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Breastmilk microbiome changes associated with lactational mastitis and treatment with dandelion extract

INTRODUCTION: Dandelion (Pugongying) is one of the most frequently used Chinese herbs for treating lactational mastitis (LM). Pugongying granules, a patented medication primarily comprised of dandelion extract, have been approved by CFDA for LM treatment in China. The aims of this study were to inve...

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Autores principales: Jin, Xinyan, Xiao, Jinhe, Lu, Chunli, Ma, Wenxin, Fan, Yingyi, Xue, Xue, Xia, Yaru, Chen, Nana, Liu, Jianping, Pei, Xiaohua
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10679338/
https://www.ncbi.nlm.nih.gov/pubmed/38029215
http://dx.doi.org/10.3389/fmicb.2023.1247868
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author Jin, Xinyan
Xiao, Jinhe
Lu, Chunli
Ma, Wenxin
Fan, Yingyi
Xue, Xue
Xia, Yaru
Chen, Nana
Liu, Jianping
Pei, Xiaohua
author_facet Jin, Xinyan
Xiao, Jinhe
Lu, Chunli
Ma, Wenxin
Fan, Yingyi
Xue, Xue
Xia, Yaru
Chen, Nana
Liu, Jianping
Pei, Xiaohua
author_sort Jin, Xinyan
collection PubMed
description INTRODUCTION: Dandelion (Pugongying) is one of the most frequently used Chinese herbs for treating lactational mastitis (LM). Pugongying granules, a patented medication primarily comprised of dandelion extract, have been approved by CFDA for LM treatment in China. The aims of this study were to investigate the etiology of LM and the mechanism by which Pugongying granules decrease LM symptoms, with a particular focus on the microbial communities found in breastmilk. METHODS: Participants were recruited from a previously performed randomized controlled trial (Identifier: NCT03756324, ClinicalTrials.gov). Between 2019 and 2020, women diagnosed with unilateral LM at the Beijing University of Chinese Medicine Third Affiliated Hospital were enrolled. In total, 42 paired breastmilk samples from the healthy and affected breasts of the participants were collected. Additionally, 37 paired pre- and post-treatment breastmilk samples from the affected breast were collected from women who received a 3-day course of either Pugongying granules (20 women) or cefdinir (17 women). Clinical outcomes [e.g., body temperature, visual analogue scale (VAS) score for breast pain, the percentage of neutrophils (NE%)] were analyzed pre- and post-treatment, and the breastmilk samples were subjected to 16S rRNA gene sequencing to analyze the alpha and beta diversities and identify significant bacteria. Finally, the relationship between microorganisms and clinical outcomes was analyzed. RESULTS: There was no significant difference in fever and pain between the Pugongying group and cefdinir group. The most prevalent bacterial genera in breastmilk were Streptococcus and Staphylococcus. Compared to healthy breastmilk, microbial diversity was reduced in affected breastmilk, and there was a higher relative abundance of Streptococcus. After Pugongying treatment, there was an increase in microbial diversity with significantly higher abundance of Corynebacterium. A negative correlation was found between Corynebacterium, VAS score, and NE%. Treatment with cefdinir did not affect microbial diversity. Taken together, our results show a correlation between LM and reduced microbial diversity, as well as an increased abundance of Streptococcus in affected breastmilk. CONCLUSION: Pugongying granules enhanced microbial diversity in breastmilk samples. Given the substantial variation in individual microbiomes, identifying specific species of Streptococcus and Corynebacterium associated with LM may provide additional insight into LM pathogenesis and treatment.
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spelling pubmed-106793382023-11-13 Breastmilk microbiome changes associated with lactational mastitis and treatment with dandelion extract Jin, Xinyan Xiao, Jinhe Lu, Chunli Ma, Wenxin Fan, Yingyi Xue, Xue Xia, Yaru Chen, Nana Liu, Jianping Pei, Xiaohua Front Microbiol Microbiology INTRODUCTION: Dandelion (Pugongying) is one of the most frequently used Chinese herbs for treating lactational mastitis (LM). Pugongying granules, a patented medication primarily comprised of dandelion extract, have been approved by CFDA for LM treatment in China. The aims of this study were to investigate the etiology of LM and the mechanism by which Pugongying granules decrease LM symptoms, with a particular focus on the microbial communities found in breastmilk. METHODS: Participants were recruited from a previously performed randomized controlled trial (Identifier: NCT03756324, ClinicalTrials.gov). Between 2019 and 2020, women diagnosed with unilateral LM at the Beijing University of Chinese Medicine Third Affiliated Hospital were enrolled. In total, 42 paired breastmilk samples from the healthy and affected breasts of the participants were collected. Additionally, 37 paired pre- and post-treatment breastmilk samples from the affected breast were collected from women who received a 3-day course of either Pugongying granules (20 women) or cefdinir (17 women). Clinical outcomes [e.g., body temperature, visual analogue scale (VAS) score for breast pain, the percentage of neutrophils (NE%)] were analyzed pre- and post-treatment, and the breastmilk samples were subjected to 16S rRNA gene sequencing to analyze the alpha and beta diversities and identify significant bacteria. Finally, the relationship between microorganisms and clinical outcomes was analyzed. RESULTS: There was no significant difference in fever and pain between the Pugongying group and cefdinir group. The most prevalent bacterial genera in breastmilk were Streptococcus and Staphylococcus. Compared to healthy breastmilk, microbial diversity was reduced in affected breastmilk, and there was a higher relative abundance of Streptococcus. After Pugongying treatment, there was an increase in microbial diversity with significantly higher abundance of Corynebacterium. A negative correlation was found between Corynebacterium, VAS score, and NE%. Treatment with cefdinir did not affect microbial diversity. Taken together, our results show a correlation between LM and reduced microbial diversity, as well as an increased abundance of Streptococcus in affected breastmilk. CONCLUSION: Pugongying granules enhanced microbial diversity in breastmilk samples. Given the substantial variation in individual microbiomes, identifying specific species of Streptococcus and Corynebacterium associated with LM may provide additional insight into LM pathogenesis and treatment. Frontiers Media S.A. 2023-11-13 /pmc/articles/PMC10679338/ /pubmed/38029215 http://dx.doi.org/10.3389/fmicb.2023.1247868 Text en Copyright © 2023 Jin, Xiao, Lu, Ma, Fan, Xue, Xia, Chen, Liu and Pei. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Microbiology
Jin, Xinyan
Xiao, Jinhe
Lu, Chunli
Ma, Wenxin
Fan, Yingyi
Xue, Xue
Xia, Yaru
Chen, Nana
Liu, Jianping
Pei, Xiaohua
Breastmilk microbiome changes associated with lactational mastitis and treatment with dandelion extract
title Breastmilk microbiome changes associated with lactational mastitis and treatment with dandelion extract
title_full Breastmilk microbiome changes associated with lactational mastitis and treatment with dandelion extract
title_fullStr Breastmilk microbiome changes associated with lactational mastitis and treatment with dandelion extract
title_full_unstemmed Breastmilk microbiome changes associated with lactational mastitis and treatment with dandelion extract
title_short Breastmilk microbiome changes associated with lactational mastitis and treatment with dandelion extract
title_sort breastmilk microbiome changes associated with lactational mastitis and treatment with dandelion extract
topic Microbiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10679338/
https://www.ncbi.nlm.nih.gov/pubmed/38029215
http://dx.doi.org/10.3389/fmicb.2023.1247868
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