Early gradual feeding with bovine colostrum improves gut function and NEC resistance relative to infant formula in preterm pigs

René L. Shen, Thomas Thymann, Mette V. Østergaard, Ann Cathrine Findal Støy, Łukasz Krych, Dennis S. Nielsen, Charlotte Lauridsen, Bolette Hartmann, Jens J. Holst, Douglas G. Burrin, Per T. Sangild

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

It is unclear when and how to start enteral feeding for preterm infants when mother’s milk is not available. We hypothesized that early and slow advancement with either formula or bovine colostrum stimulates gut maturation and prevents necrotizing enterocolitis (NEC) in preterm pigs, used as models for preterm infants. Pigs were given either total parenteral nutrition (TPN, n = 14) or slowly advancing volumes (16–64 ml·kg-1·day-1) of preterm infant formula (IF, n = 15) or bovine colostrum (BC, n = 13), both given as adjunct to parenteral nutrition. On day 5, both enteral diets increased intestinal mass (27 ± 1 vs. 22 ± 1 g/kg) and glucagon-like peptide 2 release, relative to TPN (P <0.05). The incidence of mild NEC lesions was higher in IF than BC and TPN pigs (60 vs. 0 and 15%, respectively, P <0.05). Only the IF pigs showed reduced gastric emptying and gastric inhibitory polypeptide release, and increased tissue proinflammatory cytokine levels (IL-1_ and IL-8, P <0.05) and expression of immunerelated genes (AOAH, LBP, CXCL10, TLR2), relative to TPN. The IF pigs also showed reduced intestinal villus-to-crypt ratio, lactose digestion, and some plasma amino acids (Arg, Cit, Gln, Tyr, Val), and higher intestinal permeability, compared with BC pigs (all P <0.05). Colonic microbiota analyses showed limited differences among groups. Early feeding with formula induces intestinal dysfunction whereas bovine colostrum supports gut maturation when mother’s milk is absent during the first week after preterm birth. A dietdependent feeding guideline may be required for newborn preterm infants.
OriginalsprogEngelsk
TidsskriftAmerican Journal of Physiology: Gastrointestinal and Liver Physiology
Vol/bind309
Udgave nummer5
Sider (fra-til)G310-G323
ISSN0193-1857
DOI
StatusUdgivet - 2015

Fingeraftryk

Necrotizing Enterocolitis
Infant Formula
Colostrum
Premature Infants
Glucagon-Like Peptide 2
Mothers
Gastric Inhibitory Polypeptide
Gastric Emptying
Microbiota
Premature Birth
Enteral Nutrition
Lactose
Interleukin-8
Small Intestine
Newborn Infant
Guidelines
Diet
Amino Acids
Incidence

Citer dette

Shen, René L. ; Thymann, Thomas ; Østergaard, Mette V. ; Støy, Ann Cathrine Findal ; Krych, Łukasz ; Nielsen, Dennis S. ; Lauridsen, Charlotte ; Hartmann, Bolette ; Holst, Jens J. ; Burrin, Douglas G. ; Sangild, Per T. / Early gradual feeding with bovine colostrum improves gut function and NEC resistance relative to infant formula in preterm pigs. I: American Journal of Physiology: Gastrointestinal and Liver Physiology. 2015 ; Bind 309, Nr. 5. s. G310-G323.
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abstract = "It is unclear when and how to start enteral feeding for preterm infants when mother’s milk is not available. We hypothesized that early and slow advancement with either formula or bovine colostrum stimulates gut maturation and prevents necrotizing enterocolitis (NEC) in preterm pigs, used as models for preterm infants. Pigs were given either total parenteral nutrition (TPN, n = 14) or slowly advancing volumes (16–64 ml·kg-1·day-1) of preterm infant formula (IF, n = 15) or bovine colostrum (BC, n = 13), both given as adjunct to parenteral nutrition. On day 5, both enteral diets increased intestinal mass (27 ± 1 vs. 22 ± 1 g/kg) and glucagon-like peptide 2 release, relative to TPN (P <0.05). The incidence of mild NEC lesions was higher in IF than BC and TPN pigs (60 vs. 0 and 15{\%}, respectively, P <0.05). Only the IF pigs showed reduced gastric emptying and gastric inhibitory polypeptide release, and increased tissue proinflammatory cytokine levels (IL-1_ and IL-8, P <0.05) and expression of immunerelated genes (AOAH, LBP, CXCL10, TLR2), relative to TPN. The IF pigs also showed reduced intestinal villus-to-crypt ratio, lactose digestion, and some plasma amino acids (Arg, Cit, Gln, Tyr, Val), and higher intestinal permeability, compared with BC pigs (all P <0.05). Colonic microbiota analyses showed limited differences among groups. Early feeding with formula induces intestinal dysfunction whereas bovine colostrum supports gut maturation when mother’s milk is absent during the first week after preterm birth. A dietdependent feeding guideline may be required for newborn preterm infants.",
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Early gradual feeding with bovine colostrum improves gut function and NEC resistance relative to infant formula in preterm pigs. / Shen, René L.; Thymann, Thomas; Østergaard, Mette V.; Støy, Ann Cathrine Findal; Krych, Łukasz; Nielsen, Dennis S.; Lauridsen, Charlotte; Hartmann, Bolette; Holst, Jens J.; Burrin, Douglas G.; Sangild, Per T.

