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Lower Tryptophan levels ‍in Breast Milk Linked ​to HIV Exposure and⁤ Infant Health risks

Why it Matters

Approximately 1.3 million children are born to women living with HIV annually worldwide. Even with effective antiretroviral therapy (ART) that prevents HIV transmission, these children who are exposed to HIV but not⁤ infected continue to‌ face a⁣ 50% increase in mortality in low-income settings, along with increased risks of infections, growth problems, and cognitive challenges. prior to ART, these children had mortality rates that were two to three times higher than infants not exposed to HIV. Understanding why these ‌children remain vulnerable despite not being infected has been a‍ critical gap in maternal and child health research.

This study provides the ⁣first metabolic clarification for these persistent health disparities and points toward potential nutritional interventions that could protect⁣ vulnerable infants. ‌The ⁤deficiency in tryptophan, an essential amino acid, is a key finding. tryptophan is a precursor to serotonin and melatonin, crucial for brain development and immune regulation. Its reduced availability could directly impact these critical ‍processes in infants exposed to HIV.

What the Study Did

Researchers analyzed 1,426 breast milk samples collected over 18 ⁢months from 326 women​ in Zambia (288 living with ‍HIV and 38 without HIV) as part ​of a‍ clinical trial conducted​ between 2001 and 2008. Using‍ advanced metabolomics technology,the team measured over 800 different ​metabolites in the ‌milk samples collected at multiple timepoints,from one week postpartum thru 18 months. They then validated their findings in a second cohort of⁢ 47 women from Haiti who were receiving antiretroviral therapy. ⁢Additionally, researchers performed targeted ​quantitative analysis of tryptophan and kynurenine levels in both breast milk and blood plasma to understand whether the depletion⁤ was localized to milk or reflected systemic changes in the mothers’ bodies.

The‍ use of metabolomics – a extensive analysis of small molecules – allowed the researchers to​ identify subtle changes in breast milk composition that ⁢might have been ​missed by customary methods. the longitudinal design,tracking samples over 18 months,is​ also crucial,as it captures changes in breast milk composition over​ time.

What They Found

Breast milk from women living with HIV contained significantly lower‌ tryptophan levels throughout ‍the entire‌ 18-month study period, ‌with concentrations approximately 50% lower than in milk from women without‍ HIV. The ⁤kynurenine-to-tryptophan ratio, a marker of ⁤immune activation, was significantly elevated at all study visits. Plasma ​measurements also found lower tryptophan levels in women living with HIV,‍ suggesting that the decreased level of tryptophan in milk stems from ​systemic depletion likely secondary to reduced intestinal⁣ absorption rather than a direct effect on milk production