Effect of Enteral IGF‐1 Supplementation on Feeding Tolerance, Growth, and Gut Permeability in Enterally Fed Premature Neonates

Corpeleijn, Willemijn E.; Vliet, Ineke van; Gast-Bakker, Dana-Anne H de; Schoor, Sophie R D van der; Alles, M.S.; Hoijer, Maarten; Tibboel, Dick; Goudoever, Johannes B. van

doi:10.1097/mpg.0b013e31815affec

Cited by 53 publications

(54 citation statements)

References 37 publications

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“…The BC, GF, and MF diets all decreased the intestinal permeability relative to CF feeding. This may relate to a high amount of bioactive proteins, controlling the mucosal inflammation and regulating the expression and the function of tight junction proteins (13,48,49). Surprisingly, the amount of claudin-4 was higher in CF pigs and positively correlated with intestinal permeability, suggesting that the synthesis of claudin-4 increases in response to epithelial damage.…”

Section: Discussionmentioning

confidence: 49%

“…Much effort has been made to improve the bioactivity of IF for preterm infants. Igs (7), lactoferrin (LF) (8), lysozyme (9), lactoperoxidase (10), transforming growth factor (TGFb) (11), epidermal growth factors (12), insulin-like growth factors (IGFs) (13), and osteopontin (14) -supplemented formulas have been tested and shown to have beneficial effects on intestinal health in animal models or infants (15). These bioactive proteins are all present in the whey protein fraction of milk, which is used as an ingredient in IF as whey protein concentrate (WPC) (16,17).…”

Section: Introductionmentioning

confidence: 99%

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Whey Protein Processing Influences Formula-Induced Gut Maturation in Preterm Pigs

Østergaard

Jiang

et al. 2013

The Journal of Nutrition

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Immaturity of the gut predisposes preterm infants to nutritional challenges potentially leading to clinical complications such as necrotizing enterocolitis. Feeding milk formulas is associated with greater risk than fresh colostrum or milk, probably due to loss of bioactive proteins (e.g., immunoglobulins, lactoferrin, insulin-like growth factor, transforming growth factor-β) during industrial processing (e.g., pasteurization, filtration, spray-drying). We hypothesized that the processing method for whey protein concentrate (WPC) would affect gut maturation in formula-fed preterm pigs used as a model for preterm infants. Fifty-five caesarean-delivered preterm pigs were distributed into 4 groups given 1 of 4 isoenergetic diets: formula containing conventional WPC (filtration, multi-pasteurization, standard spray-drying) (CF); formula containing gently treated WPC (reduced filtration and pasteurization, gentle spray-drying) (GF); formula containing minimally treated WPC (rennet precipitation, reduced filtration, heat treatment <40°C, freeze-drying) (MF); and bovine colostrum (used as a positive reference group) (BC). Relative to CF, GF, and MF pigs, BC pigs had greater villus heights, lactose digestion, and absorption and lower gut permeability (P < 0.05). MF and BC pigs had greater plasma citrulline concentrations than CF and GF pigs and intestinal interleukin-8 was lower in BC pigs than in the other groups (P < 0.05). MF pigs had lower concentrations of intestinal claudin-4, cleaved caspase-3, and phosphorylated c-Jun than CF pigs (P < 0.05). The conventional and gently treated WPCs had similar efficacy in stimulating proliferation of porcine intestinal epithelial cells. We conclude that processing of WPC affects intestinal structure, function, and integrity when included in formulas for preterm pigs. Optimization of WPC processing technology may be important to preserve the bioactivity and nutritional value of formulas for sensitive newborns.

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Section: Discussionmentioning

confidence: 49%

Section: Introductionmentioning

confidence: 99%

Whey Protein Processing Influences Formula-Induced Gut Maturation in Preterm Pigs

Østergaard

Jiang

et al. 2013

The Journal of Nutrition

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“…As a result, potentially pathogenic bacteria translocate from the intestinal lumen and cause systemic infections [7]. Reducing intestinal permeability is associated with gut maturation which promotes growth and avoids severe infections [4].…”

Section: Introductionmentioning

confidence: 99%

Probiotics, prebiotics infant formula use in preterm or low birth weight infants: a systematic review

