Alterations of milk oligosaccharides in mothers with gestational diabetes mellitus impede colonization of beneficial bacteria and development of RORγt⁺ Treg cell-mediated immune tolerance in neonates

ABSTRACT

Gestational diabetes mellitus (GDM) is an increasing public health concern that significantly increases the risk of early childhood allergic diseases. Altered maternal milk glycobiome may strongly affect gut microbiota and enteric-specific Treg cell-mediated development of immune tolerance in GDM infants. In this study, we found that, compared with healthy Chinese mothers, mothers with GDM had significantly lower levels of total and specific human milk oligosaccharides (HMOs) in their colostrum that subsequently increased with extension of lactation. This alteration in HMO profiles significantly delayed colonization of Lactobacillus and Bifidobacterium spp. in their breast-fed infants, resulting in a distinct gut microbial structure and metabolome. Further experiments in GDM mouse models indicated that decreased contents of milk oligosaccharides, mainly 3ʹ-sialyllactose (3ʹ-SL), in GDM maternal mice reduced colonization of bacteria, such as L. reuteri and L. johnsonii, in the neonatal gut, which impeded development of RORγt⁺ regulatory T (Treg) cell-mediated immune tolerance. Treatment of GDM neonates with 3ʹ-SL, Lactobacillus reuteri (L. reuteri) and L. johnsonii promoted the proliferation of enteric Treg cells and expression of transcription factor RORγt, which may have contributed to compromising ovalbumin (OVA)-induced allergic responses. In vitro experiments showed that 3ʹ-SL, metabolites of L. johnsonii, and lysates of L. reuteri stimulated differentiation of mouse RORγt⁺ Treg cells through multiple regulatory effects on Toll-like receptor, MAPK, p53, and NOD-like receptor signaling pathways. This study provides new ideas for the development of gut microbiota and immune tolerance in GDM newborns.

GRAPHICAL ABSTRACT

KEYWORDS:

• Gestational diabetes mellitus (GDM)
• human milk oligosaccharides (HMOs)
• gut microbiota
• RORγt⁺ treg cells, immune tolerance

Acknowledgments

We are very grateful to the mothers and infants who participated in the sample collection. We thank Mitchell Arico from Liwen Bianji (Edanz) (https://www.liwenbianji.cn) for editing the language of a draft of this manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributor

X. Li and X. Ning carried out the experiments and wrote the draft of this manuscript; Y. Wang, B. Rui and Z. Lei analyzed data; D. Yu and Y. Deng collected the human samples; B. Rui, J. Yuan, W. Li, F. Liu, J. Yan and M. Li edited the manuscript; M. Li designed the study; J. Yan and M. Li guided the research. All authors read and approved the final version of this manuscript.

Additional information

Funding

This work was supported in part by the Nutrition and Care of Maternal & Child Research Fund Project of Guangzhou Biostime Institute of Nutrition & Care (2019BINCMCF02), the National Natural Science Foundation of China (No. 22074143, 21934005, 31900920) and the Nature Science Foundation of Liaoning Province (2023-MS-260), China. This work was also supported by Liaoning Provincial Program for Top Discipline of Basic Medical Sciences, China.