Tandhälsa och amning

390 views

Published on

Published in: Education
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
390
On SlideShare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
2
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Tandhälsa och amning

  1. 1. Saliv och bröstmjölk – för hälsa eller sjukdom?2010-04-19Ämnen i både saliv och bröstmjölk kan förhindra att bakterier får fäste på tandytorna, visar Liza Danielsson Niemi i denavhandling hon försvarar vid Umeå universitet den 22 april.Bakterier samlas gärna på olika ytor i kroppen där de lever i ordnade samhällen, s.k. biofilmer. Vissa bakterier ibiofilmen har skyddsfunktioner för värden/människan medan andra kan ge infektionssjukdomar. Bakteriernas förmågaatt få fäste på ytor och celler hänger på hur väl de kan binda till mottagarmolekyler (receptorer) hos värden. I salivenfinns många molekyler som kan fungera som receptorer för bakterier, bl.a. proteinerna staterin och gp-340. Efter att desjälva har fäst på en tandyta binder de bakterier. Avhandlingen visar att staterin kan styra bindningen av Actinomyces-arter så att bindningen av infektionsorsakande bakterier förhindras och bindningen av mer hälsosamma bakteriergynnas. Det skulle kunna skydda mot infektioner.Glykoproteinet gp-340 har många biologiska funktioner och kan bl.a. binda kariesassocierade streptokocker tillbiofilmer på tänderna. I avhandlingen beskrivs ett antal storleksvarianter av gp-340 som bär skilda sockerstrukturer ochklumpar ihop (binder) bakterier på olika sätt. Varianternas roll i gp-340:s försvarsmekanismer kan förklara en delskillnader i känslighet för t.ex. karies.Även proteiner som tillförs via kosten kan påverka bindningen av bakterier. För många spädbarn är bröstmjölk denhuvudsakliga födan och den är lik saliven på många sätt. Avhandlingen visar att bröstmjölk, mer specifikt en del avbröstmjölksproteinet β-kasein och laktoferrin, kan förhindra att vissa streptokocker binder sig till tandytan.Bröstmjölken skulle därför kunna ha en skyddande effekt mot tidig kolonisation av sådana streptokocker, som i andrastudier visats vara en riskfaktor för karies. Umeå Universitet, Medecins fakultet, AktuelltHost ligands and oral bacterial adhesion: studies on phosphorylated polypeptides and gp-340 in saliva and milk Infectious diseases e.g. gastric ulcer, caries and perodontitis, are caused by bacteria in a biofilm. Adhesion of bacteria to host ligands e.g. proteins, polypeptides and glycoproteins, is a key event in biofilm formation and colonization of surfaces such as mucosa and tooth tissues. Thus, host ligands could contribute to the susceptibility to infectious diseases. The general aim of this doctoral thesis was to study the effect of phosphorylated polypeptides and gp-340 in saliva and milk on oral bacterial adhesion and aggregation. Statherin is a non-glycosylated, phosphorylated polypeptide in saliva. The polypeptide inhibits precipitation and crystal growth of calcium phosphate and mediates adhesion of microorganisms. By using a hybrid peptide construct, the domain for adhesion of Actinomyces isolated from human infections and from rodents was found to reside in the C-terminal end, and the adhesion was inhibitable. With alanine substitution the peptide recognition epitope in the C-terminal end was delineated to Q and TF, where QAATF was an optimal inhibitory peptide. In contrast, human commensal Actinomyces bound to the middle region in a non-inhibitable fashion. Gp-340 is another protein in saliva, and it is a large, multifunctional glycoprotein. Four novel size variants (I-IV) of salivary gp-340 were distinguished within individuals, and their glycoforms were characterized. All four size variants were identical in the N-terminal amino acid sequence and shared core carbohydrates. Low-glyco lung gp-340, high- glyco saliva gp-340, and size variants I-III aggregated bacteria differently. Human milk, which shares many traits with saliva, could inhibit adhesion of Streptococcus mutans to saliva-coated hydroxyapatite (s-HA), a model for teeth, in an individually varying fashion. Human milk caseins, lactoferrin, secretory IgA, and IgG inhibited the binding avidly. By using synthetic peptides the inhibitory epitope in b-casein was mapped to a C-terminal stretch of 30 amino acids. Inhibition by human milk, secretory IgA and the b-casein-derived inhibitory peptide was universal among a panel of mutans streptococci. The