Abstract
Preterm birth, bacterial colonization, and formula feeding predispose to necrotizing enterocolitis (NEC). Antibiotics are commonly administered to prevent sepsis in preterm infants, but it is not known whether this affects intestinal immunity and NEC resistance. We hypothesized that broad-spectrum antibiotic treatment improves NEC resistance and intestinal structure, function, and immunity in neonates. Caesarean-delivered preterm pigs were fed 3 days of parenteral nutrition followed by 2 days of enteral formula. Immediately after birth, they were assigned to receive either antibiotics (oral and parenteral doses of gentamycin, ampicillin, and metronidazole, ANTI, n = 11) or saline in the control group (CON, n = 13), given twice daily. NEC lesions and intestinal structure, function, microbiology, and immunity markers were recorded. None of the ANTI but 85% of the CON pigs developed NEC lesions by day 5 (0/11 vs. 11/13, P < 0.05). ANTI pigs had higher intestinal villi (+60%), digestive enzyme activities (+53-73%), and goblet cell densities (+110%) and lower myeloperoxidase (-51%) and colonic microbial density (10(5) vs. 10(10) colony-forming units, all P < 0.05). Microarray transcriptomics showed strong downregulation of genes related to inflammation and innate immune response to microbiota and marked upregulation of genes related to amino acid metabolism, in particular threonine, glucose transport systems, and cell cycle in 5-day-old ANTI pigs. In a follow-up experiment, 5 days of antibiotics prevented NEC at least until day 10. Neonatal prophylactic antibiotics effectively reduced gut bacterial load, prevented NEC, intestinal atrophy, dysfunction, and inflammation and enhanced expression of genes related to gut metabolism and immunity in preterm pigs.
Original language | English |
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Pages (from-to) | G59-G71 |
Number of pages | 13 |
Journal | American journal of physiology. Gastrointestinal and liver physiology |
Volume | 306 |
Issue number | 1 |
Early online date | 24 Oct 2013 |
DOIs | |
Publication status | Published - Jan 2014 |
Bibliographical note
We thank Andreas Vegge, Elin Skytte, and Kristina Møller from Department of Nutrition, Exercise and Sports, Faculty of Science and Mandy Grieg from Department of Large Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark for technical support with animal procedures and subsequent laboratory analyses. We also thank Annie Ravn Pedersen at the National Veterinary Institute, Copenhagen and Thomas Rebsdorf at Faculty of Agricultural Sciences, Aarhus University, Aarhus, Denmark for assistance with laboratory, microbiological, and short-chain fatty acid analyses, respectively. Finally, we thank Christian Ritz from Department of Nutrition, Exercise and Sports, University of Copenhagen, for statistical advice.GRANTS
This work was supported financially by the Danish Strategic Research Councils.
Keywords
- immature
- microbiota
- necrotizing enterocolitis
- neonates
- premature
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GSE48125: Neonatal antibotic prophylaxis modulates intestinal immunity and prevents necrotizing enterocolitis in preterm neonates
Kelly, D. (Creator), Mulder, I. E. (Creator) & Morgan, P. J. (Data Manager), GEO, 21 Aug 2013
https://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSE48125 and 16 more links, https://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSM1169059, https://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSM1169053, https://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSM1169050, https://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSM1169051, https://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSM1169049, https://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSM1169048, https://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSM1169044, https://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSM1169058, https://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSM1169057, https://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSM1169056, https://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSM1169054, https://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSM1169052, https://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSM1169055, https://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSM1169047, https://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSM1169046, https://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSM1169045 (show fewer)
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