Intestinal Permeability and Carrier-Mediated Monosaccharide Absorption in Preterm Neonates during the Early Postnatal Period

Rouwet, Ellen V.; Heineman, Erik; Buurman, Wim A.; Riet, Gerben ter; Ramsay, Graham; Blanco, Carlos E.

doi:10.1203/00006450-200201000-00012

Cited by 80 publications

(72 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Data from a clinical study of intestinal barrier function in neonates (n = 59) born between 25 and 32 weeks gestation from within 24 h of birth, using urinary lactulose: rhamnose ratio as a marker of intestinal permeability after orally administering fixed ratio of lactulose and rhamnose [175], supports the laboratory data on the developmental physiology of the immature intestinal barrier function. As urinary excretion percentages of lactulose and rhamnose are markers of paracellular and transcellular diffusion, respectively, the urinary lactulose: rhamnose ratio provides a reliable index of the permeability of the intestinal epithelium [175][176][177].…”

Section: Protein Undernutrition and Nutritionally Regulated Hormonal mentioning

confidence: 61%

Nutritionally Regulated Hormonal Factors in Prolonged Postnatal Growth Retardation and Its Associated Adverse Neurodevelopmental Outcome in Extreme Prematurity

Yeung¹,

Smyth²

2003

Neonatology

View full text Add to dashboard Cite

Recent published data show that at hospital discharge, most infants born at <30 weeks of gestation would not achieve the median birth weight of the reference fetus at the same postconceptional age, and many would be less than the 10th centile. Estimating from the current recommendations of calorie and protein intakes, these infants accrue large deficits in intakes of protein and calorie during the first weeks of life. Postnatal growth retardation over a prolonged period of time is related to neurodevelopmental delays. While a total energy intake of 120 kcal/kg/day has generally been considered adequate, protein requirement in low gestation infants remains a matter for debate. Increasing the dietary protein:calorie ratio has previously been proposed as a strategy to enhance growth and to achieve a body composition similar to that of the reference fetus. Previous study data reveal that serum insulin-like growth factor I (IGF-I) concentration is positively correlated with protein intake, and nitrogen retention, in turn, is positively correlated with serum IGF-I concentration. Remarkably, elevated serum growth hormone but low serum IGF-I concentrations have been reported in low gestation infants and in infants with intrauterine growth retardation, suggesting IGF-I being a nutritionally regulated hormonal factor in the postnatal growth retardation. As neurodevelopment in extreme prematurity is likely affected by multiple factors, we hypothesize that a combined strategy of the previously proposed hormonal supplement with hydrocortisone and tri-iodothyronine together with increased dietary protein intake (progressively increasing from 1.5 g/kg/day intravenously administered amino acids immediately after birth, then 3.6 g/100 kcal at ≈125 kcal/kg/day when enterally fed till the infant reaches a body weight of ≧1.8 kg and at ≧50th centile weight of the reference fetus at the same postconceptional age) would likely be synergistic and more effective in improving neurodevelopmental outcome.

show abstract

Section: Protein Undernutrition and Nutritionally Regulated Hormonal mentioning

confidence: 61%

Nutritionally Regulated Hormonal Factors in Prolonged Postnatal Growth Retardation and Its Associated Adverse Neurodevelopmental Outcome in Extreme Prematurity

Yeung¹,

Smyth²

2003

Neonatology

View full text Add to dashboard Cite

show abstract

“…However, this study is complicated by the absence of enteral nutrition prior to postnatal day 8. 7 The previous studies of intestinal permeability in preterm infants include evaluations in the first postnatal week 5,6 and over the first 24 days, 7 42 days, 10 and 50 days. 3 In these five studies, evaluation of intestinal permeability was performed without regard to feeding status (feeding versus not feeding) and predominantly without regard to feeding type.…”

Section: Discussionmentioning

confidence: 99%

“…3,5,6 Intestinal permeability appears to decrease with initiation of enteral feeding. 3,7 One study has shown increased permeability in preterm infants receiving formula feeds versus exclusive human milk feeds at 28 postnatal days, but not earlier or later. 3 We identified no evaluation of the effect of human milk dose on preterm infant intestinal permeability in the literature.…”

mentioning

confidence: 99%

Intestinal Permeability in Preterm Infants by Feeding Type: Mother's Milk Versus Formula

