A fermented formula in pre-term infants: clinical tolerance, gut microbiota, down-regulation of faecal calprotectin and up-regulation of faecal secretory IgA

Intestinal bacterial colonisation in pre-term infants is delayed compared with full-term infants, leading to an increased risk of gastrointestinal disease. Modulation of colonisation through dietary supplementation with probiotics or prebiotics could decrease such a risk. The present study evaluated clinical tolerance, the effects on gut microbiota, and inflammatory and immunological mucosal responses to an infant formula adapted for pre-term infants that included in its manufacturing process a fermentation step with two probiotic strains, Bifidobacterium breve C50 and Streptococcus thermophilus 065, inactivated by heat at the end of the process. A total of fifty-eight infants (gestational age: 30–35 weeks), fed either the fermented pre-term formula or a standard pre-term formula, were followed up during their hospital stay. Clinical tolerance, faecal microbiota using a culture and a culture-independent method (temporal temperature gel electrophoresis), faecal calprotectin and secretory IgA were analysed weekly. No difference was observed regarding anthropometric data and digestive tolerance, except for abdominal distension, the incidence of which was lower in infants fed the fermented formula for 2 weeks. Bacterial colonisation was not modified by the type of feeding, particularly for bifidobacteria. Faecal calprotectin was significantly lower in infants fed the fermented formula for 2 weeks, and secretory IgA increased with both mother's milk and the fermented formula. The fermented formula was well tolerated and did not significantly modulate the bacterial colonisation but had benefits on inflammatory and immune markers, which might be related to some features of gastrointestinal tolerance.

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Streptococcus thermophilus Attenuates Inflammation in Septic Mice Mediated by Gut Microbiota

SSRN Electronic Journal ◽

10.2139/ssrn.3667642 ◽

2020 ◽

Author(s):

Fu Han ◽

Gaofeng Wu ◽

Yijie Zhang ◽

haotian zheng ◽

Shichao Han ◽

...

Keyword(s):

Gut Microbiota ◽

Streptococcus Thermophilus

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Association of Urinary and Plasma Levels of Trimethylamine N-Oxide (TMAO) with Foods

Nutrients ◽

10.3390/nu13051426 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1426

Author(s):

Mauro Lombardo ◽

Giovanni Aulisa ◽

Daniele Marcon ◽

Gianluca Rizzo ◽

Maria Grazia Tarsisano ◽

...

Keyword(s):

Gut Microbiota ◽

Fish Consumption ◽

Plasma Levels ◽

Cooking Methods ◽

Saltwater Fish ◽

Increased Risk ◽

Mediator Role ◽

Fish And Shellfish ◽

The Relationship

Introduction: Trimethylamine N-oxide (TMAO) may play a key mediator role in the relationship between the diet, gut microbiota and cardiovascular diseases, particularly in people with kidney failure. The aim of this review is to evaluate which foods have a greater influence on blood or urinary trimethylamine N-oxide (TMAO) levels. Methods: 391 language articles were screened, and 27 were analysed and summarized for this review, using the keywords “TMAO” AND “egg” OR “meat” OR “fish” OR “dairy” OR “vegetables” OR “fruit” OR “food” in December 2020. Results: A strong correlation between TMAO and fish consumption, mainly saltwater fish and shellfish, but not freshwater fish, has been demonstrated. Associations of the consumption of eggs, dairy and meat with TMAO are less clear and may depend on other factors such as microbiota or cooking methods. Plant-based foods do not seem to influence TMAO but have been less investigated. Discussion: Consumption of saltwater fish, dark meat fish and shellfish seems to be associated with an increase in urine or plasma TMAO values. Further studies are needed to understand the relationship between increased risk of cardiovascular disease and plasma levels of TMAO due to fish consumption. Interventions coupled with long-term dietary patterns targeting the gut microbiota seem promising.

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Associations between stool micro-transcriptome, gut microbiota, and infant growth

Journal of Developmental Origins of Health and Disease ◽

10.1017/s2040174420001324 ◽

2021 ◽

pp. 1-7

Author(s):

Molly C. Carney ◽

Xiang Zhan ◽

Akanksha Rangnekar ◽

Maria Z. Chroneos ◽

Sarah J.C. Craig ◽

...

