Colonic fermentation of carbohydrate in the premature infant: Possible relevance to necrotizing enterocolitis

Occurrence of Necrotizing Enterocolitis May Be Dependent on Patterns of Bacterial Adherence and Intestinal Colonization: Studies in Caco-2 Tissue Culture and Weanling Rabbit Models

“…NEC is undoubtedly the result of a complex interaction of factors, including gut maturity, prior ischemic injury, inflammatory mediators, and other unidentified factors (2,(33)(34)(35)(36)(37). We cannot yet explain the pathophysiologic mechanisms underlying our observations.…”

Short-Chain Fatty Acids Induce Colonic Mucosal Injury in Rats with Various Postnatal Ages

“…In the anaerobic environment of the colon, bacteria rapidly ferment carbohydrates to gases (hydrogen, carbon dioxide, and, in some cases, methane) and SCFAs (11). This process of bacterial fermentation of undigested carbohydrates plays an important role in normal intestinal biology such as water and salt absorption in the colon, energy salvation, and colonic mucosal maturation (4,11). Because of a relative lactase deficiency in the small intestine, a significant amount of lactose ingested by normal premature infants may be fermented into SCFAs and then absorbed (12,13).…”

“…Immaturity of the intestinal mucosa may contribute to the higher incidence of NEC in premature infants. Short-chain fatty acids (SCFAs), products of bacterial fermentation in the intestinal lumen, have been proposed to play a key role in the pathogenesis of NEC (3,4). We showed previously that acetic acid and butyric acid, two of the main SCFAs, can induce concentration-and pH-dependent intestinal mucosal injury in newborn rats (5).…”

Evidence for Clostridial Implication in Necrotizing Enterocolitis through Bacterial Fermentation in a Gnotobiotic Quail Model

“…2-Ethyl butyric acid (Sigma Chemical Co., L'Isle d'Abeau, France) was used as internal standard, and total SCFA concentrations were calculated in mol/L or mol/g of wet cecal content. The relative distribution of acetic (C 2 ), propionic (C 3 ), butyric (C 4 ), valeric (C 5 ), caproic (C 6 ), and iso-acids (iC 4 , iC 5 , and iC 6 ) was calculated as the percentage of the total concentration. pH was measured when the fecal specimen quantity was sufficient (Ͼ300 mg).…”