485 - Intestinal expression of growth factors is lower in infants consuming glucose-containing formula compared to lactose-based formula and breastfeeding – a pilot study

Poster Number: 485
Publication Number: 485.1959

Background: Human milk (HM) is the universally recommended source of infant nutrition. Infant formula utilizes multiple carbohydrate sources including lactose (the carbohydrate in HM) and glucose-based sugars (ex: corn syrup). In the developing infant intestine, growth factors including vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), and fibroblast growth factor 2 (FGF2) are crucial to intestinal mucosa development and promote cellular proliferation, differentiation, and maturation.

Objective: To investigate the intestinal gene expression profile of healthy term infants and compare between exclusively breastfed (BF) vs exclusively fed lactose-based (LAC) or glucose-based (GLU) infant formula using non-invasive precision exfoliomics.

Design/Methods: This was a pilot observational study. LAC and GLU formula-fed infants had no more than 2-weeks of HM exposure and were exclusively consuming their current LAC or GLU formula for a minimum of 3 months. Stool samples were collected from all infants at 5 months of age and stored in a preservative prior to RNA sequencing. The transcriptome of exfoliated cells shed from the neonatal gut was aligned to the human reference genome, filtered and normalized. Significant (p < 0.05) differences in relative transcript abundance between groups were identified. This list of differentially expressed genes was used in Ingenuity Pathway Analysis to identify upstream regulators that explain the differences in expression between groups.

Results: There were 11 infants studied: 5 BF, 2 LAC, and 4 GLU. The carbohydrate source in the GLU formula was 80% glucose and 20% lactose. There were no significant differences in infant birth weight, sex or maternal BMI between groups. There were no differences in gene expression between the LAC vs BF groups. A total of 157 genes were differentially expressed between GLU vs BF groups; 11 were upregulated and 146 were downregulated in the GLU group. There were 8 genes identified as upstream regulators that likely drive the differential expression patterns between the GLU vs BF infants. Of these 8 genes, 3 were potent growth factors which were all downregulated in the GLU vs BF group (VEGF (p=0.001), EGF (p=0.017), and FGF2 (p=0.014)).

Conclusion(s): Consistent exposure to infant formula containing glucose during infancy was associated with differences in intestinal gene expression. Developmental growth factors VEGF, EGF, FGF2 were downregulated in infants receiving glucose-containing formula compared to exclusively breastfed infants.