Effects of Antioxidants in Human Milk on Bronchopulmonary Dysplasia Prevention and Treatment: A Review

Abstract

Bronchopulmonary dysplasia (BPD) is a severe chronic lung illness that affects neonates, particularly premature infants. It has far-reaching consequences for infant health and their families due to intractable short- and long-term repercussions. Premature infant survival and long-term quality of life are severely harmed by BPD, which is characterized by alveolarization arrest and hypoplasia of pulmonary microvascular cells. BPD can be caused by various factors, with oxidative stress (OS) being the most common. Premature infants frequently require breathing support, which results in a hyperoxic environment in the developing lung and obstructs lung growth. OS can damage the lungs of infants by inducing cell death, inhibiting alveolarization, inducing inflammation, and impairing pulmonary angiogenesis. Therefore, antioxidant therapy for BPD relieves OS and lung injury in preterm newborns. Many antioxidants have been found in human milk, including superoxide dismutase, glutathione peroxidase, glutathione, vitamins, melatonin, short-chain fatty acids, and phytochemicals. Human milk oligosaccharides, milk fat globule membrane, and lactoferrin, all unique to human milk, also have antioxidant properties. Hence, human milk may help prevent OS injury and improve BPD prognosis in premature infants. In this review, we explored the role of OS in the pathophysiology of BPD and related signaling pathways. Furthermore, we examined antioxidants in human milk and how they could play a role in BPD to understand whether human milk could prevent and treat BPD.

Human Milk Feeding for Septic Newborn Infants Might Minimize Their Exposure to Ventilation Therapy

“…This hypothesis assumes that because HM is a better scavenger of ROS than formula [ 33 ], it may defend a large population of neonates with increased oxidative stress, a critical factor that exacerbates perinatal morbidities. The list of antioxidants in breast milk that potentially protect against neonatal chronic lung disease includes more than ten elements (probiotics, phytochemicals, amino acids, trace elements, vitamins, Glutathione, oligosaccharides, catalase, melatonin, lactoferrin, among others) [ 8 ]. However, many other HM biofactors are involved and thus contribute to neonatal lung protection.…”

“…HM contains a considerable amount of antioxidant molecules [ 7 ]; antioxidants from HM can remove ROS directly or regulate signaling pathways to achieve their antioxidant actions [ 8 ]. Hence, newborn infants are heavily dependent on HM to counterbalance the oxidative stress that characterizes the different stages of the perinatal period.…”

“…Oxidative insult is a salient part of lung injury that begins as acute inflammation in respiratory distress disease and can evolve into structural scarring. Hyperoxia directly causes alveolar epithelial apoptosis, which leads to aberrant airway remodeling [ 8 ]. While there are conflicting findings in the field of neonatal respiratory support, it is generally accepted that previous lung inflammation makes the lung endothelium more susceptible to oxidant-induced injury during mechanical ventilation [ 12 ].…”

Human Milk Feeding for Septic Newborn Infants Might Minimize Their Exposure to Ventilation Therapy

“…HM conveys a considerable amount of antioxidant molecules [3]; antioxidants from HM can remove ROS directly, change the activity of antioxidant enzymes, or regulate signaling pathways to achieve their antioxidant actions [4]. Hence, newborn infants are heavily dependent on HM to counterbalance the oxidative stress that characterizes different stages of the perinatal period.…”

“…Oxidative insult is a salient part of lung injury that begins as acute inflammation in respiratory distress disease and can then evolve into chronic and structural scarring. Hyperoxia directly causes alveolar epithelium apoptosis, and this in turn leads to aberrant airway healing and remodeling [4]. While there are conflicting findings in the area of neonatal respiratory support, it is generally accepted that previous lung inflammation makes the lung endothelium and epithelium more susceptible to oxidant-induced injury during mechanical ventilation [8].…”