Profile of Human Milk Oligosaccharides and FUT2 Polymorphism of Mothers in Indonesia

Profile of Human Milk Oligosaccharides and FUT2 Polymorphism of Mothers in Indonesia: A Study on the Association Between Maternal Genotype-Phenotype Secretor Status and Short Chain Fatty Acid Profile Based on the Mother-Infant Genotype Pair

Human milk oligosaccharides (HMOs), the third most abundant constituent of breastmilk, are known to have beneficial effects on infant immunity. Maternal genetic polymorphisms cause HMO variability. The FUT2 gene determines the secretor status, whereas the FUT3 gene is responsible for the expression of Lewis fucosyltransferase. Therefore, breastmilk can be classified to four groups according to the variation. To date, this variability has not been investigated in Indonesia. This study aims to evaluate the association between FUT2 gene polymorphism and 2'-Fucosyllactose (2'-FL) secretor phenotype. In addition, infant FUT2 gene polymorphism and short chain fatty acid (SCFA) profile from stool samples are also analysed.

Study Overview

• Status: Completed
• Conditions: Breastfeeding, Exclusive

Detailed Description

Eligible mother-infant pairs are explained about this study. Those willing to participate in this study are asked for written informed consent. Mothers are interviewed about their baseline characteristics, family pedigree, nutritional intake, and routine drug consumption. Infants are checked for their birth history. Both are measured for weight and height.

Four specimens are collected from the subjects:

1. Mother

   1. Breastmilk

      Breastmilk is expressed at 8-11 AM to avoid variability due to circadian rhythm. One breast is emptied, 30 mL of breastmilk is stored in a sterile container, and the rest is returned for feeding. Breastmilk is divided to five 2-mL cryovials and stored in a -80°C freezer. The remaining is stored in a -20°C freezer.

   2. Blood

   Blood samples (3 mL) are collected for DNA extraction.

2. Infant

   1. Buccal cells

      Buccal swab kits are used to obtain samples for DNA extraction.

   2. Stool

Stool specimens are collected at the age of four weeks in a sterile container and stored in a -80°C storage before short chain fatty acid profile analysis.

• Study Type: Observational
• Enrollment (Actual): 120

Contacts and Locations

Study Locations

• Indonesia
  • DKI Jakarta
    • Jakarta Pusat, DKI Jakarta, Indonesia, 10440
      • Faculty of Medicine, Universitas Indonesia

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 2 weeks and older (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Eligible mothers and infants visiting the research site during recruitment.

Description

Inclusion Criteria:

• Mother

  1. Minimum of 18 years old
  2. With term infants aged 2-5 weeks
  3. Exclusively breastfeed
  4. Healthy condition
  5. Agree to participate and sign the informed consent

• Infant

  1. Infant with mother who fulfil the eligibility criteria

Exclusion Criteria:

• Mother

  1. Has a Caucasian ancestor in two generations above
  2. Infant has multiple congenital anomalies

• Infant

  1. Has ever received antibiotics

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Human milk oligosaccharides profile of Indonesian mothers	The concentration of 19 HMOs will be measured using high performance anion exhange chromatography with pulsed amperometric detection (HPAEC-PAD).	1 day
Proportion of FUT2 secretor genotype of mothers based on single nucleotide polymorphism (SNP) rs601338	Sequencing of coding sequence (exon 2) of FUT2 gene will be performed using a previously known outer primer from the study by Lefebvre, et al (2020). The results will be aligned with database from www.ncbi.nlm.nih.gov to find the proportion of rs601338 among mothers.	1 day
Association between rs601338 FUT2 secretor genotype and 2'-FL secretor phenotype in mothers	The association between rs601338 FUT2 genotype (homozygous dominant, heterozygous, homozygous recessive) and 2'-FL concentration will be analysed using ANOVA test.	1 day

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Novel FUT2 polymorphism in Indonesian mothers	The sequencing result of exon 2 in the FUT2 gene will be aligned with database from www.ncbi.nlm.nih.gov to find novel variants. Additional information regarding existing variants will be browsed using the same database. The allele frequency of new variants will be calculated to determine new SNP.	1 day
Proportion of FUT2 secretor genotype of infants based on single nucleotide polymorphism (SNP) rs601338	Sequencing of coding sequence (exon 2) of FUT2 gene will be performed using a previously known outer primer from the study by Lefebvre, et al (2020). The results will be aligned with database from www.ncbi.nlm.nih.gov to find the proportion of rs601338 among infants.	1 day
Novel FUT2 polymorphism in infant	The sequencing result of exon 2 FUT2 will be aligned with database from www.ncbi.nlm.nih.gov to find novel variants. Additional information regarding existing variants will be browsed using the same database. The allele frequency of new variants will be calculated to determine new SNP.	1 day
Profile of infant stool short chain fatty acid based on mother-infant FUT2 genotype pairs	The concentration of total short chain fatty acid, acetate, propionate, and butyrate in infant's stool will be measured using gas chromatography-mass spectrometry (GC-MS). Difference in the concentration between four mother-infant genotype pairs will be analysed using ANOVA test.	1 day

Collaborators and Investigators

• Sponsor: Indonesia University
• Collaborators: University Medical Center Groningen
• Investigators: Principal Investigator: Klara Yuliarti, MD, Dept of Pediatric, Faculty of Medicine, Universitas Indonesia/ Cipto Mangunkusumo General Hospital

Study record dates

Study Major Dates

• Study Start (Actual): December 1, 2021
• Primary Completion (Actual): July 31, 2022
• Study Completion (Actual): April 14, 2023

Study Registration Dates

• First Submitted: December 1, 2021
• First Submitted That Met QC Criteria: December 1, 2021
• First Posted (Actual): December 14, 2021

Study Record Updates

• Last Update Posted (Actual): September 28, 2023
• Last Update Submitted That Met QC Criteria: September 26, 2023
• Last Verified: September 1, 2023

More Information

Terms related to this study

• Keywords: Short Chain Fatty Acid; Human Milk Oligosaccharide
• Other Study ID Numbers: 21-08-0852

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No