Journal
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA
Volume 112, Issue 28, Pages E3738-E3747Publisher
NATL ACAD SCIENCES
DOI: 10.1073/pnas.1504891112
Keywords
iron homeostasis; anemia; HIF-2 alpha; pregnancy; lactation
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Funding
- NIH Grants [CA148828, DK095201]
- University of Michigan's Gastrointestinal Peptide Research Center [P30 DK034933]
- Diabetes Research and Training Center [P30 DK20572]
- Gastrointestinal Oncology SPORE [CA130810]
- American Heart Association [15POST22650034]
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The mechanisms that are essential for the maintenance of nutrient status in breast milk are unclear. Our data demonstrate that the intestine via hypoxia-inducible factor (HIF)-2 alpha is an essential regulatory mechanism for maintaining the quality of breast milk. During lactation, intestinal HIF-2 alpha is highly increased, leading to an adaptive induction of apical and basolateral iron transport genes. Disruption of intestinal HIF-2 alpha (but not HIF-1 alpha) or the downstream target gene divalent metal transporter (DMT)-1 in lactating mothers did not alter systemic iron homeostasis in the mothers, but led to anemia, decreased growth, and truncal alopecia in pups which was restored following weaning. Moreover, pups born from mothers with a disruption of intestinal HIF-2 alpha led to long-term cognitive defects. Cross-fostering experiments and micronutrient profiling of breast milk demonstrated that the defects observed were due to decreased maternal iron delivery via milk. Increasing intestinal iron absorption by activation of HIF-2 alpha or parenteral administration of iron-dextran in HIF-2 alpha knockout mothers ameliorated anemia and restored neonatal development and adult cognitive functions. The present work details the importance of breast milk iron in neonatal development and uncovers an unexpected molecular mechanism for the regulation of nutritional status of breast milk through intestinal HIF-2 alpha.
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