Donor Human Milk Protects against Bronchopulmonary Dysplasia: A Systematic Review and Meta-Analysis

Villamor-Martínez, Eduardo; Pierro, Maria; Cavallaro, Giacomo; Mosca, Fabio; Kramer, Boris W.; Villamor, Eduardo

doi:10.3390/nu10020238

Cited by 114 publications

(102 citation statements)

References 62 publications

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“…Human milk feeding decreases the risk of NEC (28). Meta-analyses suggest a benefit in feeding mother's own milk (29) and pasteurized donor human milk (30) in the prevention of BPD. In organoids derived from the terminal ileum of mouse pups, human milk exosomes have been shown to attenuate LPS induced activation of TLR4 (31).…”

Section: Discussionmentioning

confidence: 99%

Intestinal Dysbiosis and the Developing Lung: The Role of Toll-Like Receptor 4 in the Gut-Lung Axis

et al. 2020

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Background: In extremely premature infants, postnatal growth restriction (PNGR) is common and increases the risk of developing bronchopulmonary dysplasia (BPD) and pulmonary hypertension (PH). Mechanisms by which poor nutrition impacts lung development are unknown, but alterations in the gut microbiota appear to play a role. In a rodent model, PNGR plus hyperoxia causes BPD and PH and increases intestinal Enterobacteriaceae, Gram-negative organisms that stimulate Toll-like receptor 4 (TLR4). We hypothesized that intestinal dysbiosis activates intestinal TLR4 triggering systemic inflammation which impacts lung development. Methods: Rat pups were assigned to litters of 17 (PNGR) or 10 (normal growth) at birth and exposed to room air or 75% oxygen for 14 days. Half of the pups were treated with the TLR4 inhibitor TAK-242 from birth or beginning at day 3. After 14 days, pulmonary arterial pressure was evaluated by echocardiography and hearts were examined for right ventricular hypertrophy (RVH). Lungs and serum samples were analyzed by western blotting and immunohistochemistry. Results: Postnatal growth restriction + hyperoxia increased pulmonary arterial pressure and RVH with trends toward increased plasma IL1β and decreased IκBα, the inhibitor of NFκB, in lung tissue. Treatment with the TLR4 inhibitor attenuated PH and inflammation. Conclusion: Postnatal growth restriction induces an increase in intestinal Enterobacteriaceae leading to PH. Activation of the TLR4 pathway is a promising mechanism by which intestinal dysbiosis impacts the developing lung.

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Section: Discussionmentioning

confidence: 99%

Intestinal Dysbiosis and the Developing Lung: The Role of Toll-Like Receptor 4 in the Gut-Lung Axis

et al. 2020

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“…Until recently, data suggesting a bene cial impact of maternal milk feeding on BPD were limited. Some investigators had concluded that maternal milk decreased incidence of BPD [7,[11][12][13][14], but others had not thought it useful [15]. Thus we can make two postulations: either high-volume maternal milk feeding daily directly impacts BPD or BPD has an obvious effect on volume maternal milk feeding .…”

Section: Discussionmentioning

confidence: 99%

The Dose Effect of Maternal Milk on Bronchopulmonary Dysplasia in Very Low Birth Weight Infants