main conclusions are: (i) statherin mediates differential binding of commensal versus infectious Actinomyces strains with small conformation-dependent binding epitopes, (ii) salivary gp-340 has individual polymorphisms that at least affect binding of bacteria, (iii) human milk inhibits S. mutans adhesion to s-HA in an individually varying fashion, and the C-terminal end of human milk β-casein is one inhibitory component. Together these results suggest that the studied host ligands can influence the composition of the oral biofilm. Statherin may protect the host from colonization of bacteria associated with infections. Gp-340 size variants may affect functions related to host innate immune defences such as interactions with a wide array of bacteria, and human milk may have a protective effect in infants from colonization of mutans streptococci. Danielsson Niemi, Liza (Umeå universitet, Medicinsk fakultet, Odontologi, Kariologi) Host ligands and oral bacterial adhesion: studies on phosphorylated polypeptides and gp-340 in saliva and milk Umeå universitet, Medicinsk fakultet, Odontologi, Kariologi 2010-03-30 URI: urn:nbn:se:umu:diva-32894 Permanent länk: http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-32894 ISBN: 978-91-7264-969-9
  2. 2. Amning ger barnet karies-skyddande munbakterier2012-10-18Att amma sitt nyfödda barn ger det mer än bara näring. Barn som ammas helt eller delvis har lactobaciller som skyddarmot kariesbakterien Streptococcus mutans i sin munflora, medan barn som inte ammas helt saknar dessa bakterier. Detvisar en svensk studie av 207 tremånaders spädbarn vars saliv testats för olika bakterier.I fosterlivet är barnen helt sterila både i mun och i tarm. Efter födelsen får de snabbt en uppsättning bakterier ifrånmamma och omgivningen, bland annat via födan.Var tredje barn som ammades helt och cirka var fjärde som ammades delvis hade de skyddande lactobacillerna imunnen, men inte ett enda barn som flaskmatades. Forskarna efterlyser nu studier som undersöker vilken betydelsedetta har för barnens hälsa längre fram i livet, med ett primärt fokus på tidig kariesutveckling. Text: Fredrik Hedlund, Tandläkartidningen Källa:Holgerson PL, Vestman NR, Claesson R, Ohman C, Domellöf M, Tanner AC, Hernell O, Johansson I. Oral Microbial Profile Discriminates Breastfed from Formula-Fed Infants. J Pediatr Gastroenterol Nutr 2012, doi:10.1097/MPG.0b013e31826f2bc6.Oral Microbial Profile Discriminates Breast-fed From Formula-fed Infants. Abstract OBJECTIVES: Little is known about the effect of diet on the oral microbiota of infants, although diet is known to affect the gut microbiota. The aims of the present study were to compare the oral microbiota in breast-fed and formula-fed infants, and investigate growth inhibition of streptococci by infant-isolated lactobacilli. METHODS: A total of 207 mothers consented to participation of their 3-month-old infants. A total of 146 (70.5%) infants were exclusively and 38 (18.4%) partially breast-fed, and 23 (11.1%) were exclusively formula-fed. Saliva from all of their infants was cultured for Lactobacillus species, with isolate identifications from 21 infants. Lactobacillus isolates were tested for their ability to suppress Streptococcus mutans and S sanguinis. Oral swabs from 73 infants were analysed by the Human Oral Microbe Identification Microarray (HOMIM) and by quantitative polymerase chain reaction for Lactobacillus gasseri. RESULTS: Lactobacilli were cultured from 27.8% of exclusively and partially breast-fed infants, but not from formula-fed infants. The prevalence of 14 HOMIM-detected taxa, and total salivary lactobacilli counts differed by feeding method. Multivariate modelling of HOMIM-detected bacteria and possible confounders clustered samples from breast-fed infants separately from formula-fed infants. The microbiota of breast-fed infants differed based on vaginal or C-section delivery. Isolates of L plantarum, L gasseri, and L vaginalis inhibited growth of the cariogenic S mutans and the commensal S sanguinis: L plantarum >L gasseri >L vaginalis. CONCLUSIONS: The microbiota of the mouth differs between 3-month-old breast-fed and formula-fed infants. Possible mechanisms for microbial differences observed include species suppression by lactobacilli indigenous to breast milk. Holgerson PL, Vestman NR, Claesson R, Ohman C, Domellöf M, Tanner AC, Hernell O, Johansson I. *Department of