Addressing milk kinship in milk banking: experience from Singapore's first donor human milk bank

The KK Human Milk Bank (KKHMB), the first and only human milk bank in Singapore, was established in August 2017 to provide safe pasteurised donor human milk (PDHM) to vulnerable preterm and sick infants with insufficient own mother’s milk, as the use of donor human milk (DHM) is potentially lifesaving for these infants. To promote inclusivity and equal access to DHM by all the communities in our multiracial country with a Malay population of 13.5%,[5] the concept of milk kinship in Islam, which could hinder the acceptability of PDHM in Muslim preterm infants, had to be addressed.Temasek Foundation CLG LimitedPublished versionWe thank Temasek Foundation for their generous funding and support for the setup of the Temasek Foundation Cares Donor Human Milk Bank Programme

Cytokine and Chemokine Profiling in Patients with Hand, Foot and Mouth Disease in Singapore and Malaysia

10.1038/s41598-018-22379-6SCIENTIFIC REPORTS8

Circulating Salivary miRNA hsa-miR-221 as Clinically Validated Diagnostic Marker for Hand, Foot, and Mouth Disease in Pediatric Patients

Enhancements in the diagnostic capabilities using host biomarkers are currently much needed where sensitivity and specificity issues plague the diagnosis of Hand, Foot and Mouth Disease (HFMD) in pediatrics clinical samples. We investigated miRNome profiles of HFMD saliva samples against healthy children and developed miRNA-based diagnosis models. Our 6-miRNA scoring model predicted HFMD with an overall accuracy of 85.11% in the training set and 92.86% in the blinded test set of Singapore cohort. Blinded evaluation of the model in Taiwan HFMD cases resulted in 77.08% accuracy with the 6-miRNA model and 68.75% with the 4-miRNA model. The strongest predictor of HFMD in all of the panels, hsa-miR-221 was found to be consistently and significantly downregulated in all of our HFMD cohorts. This is the first study to prove that HFMD infection could be diagnosed by circulating miRNAs in patient's saliva. Moreover, this study also serves as a stepping stone towards the future development of other infectious disease diagnosis workflows using novel biomarkers. Keywords: miRNA, Biomarker, Saliva, HFMD, Machine learnin

Circulating Salivary miRNA hsa-miR-221 as Clinically Validated Diagnostic Marker for Hand, Foot, and Mouth Disease in Pediatric Patients

10.1016/j.ebiom.2018.05.006EBIOMEDICINE31299-30

Cytokine and Chemokine Profiling in Patients with Hand, Foot and Mouth Disease in Singapore and Malaysia

Abstract Hand, foot and mouth disease (HFMD) is a prevalent contagious childhood disease typically associated with fever, oral lesions and limb exanthema. While HFMD is caused by a plethora of serotypes of viruses under the genus Enterovirus within the Picornaviridae family, Coxsackievirus A16 (CV-A16) and Enterovirus 71 (EV-A71) are considered the main etiological agents. In recent years however, other viruses have also been isolated in considerable numbers from infected individuals in many regions, joining the legion commonly associated with HFMD. The present study investigated the cytokine and chemokine profiles of HFMD patients from Singapore and Malaysia for the first time. Comparative cohort studies of EV-A71-associated HFMD cases revealed that the Malaysia cohort had a distinct profile from the Singapore cohort, and this could be partly attributed by different EV-A71 genotypes. As the isolation of CV-A6, instead of CV-A16, had become prevalent in the Singapore cohort, it was also of particular interest to study the differential cytokine and chemokine profiles. Our data revealed that overlapping as well as unique profiles exist between the two major causative clinical isolates in the Singapore cohort. Having a better understanding of the respective immunological profiles could be useful for more accurate HFMD diagnosis, which is imperative for disease transmission control until multi-valent vaccines and/or broad-spectrum anti-viral drugs become available

A synbiotic intervention modulates meta-omics signatures of gut redox potential and acidity in elective caesarean born infants

