Neonatal intestinal dysbiosis

Underwood, Mark A.; Mukhopadhyay, Sagori; Lakshminrusimha, Satyanarayana; Bevins, Charles L.

doi:10.1038/s41372-020-00829-2

Cited by 51 publications

(48 citation statements)

References 150 publications

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“…In addition, in preterm infants it stimulates peristalsis and gut motility, together with the immune system through secretary IgA, lactoferrin, growth hormones and oligosaccharides, thereby lowering the extent of microbial dysbiosis [ 33 ]. By contrast, preterm infant formula appears to alter the intestinal flora selecting potential pathogenic bacteria such as Clostridia and Proteobacteria [ 46 ], despite the relatively safe osmolarity of most products (from 210 up to 270 mOsm/L) [ 47 ]. Interestingly, the positive effects of maternal milk appear to be dose-dependent, with higher intake of human milk leading to higher protection from NEC [ 45 , 48 ].…”

Section: Factors To Prevent Nec Developmentmentioning

confidence: 99%

Optimizing Nutritional Strategies to Prevent Necrotizing Enterocolitis and Growth Failure after Bowel Resection

et al. 2021

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Necrotizing enterocolitis (NEC), the first cause of short bowel syndrome (SBS) in the neonate, is a serious neonatal gastrointestinal disease with an incidence of up to 11% in preterm newborns less than 1500 g of birth weight. The rate of severe NEC requiring surgery remains high, and it is estimated between 20–50%. Newborns who develop SBS need prolonged parenteral nutrition (PN), experience nutrient deficiency, failure to thrive and are at risk of neurodevelopmental impairment. Prevention of NEC is therefore mandatory to avoid SBS and its associated morbidities. In this regard, nutritional practices seem to play a key role in early life. Individualized medical and surgical therapies, as well as intestinal rehabilitation programs, are fundamental in the achievement of enteral autonomy in infants with acquired SBS. In this descriptive review, we describe the most recent evidence on nutritional practices to prevent NEC, the available tools to early detect it, the surgical management to limit bowel resection and the best nutrition to sustain growth and intestinal function.

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Section: Factors To Prevent Nec Developmentmentioning

confidence: 99%

Optimizing Nutritional Strategies to Prevent Necrotizing Enterocolitis and Growth Failure after Bowel Resection

et al. 2021

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“…In preterm infants, the secretory IgA (sIgA) levels are lower compared to term infants 4,17 . Underdeveloped intestinal mucosa barrier and gut dysbiosis further predispose preterm infants to severe infections, such as NEC, sepsis, and diarrhea 8,20 .…”

Section: Discussion Impaired Immune System Development In Preterm Infantsmentioning

confidence: 99%

“…Prenatal exposure to inflammation may also increase the risk of bronchopulmonary dysplasia (BPD) in infants 2 . Maternal dysbiosis, either in vaginal, fecal, or oral microbiota, may cause inflammation and increase preterm birth risk 8 . Intrauterine inflammation exposure increases the Th1 responses in fetuses, resulting in membrane rupture.…”

Section: Factors Associated With Altered Immune Responsesmentioning

confidence: 99%

“…Evidence showed that infants' immune system maturation is influenced by their gut microbiota. Early balanced gut microbiota may provide adequate nutrients for their body, positively influence their immune system, and protect them against acute and chronic diseases 8 . There are four main bacterial phyla in healthy infant gut: Firmicutes, Proteobacteria, Actinobacteria, and Bacteroidetes.…”

Section: Introductionmentioning

confidence: 99%

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The Roles of Prebiotics on Impaired Immune System in Preterm Infants: A Narrative Literature Review

