Exploring human milk oligosaccharides and malaria risk in breastfed infants

There is a significant burden of malaria in young African infants – the majority of whom are breastfed from birth up to 24 months. These `break through’ malaria infections probably indicate incomplete protection by breastfeeding. There is a significant gap in our knowledge about antimalarial immunity mediated by breastfeeding and the factors involved. Our recent preliminary data demonstrated that high concentrations of specific human milk oligosaccharides (HMOs) in Ugandan mothers’ milk are differentially associated with malaria risk in their infants. HMOs represent the third most abundant component in breast milk which, upon ingestion by infants, reach the systemic circulation where they directly engage innate immune cells through specific surface receptors. Studies involving ex vivo stimulation of human cells and cell lines demonstrated that HMOs modulate the functions of macrophages and monocytes in several ways. This includes inducing anti-inflammatory or proinflammatory responses, inducing or inhibiting monocyte or macrophage activation, inhibition of proliferation or migration, and enhancing phagocytosis. A human clinical trial involving infants fed 2′- fucosyllactose (2’FL) in formula confirmed the anti-inflammatory effect of 2’FL. HMO-mediated modulation of monocyte function is highly relevant to pediatric malaria which involves monocyte dysregulation and systemic inflammation. Our long-term goal is to elucidate the role of HMOs in early innate immunity against malaria. The objective of this project is to determine the relationship between HMOs in breast milk and infant blood, monocyte function, and malaria outcomes in breast-fed infants. The central hypothesis is that direct HMO modulation of monocytes tips the balance towards disease or protection during pediatric malaria and that differences in levels of specific HMOs are linked to different malaria outcomes.

This project will set the stage for more powered mechanistic studies of HMO-monocyte interactions which will inform the design of novel antimalarial interventions. The results are generalizable to other regions with a high burden of malaria in young infants. The potential to move the field forward and make a sustainable impact is high.

NIH project details

Product Development
Vulnerable Populations

Aug 2020 — Jul 2023

$371,156

Uganda
United States