Odontology, Cariology, Umeå University †Department of Odontology, Microbiology, Umeå University ‡Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden §Department of Molecular Genetics, Forsyth Institute, Harvard School of Dental Medicine, Boston, MA. J Pediatr Gastroenterol Nutr. 2013 Feb;56(2):127-36. doi: 10.1097/MPG.0b013e31826f2bc6. PMID: 22955450Vårdpersonals skyldighet att stödja amningSverige har skrivit under Innocenti-deklarationen som talar om att vårdpersonal ska stödja amning enligt WHOsdefinition, vilken innebär delamning i 2 år eller längre. Denna deklaration omfattar även tandvårdspersonal. Med principerna för mänskliga rättigheter, speciellt de som kommer i uttryck i Barnkonventionen, är vår vision en miljö som möjliggör att mammor, familjer och andra vårdnadshavare ska kunna göra informerade val om optimalt uppfödningssätt, som är definierat som enbart amning i sex månader och därefter skall barnen fortsätta att ammas med tillägg av lämplig kost upp till två års ålder eller längre. För att uppnå denna vision krävs kunnigt, praktiskt stöd som också är nödvändigt för att uppnå högsta standard av hälsa och utveckling för späda och små barn, vilket är den universellt erkända rättigheten för varje barn. Operationella mål: Försäkra att hälsosektorn och andra relevanta sektorer skyddar, främjar och stödjer enbart amning i sex månader och därefter fortsatt amning upp till två års ålder eller längre, samtidigt som kvinnor får tillgång till det stöd de behöver inom familjen, samhället och arbetsplatsen för att uppnå dessa mål. Innocenti 2005 Översättning: Elisabeth Kylberg i samarbete med AMNIS http://www.amningshjalpen.se/images/stories/innocenti2005.pdf
  3. 3. Infant Dental Decay - Is it related to Breastfeeding?Brian Palmer, D.D.S. Lactose • found only in mammal milk • in lower intestine - turns to Lactic acid • L. acid promotes Lactobacillus bifidus • L. bifidus helps prevent intestinal putrefaction – one of the benefits of breastfeeding • Milk is the best source of calcium and lactose Guthrie, H. Introductory Nutrition, 1983, C.V.Mosby, p26 Mammals • There are 4640 species of mammals • Humans are but one species • All species breastfeed their young • Most, but not all, have lactose in their milk. – Dr. Olaf Oftedal - National Zoological Park • Humans are the only mammal with any significant decay in deciduous teeth. “Most animals do not have decay in their deciduous teeth” - Dr. Peter Emily - Father of Veterinarian Dentistry Strep mutans is highly susceptible to the bactericidal action of Lactoferrin. LF chelates iron, making this essential nutrient inaccessible to an invading microorganism. (LF is present in breastmilk) Arnold, R. et al. A Bactericidal Effect for Human Lactoferrin. Science, July 15, 1977; 197(4300):263-5 “Study demonstrates that prolonged demand breast-feeding does not lead to higher caries prevalence.” Weerheijm KL, Prolonged demand breast-feeding and nursing caries, Caries Res, 1998;32(1):46-50. Human breastmilk kills cancer cells. Catharina Svanborg of Lund, Sweden has discovered that human breastmilk has killed all cancer cells tested. The cancer killer is one of the most abundant proteins in breast milk - alpha-lactalbumin, which helps to produce lactose. Stomach acid may be the key to its activation. Research received a $200,000 grant from the American Cancer Society - the only non-American lab with ACS support P. Radelsky, Human Breast Milk Kills Cancer Cells, Discover magazine, June, 1999, 68-75. “Population-based studies do not support a definitive link between prolonged breast-feeding and caries.” H. Slavkin, Streptococcus Mutan, Early Childhood Caries and New Opportunities, JADA, Vol. 130, Dec. 1999, 1787-92. Harold C. Slavkin, D.D.S. - Director, National Institute of Dental and Craniofacial Research, National Institute of Health, Bethesda, Md. Due to the contradictory nature of previous research findings and weak methodology used - authors concluded that the evidence linking breastfeeding and infant caries remains equivocal (vague, ambiguous, doubtful, questionable). • Recommendation: There is no “right time” to wean a breast-fed infant. Joyce Sinton et al., A systematic overview of the relationship between infant feeding caries and breast-feeding. Ont Dent, 1998; 75(9)(Nov):23-27 Presentation Created by: Brian Palmer, D.D.S. Broadway Medical Building Complete presentation at: http://www.brianpalmerdds.com/pdf/caries.pdf

×