Your browser doesn't support javascript.
loading
Intestinal Barrier Maturation in Very Low Birthweight Infants: Relationship to Feeding and Antibiotic Exposure.
Saleem, Bushra; Okogbule-Wonodi, Adora C; Fasano, Alessio; Magder, Laurence S; Ravel, Jacques; Kapoor, Shiv; Viscardi, Rose M.
Afiliação
  • Saleem B; Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD.
  • Okogbule-Wonodi AC; Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD.
  • Fasano A; MassGeneral Hospital for Children, Center for Celiac Research and Treatment, Mucosal Immunology and Biology Research Center, Massachusetts General Hospital, Boston, MA.
  • Magder LS; Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD.
  • Ravel J; Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD; Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD.
  • Kapoor S; Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD.
  • Viscardi RM; Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD.
J Pediatr ; 183: 31-36.e1, 2017 04.
Article em En | MEDLINE | ID: mdl-28159311
OBJECTIVE: To test the hypothesis that feeding and antibiotic exposures affect intestinal barrier maturation in preterm infants, we serially measured intestinal permeability (IP) biomarkers in infants <33 weeks gestation (gestational age [GA]) during the first 2 weeks of life. STUDY DESIGN: Eligible infants <33 weeks GA were enrolled within 4 days of birth in a prospective study of IP biomarkers (NCT01756040). Study participants received the nonmetabolized sugars lactulose/rhamnose enterally on study days 1, 8, and 15 and lactulose/rhamnose were measured in urine by high-performance liquid chromatography. Serum zonulin and fecal alpha-1-anti-trypsin, 2 other IP markers, were measured by semiquantitative Western blot and ELISA, respectively. RESULTS: In a cohort of 43 subjects, the lactulose/rhamnose ratio was increased on day 1 and decreased over 2 weeks, but remained higher in infants born at ≤28 weeks of gestation compared with IP in infants born at >28 weeks of gestation. Exclusive breastmilk feeding was associated with more rapid maturation in intestinal barrier function. A cluster analysis of 35 subjects who had urine samples from all time points revealed 3 IP patterns (cluster 1, normal maturation: n = 20 [57%]); cluster 2, decreased IP during the first week and subsequent substantial increase: n = 5 [14%]); and cluster 3, delayed maturation: n = 10 [29%]). There were trends toward more prolonged antibiotic exposure (P = .092) and delayed initiation of feeding ≥4 days (P = .064) in infants with abnormal IP patterns. CONCLUSIONS: Intestinal barrier maturation in preterm infants is GA and postnatal age dependent, and is influenced by feeding with a maturational effect of breastmilk feeding and possibly by antibiotic exposures. TRIAL REGISTRATION: ClinicalTrials.gov: NCT01756040.
Assuntos
Palavras-chave
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Recém-Nascido de muito Baixo Peso / Absorção Intestinal / Leite Humano / Antibacterianos Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Infant / Male / Newborn Idioma: En Revista: J Pediatr Ano de publicação: 2017 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Recém-Nascido de muito Baixo Peso / Absorção Intestinal / Leite Humano / Antibacterianos Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Infant / Male / Newborn Idioma: En Revista: J Pediatr Ano de publicação: 2017 Tipo de documento: Article País de publicação: Estados Unidos