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New study reveals important role of insulin in making breast milk
Date:7/5/2013

up to 20 percent of new mothers in the United States are at risk for low milk supply due to insulin dysregulation."

Dr. Nommsen-Rivers and her colleagues were able to use a noninvasive method to capture mammary gland RNA a chain of molecules that are blueprints for making specified proteins in samples of human breast milk. They then created the first publicly accessible library of genes expressed in the mammary gland based on RNA-sequencing technology.

This approach revealed a highly sensitive portrait of the genes being expressed in human milk-making cells. They discovered an orchestrated switching on and off of various genes as the mammary gland transitions from secreting small amounts of immunity-boosting colostrum in the first days after giving birth to the copious production of milk in mature lactation.

In particular, the PTPRF gene, which is known to suppress intracellular signals that are usually triggered by insulin binding to its receptor on the cell surface, may serve as a biomarker linking insulin resistance with insufficient milk supply. These results lay the foundation for future research focused on the physiological contributors to mothers' milk supply difficulties.

Now that they've demonstrated the significance of insulin signaling in the human mammary gland, they are planning a phase I/II clinical trial with a drug used to control blood sugar in type 2 diabetes to determine whether it improves insulin action in the mammary gland, thus improving milk supply. While a drug is not an ideal way to solve the problem of sub-optimal glucose metabolism impairing breastfeeding, according to Dr. Nommsen-Rivers, it is excellent for establishing proof-of-concept through the use of a placebo controlled randomized clinical trial.

"The ideal approach is a preventive one," she says. "Modifications in diet and exercise are more powerful than any drug. After this clinical trial, we hope to study those interventions.
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Contact: Jim Feuer
jim.feuer@cchmc.org
513-636-4656
Cincinnati Children's Hospital Medical Center
Source:Eurekalert

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