Keyword(s):

Gut Microbiota ◽

Microbial Activity ◽

Metabolic Pathways ◽

Weight Status ◽

Transcriptional Activity ◽

High Throughput Sequencing ◽

Infant Growth ◽

Adult Obesity ◽

Term Infants ◽

Ribonucleic Acids

Abstract Rapid infant growth increases the risk for adult obesity. The gut microbiome is associated with early weight status; however, no study has examined how interactions between microbial and host ribonucleic acid (RNA) expression influence infant growth. We hypothesized that dynamics in infant stool micro-ribonucleic acids (miRNAs) would be associated with both microbial activity and infant growth via putative metabolic targets. Stool was collected twice from 30 full-term infants, at 1 month and again between 6 and 12 months. Stool RNA were measured with high-throughput sequencing and aligned to human and microbial databases. Infant growth was measured by weight-for-length z-score at birth and 12 months. Increased RNA transcriptional activity of Clostridia (R = 0.55; Adj p = 3.7E-2) and Burkholderia (R = −0.820, Adj p = 2.62E-3) were associated with infant growth. Of the 25 human RNAs associated with growth, 16 were miRNAs. The miRNAs demonstrated significant target enrichment (Adj p < 0.05) for four metabolic pathways. There were four associations between growth-related miRNAs and growth-related phyla. We have shown that longitudinal trends in gut microbiota activity and human miRNA levels are associated with infant growth and the metabolic targets of miRNAs suggest these molecules may regulate the biosynthetic landscape of the gut and influence microbial activity.

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The use of an in-vitro batch fermentation (human colon) model for investigating mechanisms of TMA production from choline, l-carnitine and related precursors by the human gut microbiota

European Journal of Nutrition ◽

10.1007/s00394-021-02572-6 ◽

2021 ◽

Author(s):

Priscilla Day-Walsh ◽

Emad Shehata ◽

Shikha Saha ◽

George M. Savva ◽

Barbora Nemeckova ◽

...

Keyword(s):

Gut Microbiota ◽

Metabolic Diseases ◽

Human Colon ◽

Human Studies ◽

Bacterial Strains ◽

Increased Risk ◽

Carnitine Metabolism ◽

Registration Number ◽

Vitro Model

Abstract Purpose Plasma trimethylamine-N-oxide (TMAO) levels have been shown to correlate with increased risk of metabolic diseases including cardiovascular diseases. TMAO exposure predominantly occurs as a consequence of gut microbiota-dependent trimethylamine (TMA) production from dietary substrates including choline, carnitine and betaine, which is then converted to TMAO in the liver. Reducing microbial TMA production is likely to be the most effective and sustainable approach to overcoming TMAO burden in humans. Current models for studying microbial TMA production have numerous weaknesses including the cost and length of human studies, differences in TMA(O) metabolism in animal models and the risk of failing to replicate multi-enzyme/multi-strain pathways when using isolated bacterial strains. The purpose of this research was to investigate TMA production from dietary precursors in an in-vitro model of the human colon. Methods TMA production from choline, l-carnitine, betaine and γ-butyrobetaine was studied over 24–48 h using an in-vitro human colon model with metabolite quantification performed using LC–MS. Results Choline was metabolised via the direct choline TMA-lyase route but not the indirect choline–betaine-TMA route, conversion of l-carnitine to TMA was slower than that of choline and involves the formation of the intermediate γ-BB, whereas the Rieske-type monooxygenase/reductase pathway for l-carnitine metabolism to TMA was negligible. The rate of TMA production from precursors was choline > carnitine > betaine > γ-BB. 3,3-Dimethyl-1-butanol (DMB) had no effect on the conversion of choline to TMA. Conclusion The metabolic routes for microbial TMA production in the colon model are consistent with observations from human studies. Thus, this model is suitable for studying gut microbiota metabolism of TMA and for screening potential therapeutic targets that aim to attenuate TMA production by the gut microbiota. Trial registration number NCT02653001 (http://www.clinicaltrials.gov), registered 12 Jan 2016.

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Levels of Predominant Intestinal Microorganisms in 1 Month-Old Full-Term Babies and Weight Gain During the First Year of Life

Nutrients ◽

10.3390/nu13072412 ◽

2021 ◽

Vol 13 (7) ◽

pp. 2412

Author(s):

Sonia González ◽

Marta Selma-Royo ◽

Silvia Arboleya ◽

Cecilia Martínez-Costa ◽

Gonzalo Solís ◽

...

