Tiny Bodies, Big Needs: Prospective Biobanking of Neonatal Clinical Remnant Samples

Schleif, William; Hamblin, Frances; Graham, Ernest M.; Cross, Jennifer; Fernald, Christy; Follett, Robert W; Lopes, Bryan; Martinez, Denise; Monforte, Hector; Ross-Wilkinson, Jennifer; Sellers, Austin; Brooks, Sandra

doi:10.1089/bio.2020.0113

Cited by 3 publications

(3 citation statements)

References 11 publications

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“…Translational research in NEC using infant or maternal data, tissue (including stool, breast milk, and others) will be misleading if infant classification is not entirely robust and may go some way to explain variation in study findings related to antecedent feeding practices (33), microbiome findings before "NEC" (11,12) [although these are also highly individual in well infants (34)], the role of CMV in NEC (35,36) and biomarker studies (37-39)-to quote (in relation to calprotectin as a diagnostic test for NEC), "it's not the assay, it's the definition" (40). This may become increasingly important with the development of neonatal biobanks with researchers accessing tissue, milk, stool or blood from infants labelled as NEC or FIP by remote clinicians, and where researchers themselves have no access to high level clinical data (24,(41)(42)(43).…”

Section: Meaning Of the Study: Implications And Future Researchmentioning

confidence: 99%

Time of Onset of Necrotizing Enterocolitis and Focal Perforation in Preterm Infants: Impact on Clinical, Surgical, and Histological Features

Berrington

Embleton

2021

Front. Pediatr.

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Objective: There is no gold standard test for diagnosis of necrotizing enterocolitis (NEC). Timing of onset is used in some definitions and studies in an attempt to separate NEC from focal intestinal perforation (FIP) with 14 days used as a cutoff. In a large, detailed data set we aimed to compare NEC and FIP in preterm infants born <32 weeks gestation, presenting before 14 days of life in comparison to cases presenting later.Design: Infants with NEC or FIP when parents had consented to enrollment in an observational and sample collection study were included from 2009 to 2019. Clinical, surgical, histological, and outcome data were extracted and reviewed by each author independently.Patients/Episodes: In 785 infants, 174 episodes of NEC or FIP were identified of which 73 (42%) occurred before 14 days, including 54 laparotomies and 19 episodes of medically managed NEC (“early”). There were 56 laparotomies and 45 episodes of medically managed NEC presenting on or after 14 days age (“late”).Results: In early cases, 41% of laparotomies were for NEC (22 cases) and 59% for FIP (32 cases), and in late cases, 91% of laparotomies (51 cases) were for NEC and 9% (five cases) were for FIP. NEC presenting early was more likely to present with an initial septic presentation rather than discrete abdominal pathology and less likely to have clear pneumatosis. Early cases did not otherwise differ clinically, surgically, or histologically or in outcomes compared with later cases. FIP features did not differ by age at presentation.Conclusions: Although most FIP occurred early, 14% occurred later, whereas almost one third (29%) of NEC cases (surgical and medical) presented early. Infant demographics and surgical and histological findings of early- and late-presenting disease did not differ, suggesting that early and late cases are not necessarily different subtypes of the same disease although a common pathway of different pathogenesis cannot be excluded. Timing of onset does not accurately distinguish NEC from FIP, and caution should be exercised in including timing of onset in diagnostic criteria.

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Section: Meaning Of the Study: Implications And Future Researchmentioning

confidence: 99%

Time of Onset of Necrotizing Enterocolitis and Focal Perforation in Preterm Infants: Impact on Clinical, Surgical, and Histological Features

Berrington

Embleton

2021

Front. Pediatr.

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“…Sites that have developed infrastructure for creating a neonatal biobank have described the feasibility of doing so through strengthening relationships between parents and clinical research teams to maintain sample stability between transfer from the clinical laboratory to the biorepository to encourage long-term participation in sample collection. 69 Large scale initiatives, including the integrative human microbiome project, which include prospective sample collection of fetal membranes, amniotic fluid, placenta, and postnatal stool, have the potential to improve our clarity of these dynamic early life events. 70 …”

Section: Discussionmentioning

confidence: 99%

The First 1000 Days: Assembly of the Neonatal Microbiome and Its Impact on Health Outcomes

Romano-Keeler¹,

Sun²

2022

Newborn

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Early life microbial colonization is critical for the development of the immune system, postnatal growth, and long-term health and disease. The dynamic and nascent microbiomes of children are highly individualized and are characterized by low bacterial diversity. Any disruptions in microbial colonization can contribute to shifts in normal microbial colonization that persist past the first 1000 days of life and result in intestinal dysbiosis. Here, we focus on microbiome-host interactions during fetal, newborn, and infant microbiome development. We summarize the roles of bacterial communities in fetal development and adverse health outcomes due to dysbiosis. We also discuss how internal and external factors program the microbiome's metabolic machinery as it evolves into an adult-like microbiome. Finally, we discuss the limits of current studies and future directions. Studies on the early-life microbiome will be critical for a better understanding of childhood health and diseases, as well as restorative methods for the prevention and treatment of diseases in adulthood.

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“…A detailed methodology describing participant engagement, consent, and the biobanking process with vulnerable populations is available. 43 …”

Section: Methodsmentioning

confidence: 99%

Serum brain injury biomarkers are gestationally and post-natally regulated in non-brain injured neonates

et al. 2021

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Objective: To determine the association of gestational age (GA) and day of life (DOL) with the circulating serum concentration of six brain injury-associated biomarkers in non-brain injured neonates born between 23–41 weeks’ GA. Methods: In a multicenter prospective observational cohort study, serum CNS-insult, inflammatory and trophic proteins concentrations were measured daily in the first 7 DOL. Results: 3232 serum samples were analyzed from 745 enrollees, median GA 32.3 weeks. BDNF increased 3.7% and IL-8 increased 8.9% each week of gestation. VEGF, IL-6, and IL-10 showed no relationship with GA. VEGF increased 10.8% and IL-8 18.9%, each DOL. IL-6 decreased by 15.8% each DOL. IL-10 decreased by 81.4% each DOL for DOL 0–3. BDNF did not change with DOL. Only 49.67% of samples had detectable GFAP and 33.15% had detectable NRGN. The odds of having detectable GFAP and NRGN increased by 53% and 11%, respectively, each week after 36 weeks’ GA. The odds of having detectable GFAP and NRGN decreased by 15% and 8%, respectively, each DOL. Conclusion: BDNF and IL-8 serum concentrations vary with GA. VEGF and interleukin concentrations are dynamic in the first week of life, suggesting circulating levels should be adjusted for GA and DOL for clinically relevant assessment of brain injury.

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Tiny Bodies, Big Needs: Prospective Biobanking of Neonatal Clinical Remnant Samples

Cited by 3 publications

References 11 publications

Time of Onset of Necrotizing Enterocolitis and Focal Perforation in Preterm Infants: Impact on Clinical, Surgical, and Histological Features

Time of Onset of Necrotizing Enterocolitis and Focal Perforation in Preterm Infants: Impact on Clinical, Surgical, and Histological Features

The First 1000 Days: Assembly of the Neonatal Microbiome and Its Impact on Health Outcomes

Serum brain injury biomarkers are gestationally and post-natally regulated in non-brain injured neonates

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