Impact de la pasteurisation sur la digestion gastro-intestinale du lait maternel : digestion dynamique in vitro aux stades nouveau-nés prématuré et à terme

Mother’s own milk is the ideal infant food for optimal nutrition and growth. When not available, pasteurized donor milk can be administered. Pasteurization has structural and biochemical consequences on term milk digestion1,2. Whether similar results would be observed for preterm milk remains unknown and was thus the aim of our study. An in vitro dynamic system was used to simulate digestion. Preterm human milk (n=5 donors) was digested using preterm infant digestive parameters while for term milk (n=5 donors), term infant digestive parameters were employed3,4. Each type of milk was digested as raw or pasteurized (62.5°C, 30 min) in triplicate. Digesta were sampled regularly in the gastric compartment (over 90 or 120 min for preterm or term milk, respectively) and over 180 min in the intestinal compartment. Structural changes were evaluated by confocal microscopy and laser light scattering. Proteolysis was followed by SDS-PAGE submitted to tensitometry and by quantitative peptide analysis using tandem mass spectrometry coupled to liquid chromatography. Lipolysis was evaluated by gas chromatography and thin layer chromatography fitted to flame ionisation detector.Lipolysis degree was in overall significantly lower in pasteurized than in raw milk in both preterm and term conditions, but the extent of the difference was lower for the preterm than for the term condition. Gastric lipolysis was somewhat lower in the preterm than in the term milk. Due to a higher pre-lipolysis degree in raw term milk, the pH of this milk was slightly lower and thus, as specified in our model, it impacted the gastric pH decrease, which was slightly lower than that for the other milks. The impact of pasteurization on gastric proteolysis differed according to the protein structure with β-casein being hydrolysed significantly slower and lactoferrin being hydrolysed significantly faster in term pasteurized milk compared to term raw milk. This was not statistically significant in preterm milk. Similarly, the peptidome differed between raw and pasteurized milk to a lesser extent in the preterm than in the term condition. In both preterm and term conditions, pasteurization impacted the protein susceptibility to aggregation during digestion. These results suggest that pasteurization may have a lower impact on digestion of preterm milk compared to term milk. The greater pre-lipolysis in raw term milk slightly impacted the gastric acidification, which may also have impacted the extent of digestive hydrolysis. Such results have to be confirmed by in vivo studies.