Munasir

2021

AMNT

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Background: After birth, preterm infants face numerous challenges, including short and long-term morbidities, to survive and grow well with impaired immune and gastrointestinal systems. According to data from 184 countries, preterm birth rate ranges from 5-18%, accounting for 35% of all new born deaths. Purpose: This literature review aimed to summarize the evidence for the impact of prematurity on immune system development and the benefit of prebiotics on gut microbiota and immune responses. Discussion: Various studies in this narrative literature review showed that preterm infants have both qualitative and quantitative immune response deficits compared to term infants. Preterm newborns also have impaired intestinal immunity, underdeveloped intestinal mucosa barrier, and gut dysbiosis, which predisposes them to life-threatening infections. Early balanced gut microbiota in infants believed to be essential for adequate intestinal physiological functions and immune system maturation. The use of prebiotics, including human milk oligosaccharides (HMOs) in human breast milk, has been found to decrease the risk of various infections and cognitive impairment. A previous study found that prebiotic oligosaccharides supplementation was well-tolerated, significantly increased Bifidobacteria growth, and reduced the presence of gut pathogens. Conclusions: There was robust evidence that breast milk and prebiotics supplementation may support the gut microbiome and immune system in preterm infants. However, different types of synthetic prebiotics offer different benefits, and the protective effect seems to depend on the supplementation duration and dosage.

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“…Perturbations in the infant gut microbiota have been proposed as a source of altered immunity and thus increased susceptibility to disease (8)(9)(10)(11)(12). Exposure to HIV in utero has been shown to impact the gut microbiota of HEU infants (13)(14)(15)(16), pointing to a potential link between maternal HIV status, the infant gut microbiota, and infant health.…”

Section: Introductionmentioning

confidence: 99%

Impact of maternal HIV infection on the dynamics of the infant microbiota in the first eighteen months of life

Grant-Beurmann

Jumare

Ndembi

et al. 2021

Preprint

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Background: Improved access to anti-retroviral therapy (ART) for HIV-infected mothers during pregnancy has resulted in fewer children acquiring HIV peri- and postnatally, which has in turn led to an increase in the number of children who are exposed to the virus but are not infected (HEU). HEU infants have an increased likelihood of childhood infections and adverse growth outcomes, as well as increased mortality compared to their HIV-unexposed (HUU) peers. Methods: Three hundred mother-infant-pairs were followed prenatally to 18 months postpartum (seven time points). Demographic, clinical, feeding, anthropometric and microbiome data were collected at each visit. Demographic and clinical characteristics were compared between HEU and HUU children and their mothers using Wilcoxon, Fisher’s exact and t tests. Longitudinal comparisons of alpha diversity were performed using univariable and multivariable linear regression. Multivariate association with linear models (MaAsLin2) was used to efficiently determine multivariable association between clinical metadata and microbial meta'omic features. The metabolite levels were compared using two-way repeated measures ANOVA.Results: We observed differences in the composition of maternal stool, vaginal and breast milk microbiota based on HIV status that were associated with differences in the oral and gut microbiota of HEU vs. HUU infants. Our data also demonstrated that the taxonomic composition of the infant gut microbiota differs between HEU and HUU infants for at least 15 months. Several significant correlations were found between breast milk metabolites from HIV-infected and uninfected mothers and bacterial taxa in the infant gut microbiota. Lamivudine, an ART drug, was present at high concentrations in the breast milk of our HIV-infected mothers, and we observed a significant negative correlation between lamivudine levels and the relative abundance of Bifidobacterium breve in HEU infants' gut. The presence of ART drugs in the breast milk of our HIV-infected mothers also correlated with an underweight growth outcome in their infants. Conclusions: Our data suggest that acquisition of an altered gut microbiota from an HIV-infected mother, further exacerbated by differences in breast milk composition between HIV- infected and uninfected mothers, negatively impacts growth and increases the risk of adverse clinical outcomes among HEU.

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Neonatal intestinal dysbiosis

Cited by 51 publications

References 150 publications

Optimizing Nutritional Strategies to Prevent Necrotizing Enterocolitis and Growth Failure after Bowel Resection

Optimizing Nutritional Strategies to Prevent Necrotizing Enterocolitis and Growth Failure after Bowel Resection

The Roles of Prebiotics on Impaired Immune System in Preterm Infants: A Narrative Literature Review

Impact of maternal HIV infection on the dynamics of the infant microbiota in the first eighteen months of life

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