulatory T cell
Nationell ämneskategori
Immunologi
Identifikatorer
urn:nbn:se:liu:diva-196121 (URN)10.1111/pai.13952 (DOI)001007565300001 ()37102392 (PubMedID)
Anmärkning

Funding Agencies|Cancer- och allergiforbundet; Region Ostergotland [RO-930610]; Faculty of Medicine and Health Sciences at Linkoping University; Forskningsradet i Sydostra Sverige [2019-00989]; Hjart-lungfonden [20170365, 20200301]; Joanna Cocozzas stiftelse for barnmedicinsk forskning [2020-01041]; Lisa and Johan Gronberg Foundation, Sweden; Vetenskapsradet [969326, 940313, 931756]

Tillgänglig från: 2023-07-05 Skapad: 2023-07-05 Senast uppdaterad: 2026-04-24
2. Characterization of Extracellular Vesicles From Fresh vs. Frozen Human Milk Including the Vesicular microRNA Cargo
Öppna denna publikation i ny flik eller fönster >>Characterization of Extracellular Vesicles From Fresh vs. Frozen Human Milk Including the Vesicular microRNA Cargo
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2025 (Engelska)Ingår i: JOURNAL OF EXTRACELLULAR BIOLOGY, ISSN 2768-2811, Vol. 4, nr 10, artikel-id e70092Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Human milk is rich in extracellular vesicles (EV) that may contribute to shaping neonatal immunity. Here, we evaluated whether freezing, and the addition of sodium citrate (SC), affect the characteristics of human milk EVs and their miRNAs. Freezing may compromise the milk EV population and their miRNA profile by creating artificial vesicles due to cell lysis. Furthermore, SC can be added to clear the EV fraction of micelles, that is, protein aggregates that co-isolate with milk EVs, and may affect certain downstream analyses. To investigate potential differences between milk EV and their miRNA cargo when isolated from fresh and frozen samples, mature milk samples were collected from 10 women and subjected to four different treatments: fresh and frozen; freshSC and frozenSC. Ultracentrifugation was used for EV isolation, and subsequently characterized by Nanoparticle tracking analysis, flow cytometry, Western blot and electron microscopy. While freezing without SC has no impact on the evaluated EV parameters, freezing with SC significantly altered particle mean size as measured by NTA and protein levels as studied by MACSPlex flow cytometry. Importantly, neither freezing nor SC had an impact on the EV miRNA cargo, measured by qPCR. These findings also suggest that EV isolates from frozen samples, in comparison to freshly isolated ones, can produce valid results concerning morphology, size, surface markers and the EV miRNA profile.

Ort, förlag, år, upplaga, sidor
WILEY, 2025
Nyckelord
characterization; extracellular vesicles; exosomes; freezing; human milk; microRNA; sodium citrate; storage condition
Nationell ämneskategori
Livsmedelsprocessteknik
Identifikatorer
urn:nbn:se:liu:diva-218981 (URN)10.1002/jex2.70092 (DOI)001591091200001 ()41078593 (PubMedID)2-s2.0-105018637050 (Scopus ID)
Anmärkning

Funding Agencies|the Swedish Heart and Lung Foundation

Tillgänglig från: 2025-10-23 Skapad: 2025-10-23 Senast uppdaterad: 2026-05-11
3. Proteome characterization of extracellular vesicles from human milk: Uncovering the surfaceome by a lipid‐based protein immobilization technology
Öppna denna publikation i ny flik eller fönster >>Proteome characterization of extracellular vesicles from human milk: Uncovering the surfaceome by a lipid‐based protein immobilization technology
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2024 (Engelska)Ingår i: Journal of Extracellular Biology, ISSN 2768-2811, Vol. 3, nr 11Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Breast milk is an essential source of nutrition and hydration for the infant. In addition, this highly complex fluid is rich in extracellular vesicles (EVs). Here, we have applied a microfluidic technology, lipid-based protein immobilization (LPI) and liquid chromatography with tandem mass spectrometry (LC-MS/MS) to characterize the proteome of human milk EVs. Mature milk from six mothers was subjected to EV isolation by ultracentrifugation followed by size exclusion chromatography. Three of the samples were carefully characterized; suggesting a subset enriched by small EVs. The EVs were digested by trypsin in an LPI flow cell and in-solution digestion, giving rise to two fractions of peptides originating from the surface proteome (LPI fraction) or the complete proteome (in-solution digestion). LC-MS/MS recovered peptides corresponding to 582 proteins in the LPI fraction and 938 proteins in the in-solution digested samples; 400 of these proteins were uniquely found in the in-solution digested samples and were hence denoted "cargo proteome". GeneOntology overrepresentation analysis gave rise to distinctly different functional predictions of the EV surfaceome and the cargo proteome. The surfaceome tends to be overrepresented in functions and components of relevance for the immune system, while the cargo proteome primarily seems to be associated with EV biogenesis.

Ort, förlag, år, upplaga, sidor
John Wiley & Sons, 2024
Nyckelord
breast milk; exosomes; extracellular vesicles; human milk; immune regulation; mass spectrometry; proteomics
Nationell ämneskategori
Molekylärbiologi
Identifikatorer
urn:nbn:se:liu:diva-212692 (URN)10.1002/jex2.70020 (DOI)001519378500001 ()39512873 (PubMedID)
Forskningsfinansiär
Vetenskapsrådet, 2019‐00989Vetenskapsrådet, 2022‐00595
Anmärkning

Funding Agencies|Faculty of Medicine and Health Sciences, Linkoping University; Swedish Research Council [2019-00989, 2022-00595]; Joanna Cocozza Foundation for Pediatric Research; Swedish Heart Lung Foundation [20710365]; Swedish Cancer and Allergy Foundation; Swedish Research Council [2022-00595, 2019-00989] Funding Source: Swedish Research Council

Tillgänglig från: 2025-03-31 Skapad: 2025-03-31 Senast uppdaterad: 2026-04-24Bibliografiskt granskad

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