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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThe burden of rotavirus infection is significant, and in 2008 rotavirus was estimated to cause 25 million outpatient visits, \u0026gt;2 million hospitalizations, and \u0026gt;?453,000 deaths in children aged \u0026lt;5 years. This article reviews whether human milk oligosaccharides decreases rotavirus infectivity by reducing binding and modulating gut microflora.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Ematernal nutrition\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Epediatric nutrition\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ebacterial infections\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \n         \u003Cp id=\u0022p-2\u0022\u003ERotavirus infection is reduced by breastfeeding in the first year of life (Panda S et al. \u003Cem\u003EEpidemiol Infect\u003C\/em\u003E 2014). Human milk oligosaccharides (HMO) are thought to contribute to this protection, in part by binding to some rotavirus strains and interrupting virus binding to host cell glycoconjugate receptors.\u003C\/p\u003E\n         \u003Cp id=\u0022p-3\u0022\u003EThe burden of rotavirus infection is significant. In 2008, based on global surveillance by the World Health Organization, rotavirus was estimated to cause 25 million outpatient visits, \u0026gt;2 million hospitalizations [\u003Ca href=\u0022http:\/\/www.who.int\/biologicals\/areas\/vaccines\/rotavirus\/background\/en\/\u0022\u003Ehttp:\/\/www.who.int\/biologicals\/areas\/vaccines\/rotavirus\/background\/en\/\u003C\/a\u003E], and \u0026gt;453,000 deaths in children aged \u0026lt;5 years [\u003Ca href=\u0022http:\/\/www.who.int\/immunization\/monitoring_surveillance\/burden\/estimates\/rotavirus\/en\/\u0022\u003Ehttp:\/\/www.who.int\/immunization\/monitoring_surveillance\/burden\/estimates\/rotavirus\/en\/\u003C\/a\u003E]. The greatest disease burden is in developing countries where the availability of rotavirus vaccines is limited and also seems to be less effective [Patel MM et al. \u003Cem\u003EPediatr Infect Dis J\u003C\/em\u003E 2011].\u003C\/p\u003E\n         \u003Cp id=\u0022p-4\u0022\u003ESharon M. Donovan, PhD, RD, University of Illinois, Urbana, Illinois, USA, reviewed work by her group that tested the hypothesis that HMO, particularly those forms containing sialic acid, would decrease rotavirus infectivity by reducing binding and modulating gut microflora.\u003C\/p\u003E\n         \u003Cp id=\u0022p-5\u0022\u003EIn a set of experiments to screen for rotavirus inhibitory activity \u003Cem\u003Ein vitro\u003C\/em\u003E, they found that sialyllactose-containing HMO and HMO isolated from preterm human milk (iHMO) inhibited infectivity and binding of sialic acid-dependent rotavirus at those concentrations present in human milk [Hester SN et al. \u003Cem\u003EBr J Nutr\u003C\/em\u003E 2013]. They also found dose-dependent effects for binding and infectivity, which were more effective at a lower concentrations with 6\u2032-sialyllactose than with 3\u2032-sialyllactose; the groups believes that this distinction may be related to differences in the structures of the cellular binding sites. Dr. Donovan stated these results support sialic acid-dependent rotavirus binding by sialic acid-containing HMO as a primary mechanism of action.\u003C\/p\u003E\n         \u003Cp id=\u0022p-6\u0022\u003ENext, they studied the ability of HMO to inhibit rotavirus activity \u003Cem\u003Ein situ\u003C\/em\u003E using a piglet model. They showed that both sialic acid-containing HMO and a neutral HMO (lacto-N-neotetraose, LNnT) decreased rotavirus infectivity in isolated loops of intestine [Hester SN et al. \u003Cem\u003EBr J Nutr\u003C\/em\u003E 2013], suggesting other possible mechanisms for the effect of HMO. Dr. Donovan noted that this study was also important for establishing a model that will allow for the screening of different HMO fractions, such as neutral and acidic, in order to determine which are most efficacious before testing in rotavirus infection studies \u003Cem\u003Ein vivo\u003C\/em\u003E, which would require large quantities of HMO.\u003C\/p\u003E\n         \u003Cp id=\u0022p-7\u0022\u003EFinally, Dr. Donovan showed the results of an \u003Cem\u003Ein vivo\u003C\/em\u003E study of rotavirus infection in colostrum-deprived piglets, which sought to determine the efficacy of formula supplemented with HMO (4 g\/L), compared with formula alone. Dietary HMO reduced the duration of rotavirus infection by 30 hours, primarily by reducing the second wave of infection [Li M et al. \u003Cem\u003EISME J\u003C\/em\u003E 2014]. The effect of HMO on diarrhea and on the rates of initial and reinfection are detailed in \u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E. HMO increased serum rotavirus-specific immunoglobulin M (IgM) and increased interferon gamma (IFN-\u03b3) and interleukin-10 (IL-10) levels in the ileum, which suggests the effects of HMO on both systemic and mucosal immunity, said Dr. Donovan. Furthermore, rotavirus infection significantly modified the microflora at the level of the phyla, family, and genus in the ascending colon, and that HMO promoted the growth of Lachnospiraceae.\u003C\/p\u003E\n         \u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/16466\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/16466\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/16466\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n               \u003Cp id=\u0022p-8\u0022 class=\u0022first-child\u0022\u003EImprovements in Rotavirus Infection With Human Milk Oligosaccharides Added to Formula\u003C\/p\u003E\n            \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/5\/20.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzlw42\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzlw42\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}