Mugambi

Musekiwa

Lombard

et al. 2012

Nutr J

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BackgroundPrevious reviews (2005 to 2009) on preterm infants given probiotics or prebiotics with breast milk or mixed feeds focused on prevention of Necrotizing Enterocolitis, sepsis and diarrhea. This review assessed if probiotics, prebiotics led to improved growth and clinical outcomes in formula fed preterm infants.MethodsCochrane methodology was followed using randomized controlled trials (RCTs) which compared preterm formula containing probiotic(s) or prebiotic(s) to conventional preterm formula in preterm infants. The mean difference (MD) and corresponding 95% confidence intervals (CI) were reported for continuous outcomes, risk ratio (RR) and corresponding 95% CI for dichotomous outcomes. Heterogeneity was assessed by visual inspection of forest plots and a chi2 test. An I2 test assessed inconsistencies across studies. I2> 50% represented substantial heterogeneity.ResultsFour probiotics studies (N=212), 4 prebiotics studies (N=126) were included. Probiotics: There were no significant differences in weight gain (MD 1.96, 95% CI: -2.64 to 6.56, 2 studies, n=34) or in maximal enteral feed (MD 35.20, 95% CI: -7.61 to 78.02, 2 studies, n=34), number of stools per day increased significantly in probiotic group (MD 1.60, 95% CI: 1.20 to 2.00, 1 study, n=20). Prebiotics: Galacto-oligosaccharide / Fructo-oligosaccharide (GOS/FOS) yielded no significant difference in weight gain (MD 0.04, 95% CI: -2.65 to 2.73, 2 studies, n=50), GOS/FOS yielded no significant differences in length gain (MD 0.01, 95% CI: -0.03 to 0.04, 2 studies, n=50). There were no significant differences in head growth (MD −0.01, 95% CI: -0.02 to 0.00, 2 studies, n=76) or age at full enteral feed (MD −0.79, 95% CI: -2.20 to 0.61, 2 studies, n=86). Stool frequency increased significantly in prebiotic group (MD 0.80, 95% CI: 0.48 to 1.1, 2 studies, n=86). GOS/FOS and FOS yielded higher bifidobacteria counts in prebiotics group (MD 2.10, 95% CI: 0.96 to 3.24, n=27) and (MD 0.48, 95% CI: 0.28 to 0.68, n=56).ConclusionsThere is not enough evidence to state that supplementation with probiotics or prebiotics results in improved growth and clinical outcomes in exclusively formula fed preterm infants.

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“…For diagnostic purposes, a prospective analysis was performed in which levels of salivary derived epidermal growth factor (sEGF) were found to be significantly lower in preterm infants, and more rapid elevations of sEGF during the first weeks of life were associated with a greater incidence of NEC (48). For therapeutic purposes, another study evaluated levels of insulin-like growth factor 1 (IGF-1) and its effects on maturation of intestinal function in preterm infants (49). It was suspected that supplementation of IGF-1 in preterm formulas would speed the growth and development of the barrier and absorptive features of the gut (49), thereby potentially decreasing the likelihood of NEC development.…”

Section: Previously Studied Techniquesmentioning

confidence: 99%

“…For therapeutic purposes, another study evaluated levels of insulin-like growth factor 1 (IGF-1) and its effects on maturation of intestinal function in preterm infants (49). It was suspected that supplementation of IGF-1 in preterm formulas would speed the growth and development of the barrier and absorptive features of the gut (49), thereby potentially decreasing the likelihood of NEC development. However, supplementation was not found to be substantially beneficial, possibly due to synergy with other factors that were not supplemented in conjunction with IGF-1 (49).…”

Section: Previously Studied Techniquesmentioning

confidence: 99%

Biomarkers for Infants at Risk for Necrotizing Enterocolitis: Clues to Prevention?

et al. 2009

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Effect of Enteral IGF‐1 Supplementation on Feeding Tolerance, Growth, and Gut Permeability in Enterally Fed Premature Neonates

Abstract: Although gut permeability showed a faster decrease in the IGF-1 supplement group, our data do not support IGF-1 supplementation to infant formula.

Cited by 53 publications

References 37 publications

Whey Protein Processing Influences Formula-Induced Gut Maturation in Preterm Pigs

Whey Protein Processing Influences Formula-Induced Gut Maturation in Preterm Pigs

Probiotics, prebiotics infant formula use in preterm or low birth weight infants: a systematic review

Biomarkers for Infants at Risk for Necrotizing Enterocolitis: Clues to Prevention?

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