Effect of Neutral and Acidic Oligosaccharides on Fecal IL-8 and Fecal Calprotectin in Preterm Infants

Abstract

ABSTRACT:The gastrointestinal inflammatory response may play a role in the susceptibility of preterm infants for infections. We previously reported a trend toward lower endogenous infection morbidity after enteral supplementation of neutral and acidic oligosaccharides ( SC GOS/ LC FOS/AOS). We hypothesize that enteral supplementation of prebiotics may decrease infectious morbidity by reducing intestinal inflammation. Therefore, we aimed to determine the effect of enteral supplementation of prebiotics on intestinal inflammation, as measured by fecal IL-8 (f-IL-8) and calprotectin (f-calprotectin), in preterm infants. In a randomized controlled trial, infants with a GA Ͻ32 wk and/or birth weight Ͻ1,500 g received enteral supplementation of prebiotics or placebo (maltodextrin) between d 3 and 30 of life. F-IL-8 and f-calprotectin was assessed at baseline, d 7, 14, and 30 of life. In total, 113 infants were included. Baseline patient and nutritional characteristics were not different in the SC GOS/ LC FOS/AOS (n ϭ 55) and the placebo group (n ϭ 58). Enteral supplementation of prebiotics had no effect on f-IL-8 and f-calprotectin. F-IL-8 and f-calprotectin were strongly correlated at all time points (p Ͻ 0.001). In conclusion, enteral supplementation of prebiotics ( SC GOS/ LC FOS/AOS) does not affect f-IL-8 and fcalprotectin levels in preterm infants. (Pediatr Res 69: 255-258, 2011) I mmaturity of the immune system and the gastrointestinal tract may play a pivotal role in the susceptibility of preterm infants for infections. The maturation of the immune system is influenced by bacterial antigens of the intestinal microbiota (1). This interaction leads to metabolic and immunologic reactions by the epithelial cells and the underlying lymphoid cells and is called the bacterial-epithelial "cross talk" (2). The bacterialepithelial "cross talk" between the intestinal microbiota and immune system may cause an inflammatory response, which may further increase the susceptibility of preterm infants for serious infections and necrotizing enterocolitis (NEC) (3).Invasive measurement of the inflammatory response of the gastrointestinal tract is difficult in preterm infants. However, noninvasive markers measuring inflammation of the gastrointestinal tract have been investigated. IL-8 is a proinflammatory cytokine produced by myelomonocytic cells that attracts and activates neutrophils and monocytes (4). In children with inflammatory bowel disease, IL-8 from organ-cultured lamina propria biopsies is related to inflammatory activity (5). Furthermore, in an in vitro study, Nanthakumar et al. (6) showed an enhanced IL-8 response of immature human enterocytes compared with mature enterocytes of older children. IL-8 precedes calprotectin in the inflammatory cascade. Calprotectin, released from neutrophils and monocytes, has several biological functions including fungicidal, antibacterial, and antiproliferative effects (7,8). Both IL-8 and calprotectin can be measured in the feces. Fecal calprotectin (f-calprotectin) is increased in pr...

Coupling flash liquid chromatography with mass spectrometry for enrichment and isolation of milk oligosaccharides for functional studies

“…Abundant carbohydrates also interfere with bacterial growth studies on the low abundant non-digestible oligosaccharides. The capabilities of the method include isolation of oligosaccharides by monosaccharide composition and class[29] (e.g. neutral versus acidic).…”

Rapid Fecal Calprotectin (FC) Analysis: Point of Care Testing for Diagnosing Early Necrotizing Enterocolitis

“…As such, it is important to note that although five of our infants received GOS supplements, we do not believe that this affects FC levels. Westerbeek et al, 19 studied this in preterm infants and reported that they observed no difference in FC levels between their prebiotic supplemented group and the placebo group at 48 hours after birth, or at postnatal days 7, 14, and 30.…”

Prebiotic Oligosaccharides in Premature Infants

“…Nonparametric methods were used for between-group comparisons for qPCR outcomes. The prebiotic product administered in previous studies (23) was not available to us; therefore, we switched to a powdered GOS product for the remaining 4 infants in this group. Descriptive statistics for the 4 groups are summarized in Table 2.…”