Keyword(s):

Weight Gain ◽

Gut Microbiota ◽

Early Life ◽

Later Life ◽

Full Term ◽

First Year ◽

Term Infants ◽

Term Newborns ◽

Infant Weight Gain ◽

First Year Of Life

The early life gut microbiota has been reported to be involved in neonatal weight gain and later infant growth. Therefore, this early microbiota may constitute a target for the promotion of healthy neonatal growth and development with potential consequences for later life. Unfortunately, we are still far from understanding the association between neonatal microbiota and weight gain and growth. In this context, we evaluated the relationship between early microbiota and weight in a cohort of full-term infants. The absolute levels of specific fecal microorganisms were determined in 88 vaginally delivered and 36 C-section-delivered full-term newborns at 1 month of age and their growth up to 12 months of age. We observed statistically significant associations between the levels of some early life gut microbes and infant weight gain during the first year of life. Classifying the infants into tertiles according to their Staphylococcus levels at 1 month of age allowed us to observe a significantly lower weight at 12 months of life in the C-section-delivered infants from the highest tertile. Univariate and multivariate models pointed out associations between the levels of some fecal microorganisms at 1 month of age and weight gain at 6 and 12 months. Interestingly, these associations were different in vaginally and C-section-delivered babies. A significant direct association between Staphylococcus and weight gain at 1 month of life was observed in vaginally delivered babies, whereas in C-section-delivered infants, lower Bacteroides levels at 1 month were associated with higher later weight gain (at 6 and 12 months). Our results indicate an association between the gut microbiota and weight gain in early life and highlight potential microbial predictors for later weight gain.

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Prevalence of small for gestational age infants in 21 cities in China, 2014–2019

Scientific Reports ◽

10.1038/s41598-021-87127-9 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Hui He ◽

Huazhang Miao ◽

Zhijiang Liang ◽

Ye Zhang ◽

Wei Jiang ◽

...

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Health Information System ◽

Guangdong Province ◽

Significant Negative Correlation ◽

Term Infants ◽

Per Capita Gdp ◽

Increased Risk ◽

Per Capita ◽

Epidemiological Characteristics

AbstractInfants who are small for gestational age (SGA) are at increased risk of neonatal and infant death, non-communicable diseases and growth retardation. However, the epidemiological characteristics of SGA remain unclear. We aim to explore the prevalence of SGA and to examine its socioeconomic associations by using data from 21 cities. 10,515,494 single live birth records between 2014 and 2019 from the Guangdong Women and Children Health Information System were included in the study. Descriptive statistical methods were used to analyze the prevalence trend of SGA and its distribution. We also analyze the associations between the prevalence of SGA and per-capita GDP. The prevalence of SGA in Guangdong Province from the years 2014–2019 was 13.17%, 12.96%, 11.96%, 12.72%, 11.45%, 11.30% respectively, and the overall prevalence was 12.28%. The prevalence of term SGA infants in Guangdong Province was 12.50%, which was much higher than that of preterm SGA (7.71%). There was a significant negative correlation between the SGA prevalence and per-capita GDP in 21 cities of Guangdong Province. The level of economic development may affect the prevalence of SGA. The prevalence of SGA in full term infants is significantly higher than in premature infants, suggesting that most SGA infants may be born at a later gestational age.

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Outcomes of full-term infants with bilious vomiting: observational study of a retrieved cohort

Archives of Disease in Childhood ◽

10.1136/archdischild-2013-305724 ◽

2014 ◽

Vol 100 (1) ◽

pp. 14-17 ◽

Cited By ~ 9

Author(s):

Syed Mohinuddin ◽

Pankaj Sakhuja ◽

Benjie Bermundo ◽

Nandiran Ratnavel ◽

Stephen Kempley ◽

...

Keyword(s):