Taylor

Basile

Ebeling

et al. 2009

Breastfeeding Medicine

142

View full text Add to dashboard Cite

Background and Objective: Intestinal permeability in preterm infants represents a critical balance between absorption of nutritional agents and protection from dangerous pathogens. This study identified the relationship between feeding type (human milk and formula) and intestinal permeability as measured by lactulose to mannitol ratio in preterm infants in the first postnatal month. Study Design: Sixty-two preterm (Յ32 weeks of gestation) infants had assessment of feeding type and evaluation with enteral lactulose and mannitol administration and urinary measurement at three time points in the first postnatal month. Results: Infants who received the majority of feeding as human milk (Ͼ75%) demonstrated significantly lower intestinal permeability when compared to infants receiving minimal or no human milk (Ͻ25% or none) at postnatal days 7, 14, and 30 (p ϭ 0.02, 0.02, and 0.047, respectively). When infants receiving any human milk were compared to infants receiving formula only, a significant difference existed at day 7 and day 14 but not for day 30 (p ϭ 0.04, 0.02, and 0.15, respectively). With evaluation over the complete study period, exclusively formulafed infants demonstrated a 2.8-fold higher composite median lactulose/mannitol ratio when compared with those who received any human milk. Infants who received Ͼ75% of enteral feeding as mother's milk demonstrated a 3.8-fold lower composite median ratio when compared to infants receiving Ͻ25% or no mother's milk. Conclusion: Preterm infant intestinal permeability was significantly decreased for those receiving human milk versus formula in a dose-related manner in the first postnatal month.

show abstract

“…The underlying mechanisms remain poorly understood, but increased intestinal permeability and inadequate intestinal immune responses in preterm neonates are associated with gastrointestinal disorders (2)(3)(4). In order to define the maturational stage of the gut, markers of gut maturity are required.…”

mentioning

confidence: 99%

Intestinal fatty acid–binding protein: a possible marker for gut maturation

et al. 2014

View full text Add to dashboard Cite

Background: Gut immaturity is linked with postnatal intestinal disorders. However, biomarkers to assess the intestinal developmental stage around birth are lacking. The aim of this study was to gain more insight on intestinal fatty acid-binding protein (I-FABP) as an indicator of gut maturity. Methods: Antenatal I-FABP distribution and release was investigated in extremely premature, moderately premature, and term lambs, and these findings were verified in human urinary samples. Ileal I-FABP distribution was confirmed in autopsy material within 24 h postnatally. results: Median (range) serum I-FABP levels were lower in extremely premature lambs compared with moderately premature lambs (156 (50.0-427) vs. 385 (100-1,387) pg/ml; P = 0.02). Contrarily, median early postnatal urine I-FABP levels in human infants were higher in extremely premature compared with moderately premature and term neonates (1,219 (203-15,044) vs. 256 (50-1,453) and 328 (96-1,749) pg/ml; P = 0.008 and P = 0.04, respectively). I-FABP expression was most prominent in nonvacuolated enterocytes and increased with rising gestational age (GA) in ovine and human tissue samples. The epithelial distribution pattern changed from a phenotype displaying I-FABP-positive enterocytes merely in the crypts early in gestation into a phenotype with I-FABP expressing cells exclusively present in the villus tips at term in ovine and human tissue. conclusion: In this ovine and human study, increasing GA is accompanied by an increase in I-FABP tissue content. Cord I-FABP levels correlate with gestation in ovine fetuses, identifying I-FABP as a marker for gut maturation. Raised postnatal urine I-FABP levels in preterm human infants may indicate intestinal injury and/or inflammation in utero.

show abstract

Intestinal Permeability and Carrier-Mediated Monosaccharide Absorption in Preterm Neonates during the Early Postnatal Period

Cited by 80 publications

References 33 publications

Nutritionally Regulated Hormonal Factors in Prolonged Postnatal Growth Retardation and Its Associated Adverse Neurodevelopmental Outcome in Extreme Prematurity

Nutritionally Regulated Hormonal Factors in Prolonged Postnatal Growth Retardation and Its Associated Adverse Neurodevelopmental Outcome in Extreme Prematurity

Intestinal Permeability in Preterm Infants by Feeding Type: Mother's Milk Versus Formula

Intestinal fatty acid–binding protein: a possible marker for gut maturation

Contact Info

Product

Resources

About