Effects of Recombinant Human Prolactin on Breast Milk Composition

Abstract

WHAT'S KNOWN ON THIS SUBJECT:The direct effects of prolactin on the nutritional and antimicrobial composition of breast milk have not been examined previously in women. WHAT THIS STUDY ADDS:The study demonstrates that recombinant human prolactin increases milk volume, induces changes in milk composition consistent with those during normal lactogenesis, and increases antimicrobially active oligosaccharide concentrations. The data suggest that prolactin is an important mediator of normal lactogenesis. abstract OBJECTIVE: The objective of this study was to determine the impact of recombinant human prolactin (r-hPRL) on the nutritional and immunologic composition of breast milk. METHODS:We conducted 2 trials of r-hPRL treatment. In the first study, mothers with documented prolactin deficiency were given r-hPRL every 12 hours in a 28-day, open-label trial. In the second study, mothers with lactation insufficiency that developed while they were pumping breast milk for their preterm infants were given r-hPRL daily in a 7-day, double-blind, placebo-controlled trial. Breast milk characteristics were compared before and during 7 days of treatment. RESULTS:Among subjects treated with r-hPRL (N ϭ 11), milk volumes (73 Ϯ 36 to 146 Ϯ 54 mL/day; P Ͻ .001) and milk lactose levels (155 Ϯ 15 to 184 Ϯ 8 mmol/L; P ϭ .01) increased, whereas milk sodium levels decreased (12.1 Ϯ 2.0 to 8.3 Ϯ 0.5 mmol/L; P ϭ .02). Milk calcium levels increased in subjects treated with r-hPRL twice daily (2.8 Ϯ 0.6 to 5.0 Ϯ 0.9 mmol/L; P ϭ .03). Total neutral (1.5 Ϯ 0.3 to 2.5 Ϯ 0.4 g/L; P ϭ .04) and acidic (33 Ϯ 4 to 60 Ϯ 6 mg/L; P ϭ .02) oligosaccharide levels increased in r-hPRL-treated subjects, whereas total daily milk immunoglobulin A secretionwas unchanged.CONCLUSIONS: r-hPRL treatment increased milk volume and induced changes in milk composition similar to those that occur during normal lactogenesis. r-hPRL also increased antimicrobially active oligosaccharide concentrations. These effects were achieved for women with both prolactin deficiency and lactation insufficiency.

Providing the plant extract silymarin to lactating sows: effects on litter performance and oxidative stress in sows

“…Tedesco et al (2004) also reported no effect of silymarin on standard milk composition of cows with increased milk yield due to treatment. On the other hand, in a study done with women, treatment with recombinant human prolactin not only affected milk volume but also its composition (Powe et al, 2011).…”

Management of Hypopituitarism

“…Since the major role of PRL is limited to lactation post-delivery, it was only investigated in one study subcutaneous injection of recombinant human PRL (60 µg/kg) in a twice-daily administration every 12 h in mothers with PRL deficiency. At the end of the 28-day study, PRL increased significantly, and milk volume increased from 3.4 ± 1.6 to 66.1 ± 8.3 mL/d with changes in milk composition similar to normal lactogenesis [82,83].…”

Impaired prolactin actions mediate altered offspring metabolism induced by maternal high‐fat feeding during lactation

“…PRL is an important regulator of milk composition; it promotes the expression of β‐casein (63), whey acidic protein (64), lactoglobulin (65), and α‐lactalbumin (66), leading, in turn, to increased lactose biosynthesis and milk volume (likely through enhanced production of lactose) (52, 67). PRL also increases calcium levels (68, 69) and reduces sodium concentrations (69), at least in part secondary to its effects, reducing the permeability of the epithelial barrier of the MG (69, 70). Two groups of milk components that could explain indirect beneficial actions of PRL on the offspring metabolism are FA and milk oligosaccharides.…”

“…This group of glycans serves as prebiotics for intestinal commensal bacteria and also interacts with pathogenic bacteria, preventing their binding to the host intestinal cells and therefore protecting against infections. Moreover, milk oligosaccharides may also act as immunomodulators to regulate the development of the infant intestine (69, 76, 77). Therefore, it is clear that by regulating MG function and milk composition, PRL regulates the offspring metabolism.…”

“…Whether FA esters of hydroxy FA or other novel functional FA are present in breast milk, and whether their levels are modulated by PRL action in the MG during lactation, is unknown. PRL also elevates the levels of neutral and acidic oligosaccharides in the milk (69). This group of glycans serves as prebiotics for intestinal commensal bacteria and also interacts with pathogenic bacteria, preventing their binding to the host intestinal cells and therefore protecting against infections.…”