Posterior Probability ◽

Abdominal Distension ◽

Clinical Findings ◽

Likelihood Ratios ◽

Term Infants ◽

X Ray ◽

Bilious Vomiting ◽

Term Newborns ◽

Time Critical ◽

Surgical Condition

Bilious vomiting in a neonate may be a sign of intestinal obstruction often resulting in transfer requests to surgical centres. The aim of this study was to assess the use of clinical findings at referral in predicting outcomes and to determine how often such patients have a time-critical surgical condition (eg, volvulus, where a delay in treatment is likely to compromise gut viability).Methods4-year data and outcomes of all term newborns aged ≤7 days with bilious vomiting transferred by a regional transfer service were analysed. Specificity, sensitivity, likelihood ratios, correlations, prior and posterior probability of clinical findings in predicting newborns with surgical diagnosis were calculated.ResultsOf 163 neonates with bilious vomiting, 75 (46%) had a surgical diagnosis and 23 (14.1%) had a time-critical surgical condition. The diagnosis of a surgical condition in neonates with bilious vomiting was significantly associated with abdominal distension (χ2=5.17, p=0.023), abdominal tenderness (χ2=5.90, p=0.015) and abnormal abdominal X-ray findings (χ2=5.68, p=0.017) but not with palpation findings of a soft as compared with a tense abdomen (χ2=3.21, p=0.073). Abnormal abdominal X-ray, abdominal distension and tenderness had 97%, 74% and 62% sensitivity, respectively, with regard to association with an underlying surgical diagnosis. Normal abdominal X-ray reduced the posterior probability of surgical diagnosis from 50% to 16%. Overall, clinical findings at referral did not differentiate between infants with or without surgical or time-critical condition.ConclusionsWe recommend that term neonates with bilious vomiting referred for transfer are prioritised as time critical.

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Early‐life cytomegalovirus infection is associated with gut microbiota perturbations and increased risk of atopy

Pediatric Allergy and Immunology ◽

10.1111/pai.13658 ◽

2021 ◽

Author(s):

Hind Sbihi ◽

Karen E. Simmons ◽

Malcolm R. Sears ◽

Theo J. Moraes ◽

Allan B. Becker ◽

...

Keyword(s):

Gut Microbiota ◽

Early Life ◽

Cytomegalovirus Infection ◽

Increased Risk

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Vaccinations in Infants Born Preterm: An Update

Current Pediatric Reviews ◽

10.2174/157339631666620011609445 ◽

2020 ◽

Vol 16 (2) ◽

pp. 148-155

Author(s):

Areti Aphrodite Sioriki ◽

Despoina Gkentzi ◽

Evangelia Papadimitriou ◽

Gabriel Dimitriou ◽

Ageliki Karatza

Keyword(s):

Preterm Infants ◽

Vaccine Safety ◽

Full Term ◽

Morbidity And Mortality ◽

Term Infants ◽

Safety And Efficacy ◽

Vaccine Preventable Diseases ◽

Increased Risk ◽

Protective Antibodies

Infants born prematurely (before completion of 37 weeks of gestation) are at increased risk of morbidity and mortality due to vaccine preventable diseases, mostly because of their immunological immaturity and failure of transfer of maternal protective antibodies. Despite their great need of being vaccinated, concerns on vaccine safety and efficacy, constitute the main reasons for which vaccinations are often delayed in this group. In this review we summarize the latest evidence on vaccine safety, efficacy and immunogenicity in preterm infants which is similar to full-term infants. Therefore there is no reason for delaying vaccination in this population.

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Low incidence of surgical pathology in infants with bilious vomiting

10.21203/rs.3.rs-908820/v1 ◽

2021 ◽

Author(s):

David Andrew Cummins ◽

Carl Kuschel

Keyword(s):

Imaging Study ◽

Hirschsprung Disease ◽

Abdominal Distension ◽

Surgical Pathology ◽

Term Infants ◽

Term Neonates ◽

Bilious Vomiting ◽

Highly Sensitive ◽

Abdominal Radiographs ◽

Low Incidence

Abstract Background: Bilious vomiting in the neonate is an important presenting sign of intestinal obstruction. We conducted a review of the presentation and management of term neonates admitted with bilious vomiting (BV) to determine the incidence of a surgical pathology in our population.  Design: Retrospective cohort study using a prospectively maintained database.  Participants: All term infants admitted to NICU with BV at the Royal Women’s Hospital Melbourne during a 5-calendar year period.  Results: All 153 babies had at least one imaging study. 128 (83.7%) had plain abdominal radiographs. 127 (83%) underwent upper gastrointestinal contrast scan (UGI) and 103 (67.3%) had both. 6 (3.9%) UGI studies were abnormal, with 3 babies (1.9%) subsequently having surgical pathology (2 volvulus, 1 Hirschsprung disease). Only 6 (3.9%) babies in our cohort had a surgical pathology identified (4 Hirschsprung disease, 2 malrotation). Babies with surgical pathology were more likely to present later (median 40 hours versus 23 hours). Abdominal distension was highly sensitive for surgical pathology.  Conclusion: The incidence of surgical pathology in this cohort was low compared to other studies. It is more likely in infants presenting with BV after 24 hours. 

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