The compromised gut microbiome that results from C-section birth has been hypothesized as a risk factor for the development of non-communicable diseases (NCD). In a double-blind randomized controlled study, 153 infants born by elective C-section received an infant formula supplemented with either synbiotic, prebiotics, or unsupplemented from birth until 4 months old. Vaginally born infants were included as a reference group. Stool samples were collected from day 3 till week 22. Multi-omics were deployed to investigate the impact of mode of delivery and nutrition on the development of the infant gut microbiome, and uncover putative biological mechanisms underlying the role of a compromised microbiome as a risk factor for NCD. Results: As early as day 3, infants born vaginally presented a hypoxic and acidic gut environment characterized by an enrichment of strict anaerobes (Bifidobacteriaceae). Infants born by C-section presented the hallmark of a compromised microbiome driven by an enrichment of Enterobacteriaceae. This was associated with meta-omics signatures characteristic of a microbiome adapted to a more oxygen-rich gut environment, enriched with genes associated with reactive oxygen species metabolism and lipopolysaccharide biosynthesis, and depleted in genes involved in the metabolism of milk carbohydrates. The synbiotic formula modulated expression of microbial genes involved in (oligo)saccharide metabolism, which emulates the eco-physiological gut environment observed in vaginally born infants. The resulting hypoxic and acidic milieu prevented the establishment of a compromised microbiome. Conclusions: This study deciphers the putative functional hallmarks of a compromised microbiome acquired during C-section birth, and the impact of nutrition that may counteract disturbed microbiome development

A synbiotic intervention modulates meta-omics signatures of gut redox potential and acidity in elective caesarean born infants

The compromised gut microbiome that results from C-section birth has been hypothesized as a risk factor for the development of non-communicable diseases (NCD). In a double-blind randomized controlled study, 153 infants born by elective C-section received an infant formula supplemented with either synbiotic, prebiotics, or unsupplemented from birth until 4 months old. Vaginally born infants were included as a reference group. Stool samples were collected from day 3 till week 22. Multi-omics were deployed to investigate the impact of mode of delivery and nutrition on the development of the infant gut microbiome, and uncover putative biological mechanisms underlying the role of a compromised microbiome as a risk factor for NCD. Results: As early as day 3, infants born vaginally presented a hypoxic and acidic gut environment characterized by an enrichment of strict anaerobes (Bifidobacteriaceae). Infants born by C-section presented the hallmark of a compromised microbiome driven by an enrichment of Enterobacteriaceae. This was associated with meta-omics signatures characteristic of a microbiome adapted to a more oxygen-rich gut environment, enriched with genes associated with reactive oxygen species metabolism and lipopolysaccharide biosynthesis, and depleted in genes involved in the metabolism of milk carbohydrates. The synbiotic formula modulated expression of microbial genes involved in (oligo)saccharide metabolism, which emulates the eco-physiological gut environment observed in vaginally born infants. The resulting hypoxic and acidic milieu prevented the establishment of a compromised microbiome. Conclusions: This study deciphers the putative functional hallmarks of a compromised microbiome acquired during C-section birth, and the impact of nutrition that may counteract disturbed microbiome development

Data for: "A synbiotic intervention modulates meta-omics signatures of gut redox potential and acidity in elective caesarean born infants"

Supplementary datasets published to support the paper, "A synbiotic intervention modulates meta-omics signatures of gut redox potential and acidity in elective caesarean born infants". Table 1 contains information on the number of subjects per group and number of 16S rRNA samples per group and time point, Table 2 contains 16S rRNA sequencing outputs, Table 3 contains Permutational Multivariate Analysis of Variance (PERMANOVA) tests, Table 4 contains 16S rRNA Family data (Mean and SD) per group and time point, Table 5 contains 16S rRNA Genus data (Mean and SD) per group and time point, and Table 6 provides 16S rRNA Species data (Mean and SD) per group and time point. Table 7-9 contain non-parametric Mann-Whitney U tests performed at each time point on each pair of study group combination at family level (Table 7), genus level (Table 8), and species level (table 9). Table 10 contains categorization of bacterial families into functional groups (anaerobic/aerobic metabolism and Lactic Acid Bacteria). Table 11 contains KEGG functional annotation and Table 12 contains SEED functional annotation. Raw 16S rRNA data are available at https://www.ebi.ac.uk using accession number PRJEB44790. Shotgun Metagenomics and Metatranscriptomics data are available at https://www.ncbi.nlm.nih.gov under accession number PRJNA726032