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Diet- and colonization-dependent intestinal dysfunction predisposes to necrotizing enterocolitis in preterm pigs

In English

Författare

  • PT Sangild
  • RH Siggers
  • M Schmidt
  • J Elnif
  • CR Bjornvad
  • T Thymann
  • ML Grondahl
  • AK Hansen
  • SK Jensen
  • M Boye
  • L Moelbak
  • RK Buddington
  • Björn Weström
  • JJ Holst
  • DG Burrin
Visa allt

Summary, in English

Background & Aims: Preterm birth and formula feeding are key risk factors associated with necrotizing enterocolitis (NEC) in infants, but little is known about intestinal conditions that predispose to disease. Thus, structural, functional, and microbiologic indices were used to investigate the etiology of spontaneous NEC development in preterm pigs. Methods : Piglets were delivered by cesarean section at 92% gestation, reared in infant incubators, and fed infant formula or colostrum every 3 hours (n = 120) until tissue collection at 1-2 days of age. Results: Clinical and histopathologic signs of NEC were observed in 57% of pigs fed FORMULA (26/46) and in 5% of pigs fed COLOSTRUM (2/38) (P <.05). Relative to COLOSTRUM, both healthy and sick FORMULA pigs had reduced intestinal villous heights, enzyme activities, nutrient absorption, and antioxidant levels and higher inducible nitric oxide synthetase activity (P <.05). In healthy pigs, mucosal microbial diversity remained low and diet independent. NEC pigs showed bacterial over-growth, and a high mucosal density of Clostridium perfringens was detected in some but not all pigs. Germfree conditions and antiserum against Clostridium perfringens toxin prevented intestinal dysfunction and NEC in formula-fed pigs, whereas the gut trophic factors, epidermal growth factor, and glucagon-like peptide 2 had limited effects. Conclusions: A subclinical, formula-induced mucosal atrophy and dysfunction predispose to NEC and bacterial overgrowth. The adverse feeding effects are colonization dependent and may be reduced by factors in colostrum that include antibodies against aggressive toxins such as those of Clostridium perfringens.

Publiceringsår

2006

Språk

Engelska

Sidor

1776-1792

Publikation/Tidskrift/Serie

Gastroenterology

Volym

130

Issue

6

Dokumenttyp

Artikel i tidskrift

Förlag

Elsevier

Ämne

  • Gastroenterology and Hepatology

Status

Published

ISBN/ISSN/Övrigt

  • ISSN: 1528-0012