Zhang

et al. 2020

Preprint

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Background Human breast milk has potential protective effects against bronchopulmonary dysplasia (BPD). However, limited multicenter research has been reported on the association between the dose of maternal milk and BPD in China. In this study, we aimed to evaluate the dose effects of maternal milk on BPD and other neonatal morbidities in very low birth weight (VLBW) infants. Methods We conducted a retrospective cohort study of preterm infants of gestational age ≤ 34 weeks and birth weight < 1500 g admitted to the multicenter clinical research database for breastfeeding quality improvement in Jiangsu province. Multivariate analysis was performed to compare the effect on neonatal outcomes of daily graded doses of maternal milk throughout the first 4 weeks of life versus a reference group receiving no maternal milk. Models were adjusted for potential confounding variables. Results Of 964 included infants, 279 (28.9%) received exclusive preterm formula, another 128 (13.3%) received 1–24 ml/kg, 139 (14.4%) received 25–49 ml/kg, and 418 (43.4%) received ≥ 50 ml/kg maternal milk for the first 4 weeks of life. Compared with infants receiving exclusive formula, those receiving the highest volume of maternal milk daily (≥ 50 ml/kg) had lower incidences of BPD (27.5% in ≥ 50 ml/kg maternal milk vs. 40.1% in formula), moderate and severe BPD (8.9% in ≥ 50 ml/kg maternal milk vs. 16.1% in formula), necrotizing enterocolitis (NEC; 3.8% in ≥ 50 ml/kg maternal milk vs. 10.8% in formula), late-onset sepsis (LOS; 9.3% in ≥ 50 ml/kg maternal milk vs. 19.7% in formula), and extrauterine growth retardation (EUGR; 38.5% in ≥ 50 ml/kg maternal milk vs. 57.6% in formula). Logistic regression indicated that those receiving ≥ 50 ml/kg/day maternal milk had lower odds of BPD (adjusted odds ratio [AOR] 0.453; 95% confidence interval [CI]: 0.309, 0.666), moderate and severe BPD (AOR 0.430; 95% CI: 0.249, 0.742), NEC (AOR 0.314; 95% CI: 0.162, 0. 607), LOS (AOR 0.420; 95% CI: 0.263, 0.673), and EUGR (AOR 0.685; 95% CI: 0.479, 0.979). Conclusions A daily threshold amount of ≥ 50 ml/kg maternal milk in the first 4 weeks of life was associated with lower incidence of BPD as well as NEC, LOS, and EUGR in VLBW infants. Trial registration: ClinicalTrials.gov Identifier: NCT03453502

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“…(51) El inicio precoz de nutrición parenteral con aporte proteico de 3-4 g/kg/día, la estimulación trófica gastrointestinal y la alimentación exclusiva con leche de la propia madre o de donante también son factores preventivos. (68) La investigación de nutrientes que puedan ser de utilidad en la prevención o tratamiento de DBP, incluyen glutamina, cisteína y N-acetil cisteína, L-arginina y L-citrulina, ácidos grasos poli-insaturados de cadena larga ("PUFA"), inositol, selenio, y algunas vitaminas antioxidantes como la vitamina A. La evidencia muestra, que la vitamina A y los "PUFA" pueden prevenir DBP, y que la L-citrulina, puede convertirse en un nuevo método para tratar la hipertensión pulmonar (HP) crónica asociada con DBP.…”

Section: Hidratación Parenteral Y Nutriciónunclassified

Recomendaciones del VIII Consenso Clínico de SIBEN para la Displasia Broncopulmonar

Sola¹,

Fariña²,

Mir³

et al. 2018

NeoReviews

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Dr Sola has disclosed that he is the Vice President of Medical Affairs with Masimo Corporation. Drs Fariña and Mir have disclosed no financial relationships relevant to the article. Dr Golombek has disclosed that he is on the speakers' bureau with Mallinckrodt and a consultant with Prolacta. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. El Dr Sola es VP de Medical Affairs de Masimo Corporation. Los Dres. Fariña y Mir declaran ausencia de conflicto de interés. El Dr Golombek pertenece al Speakers' Bureau de Mallinckrodt, y es Consultor de Prolacta. Este artículo no contiene una discusión sobre el uso no aprobado / investigativo de un producto / dispositivo comercial. En este Consenso participaron 48 profesionales de 12 países de Latinoamérica y España. La coordinación y revisión estuvo a cargo de los investigadores principales Dres. Fariña, Mir y Sola quienes han condensado todo el material trabajado. Los participantes del Consenso por orden alfabético fueron:

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Donor Human Milk Protects against Bronchopulmonary Dysplasia: A Systematic Review and Meta-Analysis

Cited by 114 publications

References 62 publications

Intestinal Dysbiosis and the Developing Lung: The Role of Toll-Like Receptor 4 in the Gut-Lung Axis

Intestinal Dysbiosis and the Developing Lung: The Role of Toll-Like Receptor 4 in the Gut-Lung Axis

The Dose Effect of Maternal Milk on Bronchopulmonary Dysplasia in Very Low Birth Weight Infants

Recomendaciones del VIII Consenso Clínico de SIBEN para la Displasia Broncopulmonar

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