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Diet- and colonization-dependent intestinal dysfunction predisposes to necrotizing enterocolitis in preterm pigs

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Author

  • PT Sangild
  • RH Siggers
  • M Schmidt
  • J Elnif
  • CR Bjornvad
  • T Thymann
  • ML Grondahl
  • AK Hansen
  • SK Jensen
  • M Boye
  • L Moelbak
  • RK Buddington
  • Björn Weström
  • JJ Holst
  • DG Burrin
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Summary, in English

Background & Aims: Preterm birth and formula feeding are key risk factors associated with necrotizing enterocolitis (NEC) in infants, but little is known about intestinal conditions that predispose to disease. Thus, structural, functional, and microbiologic indices were used to investigate the etiology of spontaneous NEC development in preterm pigs. Methods : Piglets were delivered by cesarean section at 92% gestation, reared in infant incubators, and fed infant formula or colostrum every 3 hours (n = 120) until tissue collection at 1-2 days of age. Results: Clinical and histopathologic signs of NEC were observed in 57% of pigs fed FORMULA (26/46) and in 5% of pigs fed COLOSTRUM (2/38) (P <.05). Relative to COLOSTRUM, both healthy and sick FORMULA pigs had reduced intestinal villous heights, enzyme activities, nutrient absorption, and antioxidant levels and higher inducible nitric oxide synthetase activity (P <.05). In healthy pigs, mucosal microbial diversity remained low and diet independent. NEC pigs showed bacterial over-growth, and a high mucosal density of Clostridium perfringens was detected in some but not all pigs. Germfree conditions and antiserum against Clostridium perfringens toxin prevented intestinal dysfunction and NEC in formula-fed pigs, whereas the gut trophic factors, epidermal growth factor, and glucagon-like peptide 2 had limited effects. Conclusions: A subclinical, formula-induced mucosal atrophy and dysfunction predispose to NEC and bacterial overgrowth. The adverse feeding effects are colonization dependent and may be reduced by factors in colostrum that include antibodies against aggressive toxins such as those of Clostridium perfringens.

Department/s

Publishing year

2006

Language

English

Pages

1776-1792

Publication/Series

Gastroenterology

Volume

130

Issue

6

Document type

Journal article

Publisher

Elsevier

Topic

  • Gastroenterology and Hepatology

Status

Published

ISBN/ISSN/Other

  • ISSN: 1528-0012