Project description:There is little information regarding the allergen content of milk feeds in the preterm population. Previous studies have evaluated specific proteins/peptides via ELISA, but no studies have performed a broad analysis of the allergenic peptide content and protease activity of milk feeds in this population. Preterm infants spend a critical window of time for immune development in the Newborn Intensive Care Unit (NICU), and may receive fortified donor milk, maternal milk or formula feeds via nasogastric tube or bottle instead of fresh breastmilk via breastfeeding.
Project description:Necrotizing enterocolitis (NEC) is an acute and life-threatening gastrointestinal disorder afflicting preterm infants, which is currently unpreventable. Fecal microbiota transplantation (FMT) is a promising preventative therapy, but potential bacterial infection raise concern. Removal of bacteria from donor feces may reduce this risk while maintaining the NEC-preventive effects. We aimed to assess preclinical efficacy and safety of bacteria-free fecal filtrate transfer (FFT). Using fecal material from healthy suckling piglets, we administered FMT rectally, or cognate FFT either rectally or oro-gastrically to formula-fed preterm, cesarean-delivered piglets as a model for preterm infants, We compared gut pathology and related safety parameters with saline controls, and analyzed ileal mucosal transcriptome to gauge the host e response to FMT and FFT treatments relative to control. Results showed that oro-gastric FFT prevented NEC, whereas FMT did not perform better than control. Moreover, FFT but not FMT reduced intestinal permeability, whereas FMT animals had reduced body weight increase and intestinal growth. Global gene expression of host mucosa responded to FMT but not FFT with increased and decreased bacterial and viral defense mechanisms, respectively. In conclusion, as preterm infants are extremely vulnerable to enteric bacterial infections, rational NEC-preventive strategies need incontestable safety profiles. Here we show in a clinically relevant animal model that FFT, as opposed to FMT, efficiently prevents NEC without any recognizable side effects. If translatable to preterm infants, this could lead to a change of practice and in turn a reduction in NEC burden.
Project description:Delivery of the baby before 37 weeks of completed gestation is deemed to be preterm birth. Admission of these preterm infants to the conventional neonatal intensive care unit (NICU) to manage their fragile physiology also tends to cause considerable stress that impedes the baby’s normal development. A recent innovation in neonatal care is the mother-neonatal ICU (MNICU), where the mother is not a mere visitor but has her bed inside the MNICU by the baby’s side. This study enrolled 200 low birth weight preterm babies (gestational age 28-37 weeks; weight 0.800–1.8 kg) randomized to MNICU & NICU. Saliva was collected from the 200 preterm neonates at the time of admission and discharge. We measured cortisol levels in the saliva of these samples, as the hormone is an established biomarker for stress. Salivary proteomics was also performed on 12 pairs of salivary samples chosen on basis of significant growth and development of these neonates. To study the differential proteome signature in these conditions MS-based data independent acquisition identified and quantified 342 and 308 protein groups, respectively. Differential protein analysis of these proteins revealed 41 differentially expressed proteins (DEPs). Pathway enrichment of unique DEPs in MNICU vs NICU comparison revealed improvement in immunity and metabolism-associated pathways at discharge. Quantitative analysis of the standard proteins from arrival and discharge groups revealed differential expression of these proteins. In differential expression analysis, we identified 28 upregulated and 16 downregulated proteins in neonates admitted to MNICU compared to NICU. A similar analysis for neonates at discharge identified 22 upregulated and 19 downregulated proteins. Further pathway enrichment of differential proteins unique to each group; 22 DEPs were present only in the arrival group, and 19 were in the discharge group. The data show a marked, statistically significant improvement in the overall well-being of preterm children admitted to MNICU and provided KMC compared to the NICU group. Thus, our study provides evidence in favor of easily available, cost-effective care that can make huge difference in the outcome of preterm neonates, particularly in low-income settings.
Project description:Sequencing of 16S ribosomal RNA (rRNA) gene, which has improved the characterization of microbial community, has made it possible to detect a low level Helicobacter pylori (HP) sequences even in HP-negative subjects which were determined by a combination of conventional methods. This study was conducted to obtain a cutoff value for HP colonization in gastric mucosa biopsies and gastric juices by the pyrosequencing method. Corresponding author: Department of Internal Medicine, Seoul National University Bundang Hospital, Seoungnam, Gyeonggi-do, Korea; Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea (Tel., +82-31-787-7008; e-mail, nayoungkim49@empas.com). Microbial DNA from gastric mucosal samples [gastric antrum (n=63, mucosal biopsy), follow-up sample on gastric antrum (n=16, mucosal biopsy), and gastric body (n=18, mucosal biopsy)] and gastric juices (n=4, not mucosal biopsy) was amplified by nested PCR using universal bacterial primers, and the 16S rRNA genes were pyrosequenced.
Project description:Bacterial sepsis is associated with high morbidity and mortality in preterm infants. However, diagnosis of sepsis and identification of the causative agent remains challenging. Our aim was to determine genome-wide expression profiles of very low birth weight (VLBW) infants with and without bacterial sepsis and assess differences.
Project description:Over the course of milk digestion, native milk proteases and infant digestive proteases fragment intact proteins into peptides with potential bioactivity. This study investigated the release of peptides over three hours of gastric digestion in 14 preterm infant sample sets. The peptide content was extracted and analyzed from milk and gastric samples via Orbitrap tandem mass spectrometry. The relative ion intensity (abundance) and count of peptides in each sample were compared over time and between infants fed milk fortified with bovine milk fortifier and infants fed unfortified milk. Bioactivity of the identified peptides was predicted by sequence homology to known bioactive milk peptides. Both total and bioactive peptide abundance and count continuously increased over three hours of gastric digestion. After accounting for infant weight, length, and post-conceptual age, fortification of milk limited the release of peptides from human milk proteins. Peptides that survived further gastric digestion after their initial release were structurally more similar to bioactive peptides than non-surviving peptides. This work is the first to provide a comprehensive profile of milk peptides released during gastric digestion over time, which is an essential step in determining which peptides are most likely to be biologically relevant in the infant.
Project description:Unpublished single cell RNAseq data from pan-GI integration study from healthy adult donors (20-70 years old; stomach, duodenum, ileum) and control samples from preterm infants (23-31 PCW; small intestine and colon). Details for sample processing can be found in the manuscript.