I: American Journal of Physiology: Gastrointestinal and Liver Physiology, Bind 309, Nr. 5, 2015, s. G310-G323.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Early gradual feeding with bovine colostrum improves gut function and NEC resistance relative to infant formula in preterm pigs

AU - Shen, René L.

AU - Thymann, Thomas

AU - Østergaard, Mette V.

AU - Støy, Ann Cathrine Findal

AU - Krych, Łukasz

AU - Nielsen, Dennis S.

AU - Lauridsen, Charlotte

AU - Hartmann, Bolette

AU - Holst, Jens J.

AU - Burrin, Douglas G.

AU - Sangild, Per T.

PY - 2015

Y1 - 2015

N2 - It is unclear when and how to start enteral feeding for preterm infants when mother’s milk is not available. We hypothesized that early and slow advancement with either formula or bovine colostrum stimulates gut maturation and prevents necrotizing enterocolitis (NEC) in preterm pigs, used as models for preterm infants. Pigs were given either total parenteral nutrition (TPN, n = 14) or slowly advancing volumes (16–64 ml·kg-1·day-1) of preterm infant formula (IF, n = 15) or bovine colostrum (BC, n = 13), both given as adjunct to parenteral nutrition. On day 5, both enteral diets increased intestinal mass (27 ± 1 vs. 22 ± 1 g/kg) and glucagon-like peptide 2 release, relative to TPN (P <0.05). The incidence of mild NEC lesions was higher in IF than BC and TPN pigs (60 vs. 0 and 15%, respectively, P <0.05). Only the IF pigs showed reduced gastric emptying and gastric inhibitory polypeptide release, and increased tissue proinflammatory cytokine levels (IL-1_ and IL-8, P <0.05) and expression of immunerelated genes (AOAH, LBP, CXCL10, TLR2), relative to TPN. The IF pigs also showed reduced intestinal villus-to-crypt ratio, lactose digestion, and some plasma amino acids (Arg, Cit, Gln, Tyr, Val), and higher intestinal permeability, compared with BC pigs (all P <0.05). Colonic microbiota analyses showed limited differences among groups. Early feeding with formula induces intestinal dysfunction whereas bovine colostrum supports gut maturation when mother’s milk is absent during the first week after preterm birth. A dietdependent feeding guideline may be required for newborn preterm infants.

AB - It is unclear when and how to start enteral feeding for preterm infants when mother’s milk is not available. We hypothesized that early and slow advancement with either formula or bovine colostrum stimulates gut maturation and prevents necrotizing enterocolitis (NEC) in preterm pigs, used as models for preterm infants. Pigs were given either total parenteral nutrition (TPN, n = 14) or slowly advancing volumes (16–64 ml·kg-1·day-1) of preterm infant formula (IF, n = 15) or bovine colostrum (BC, n = 13), both given as adjunct to parenteral nutrition. On day 5, both enteral diets increased intestinal mass (27 ± 1 vs. 22 ± 1 g/kg) and glucagon-like peptide 2 release, relative to TPN (P <0.05). The incidence of mild NEC lesions was higher in IF than BC and TPN pigs (60 vs. 0 and 15%, respectively, P <0.05). Only the IF pigs showed reduced gastric emptying and gastric inhibitory polypeptide release, and increased tissue proinflammatory cytokine levels (IL-1_ and IL-8, P <0.05) and expression of immunerelated genes (AOAH, LBP, CXCL10, TLR2), relative to TPN. The IF pigs also showed reduced intestinal villus-to-crypt ratio, lactose digestion, and some plasma amino acids (Arg, Cit, Gln, Tyr, Val), and higher intestinal permeability, compared with BC pigs (all P <0.05). Colonic microbiota analyses showed limited differences among groups. Early feeding with formula induces intestinal dysfunction whereas bovine colostrum supports gut maturation when mother’s milk is absent during the first week after preterm birth. A dietdependent feeding guideline may be required for newborn preterm infants.

U2 - 10.1152/ajpgi.00163.2015.

DO - 10.1152/ajpgi.00163.2015.

M3 - Journal article

VL - 309

SP - G310-G323

JO - American Journal of Physiology: Gastrointestinal and Liver Physiology

JF - American Journal of Physiology: Gastrointestinal and Liver Physiology

SN - 0193-1857

IS - 5

ER -