The World Health Organisation recommends exclusive breastfeeding for the first six months of an infant's life and in combination with solid food thereafter. This recommendation was introduced based on research sho...The World Health Organisation recommends exclusive breastfeeding for the first six months of an infant's life and in combination with solid food thereafter. This recommendation was introduced based on research showing numerous health benefits of breastfeeding for both the mother and the infant. However, there is always concern regarding the transfer of medications from mother to their breastfed baby via milk. Pharmacokinetic properties of a drug are usually used to predict its transferability into breast milk. Although most drugs are compatible with breastfeeding, cases of toxic drug exposure have been reported. This is thought to be due to active transport mechanisms whereby efflux transporter proteins expressed in the epithelial cells of the mammary gland actively secrete drugs into milk. An example of such efflux transporters including the breast cancer resistance protein which is strongly induced during lactation and this could result in contamination of milk with the substrates of this transporter which may place the suckling infant at risk of toxicity. Furthermore, there is little known about the substrate specificity of most efflux transporters as we have highlighted in this review. There also exists some degree of contradiction between in vivo and in vitro studies which makes it difficult to conclusively predict outcomes and drug-drug interactions.展开更多
目的:探讨母血、乳汁中补体C1q/肿瘤坏死因子相关蛋白3(complement-C1q/tumor necrosis factor-related protein 3,CTRP3)水平与重度子痫前期的相关性。方法:选取重度子痫前期患者45例为观察组,无并发症足月分娩的产妇41例作为对照组,...目的:探讨母血、乳汁中补体C1q/肿瘤坏死因子相关蛋白3(complement-C1q/tumor necrosis factor-related protein 3,CTRP3)水平与重度子痫前期的相关性。方法:选取重度子痫前期患者45例为观察组,无并发症足月分娩的产妇41例作为对照组,收集产前及产后的母体静脉血及产后72 h的乳汁,酶联免疫吸附法检测血清及乳汁中CTRP3水平,分析血清及乳汁中CTRP3水平与重度子痫前期的相关性。结果:观察组产前、产后母血CTRP3水平均明显低于对照组(均P<0.05),两组乳汁CTRP3水平差异无统计学意义(P>0.05)。母血CTRP3水平与乳汁中CTRP3水平无相关性(P>0.05)。结论:母血CTRP3水平与重度子痫前期的发生有关,其降低机制仍需进一步探索。乳汁CTRP3水平与重度子痫前期的相关性并不明确。展开更多
文摘The World Health Organisation recommends exclusive breastfeeding for the first six months of an infant's life and in combination with solid food thereafter. This recommendation was introduced based on research showing numerous health benefits of breastfeeding for both the mother and the infant. However, there is always concern regarding the transfer of medications from mother to their breastfed baby via milk. Pharmacokinetic properties of a drug are usually used to predict its transferability into breast milk. Although most drugs are compatible with breastfeeding, cases of toxic drug exposure have been reported. This is thought to be due to active transport mechanisms whereby efflux transporter proteins expressed in the epithelial cells of the mammary gland actively secrete drugs into milk. An example of such efflux transporters including the breast cancer resistance protein which is strongly induced during lactation and this could result in contamination of milk with the substrates of this transporter which may place the suckling infant at risk of toxicity. Furthermore, there is little known about the substrate specificity of most efflux transporters as we have highlighted in this review. There also exists some degree of contradiction between in vivo and in vitro studies which makes it difficult to conclusively predict outcomes and drug-drug interactions.
