Preterm neonatal immunology at the intestinal interface

Belkum, Max Van; Alvarez, Lybil Mendoza; Neu, Josef

doi:10.1007/s00018-019-03316-w

Cited by 36 publications

(23 citation statements)

References 201 publications

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“…Similar results were presented by Abuidhail et al (21), who showed that the IgM concentration in milk samples from the 1st month of lactation was significantly higher (103 ± 31 mg/L) than for the 4th and the 6th month of lactation (64 ± 25 and 48 ± 18 mg/L, respectively) (21). Moreover, the concentration of IgM from the 2nd to the 6th day of lactation was positively associated with overweight and obesity of the mother before pregnancy as well as with primiparity and negatively associated with smoking during pregnancy (22).…”

Section: Introductionmentioning

confidence: 83%

“…During the first 3 months of life, the infant has at his disposal only maternal-derived immunoglobulins, delivered during pregnancy and breastfeeding, which are crucial for shaping and modulation of his immunity. Maternal milk immunoglobulins, due to the passive immunity transfer, are delivered to the gastrointestinal tract and participate in homeostatic mechanisms in the neonatal gut ( 23 ). Moreover, the latest reports confirmed that milk SIgA modulates the interactions between microbiota and the infant's gut and is essential for the prevention of necrotizing enterocolitis development ( 38 ).…”

Section: Discussionmentioning

confidence: 99%

“…After birth, newborns are completely reliant on maternal immunoglobulins because of the immature immune system. Immunoglobulins delivered with mother's milk are crucial in shaping neonatal immunity during the first 3 months since there is a lack of functional plasma cells which are responsible for the synthesis of the newborn's IgG ( 11 , 23 ). The main biological functions of SIgA include intracellular neutralization of viruses and inhibition of their transcytosis, inhibition of adhesion of pathogenic bacteria to host mucosa, and agglutination of viruses and bacteria ( 12 , 24 – 26 ).…”

Section: Introductionmentioning

confidence: 99%

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Changes in Human Milk Immunoglobulin Profile During Prolonged Lactation

et al. 2020

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Mother's milk immunoglobulins (Igs) delivered to infants during breastfeeding are crucial in shaping and modulating immature infants' immune system and provide efficient protection against pathogens. The aim of the study was to evaluate the immunoglobulin concentrations in milk of 116 lactating mothers over prolonged lactation from the 1st to the 48th month using the ELISA method. The concentration of proteins, SIgA and IgG, but not IgM, showed a positive correlation (r = 0.69, p < 0.005; r = 0.54, p < 0.05; and r = 0.27, p < 0.05, respectively) with lactation from the 1st to the 48th month. The lowest concentrations of SIgA and IgG were observed for the first year (2.12 ± 0.62 g/L and 14.71 ± 6.18 mg/L, respectively) and the highest after the 2nd year of lactation (7.55 ± 7.16 g/L and 18.95 ± 6.76 mg/L, respectively). The IgM concentration remained stable during 2 years (2.81 ± 2.74 mg/L), but after 24 months it was higher (3.82 ± 3.05 mg/L), although not significantly. Moreover, negative correlations of protein (r = −0.24, p < 0.05) and SIgA (r = −0.47, p < 0.05) concentrations with the number of feedings were found. Human milk after the 2nd year of lactation contains significantly higher concentrations of protein, SIgA, and IgG. High concentration of immunoglobulins and protein during prolonged lactation is an additional argument to support breastfeeding even after introducing solid foods and should be one of the overarching goals in the protection of children's health.

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Section: Introductionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Changes in Human Milk Immunoglobulin Profile During Prolonged Lactation

et al. 2020

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“…On the other hand, commensal bacteria are able to inhibit signaling and inflammatory mediator production downstream of these receptors or induce anti-inflammatory cytokine production, thereby actively suppressing gut inflammation. However, the underdeveloped preterm intestinal epithelium is highly permeable and more easily colonized by pathogenic bacteria because of reduced gastrointestinal motility as well as limited enteric nervous system function (39), all of which set the stage for destructive dysbiosis, chronic inflammation, and microbial translocation through the weakened intestinal barrier, leading to potentially lethal diseases of prematurity. Additionally, the premature intestinal epithelium expresses high levels of TLR4, which causes an overreaction by the host immune system to gut bacteria that leads to excessive inflammation (25,40).…”

Section: Physical Epithelial Barriers Associated Signaling and Thementioning

confidence: 99%

Dysregulated Mucosal Immunity and Associated Pathogeneses in Preterm Neonates

Sampah

Hackam

2020

Front. Immunol.

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Many functions of the immune system are impaired in neonates, allowing vulnerability to serious bacterial, viral and fungal infections which would otherwise not be pathogenic to mature individuals. This vulnerability is exacerbated in compromised newborns such as premature neonates and those who have undergone surgery or who require care in an intensive care unit. Higher susceptibility of preterm neonates to infections is associated with delayed immune system maturation, with deficiencies present in both the innate and adaptive immune components. Here, we review recent insights into early life immunity, and highlight features associated with compromised newborns, given the challenges of studying neonatal immunity in compromised neonates due to the transient nature of this period of life, and logistical and ethical obstacles posed by undertaking studies newborns and infants. Finally, we highlight how the unique immunological characteristics of the premature host play key roles in the pathogenesis of diseases that are unique to this population, including necrotizing enterocolitis and the associated sequalae of lung and brain injury.

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“…Classic NEC appears to be related to excessive inflammatory responses, with serum cytokines and chemokines, especially IL-8 significantly elevated [33]. Other factors that are elevated and could potentially be used as biomarkers for NEC include claudin 3 (a tight junction protein), intestinal fatty acid-binding protein which is produced by the epithelial cells and fecal calprotectin which is the product of inflammatory cells [32].…”

Section: Intestinal Immaturity and Inflammationmentioning

confidence: 99%

Necrotizing Enterocolitis: The Future

Neu¹

2020

Neonatology

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Progress in our understanding of the pathophysiology, prevention and treatment of necrotizing enterocolitis (NEC) has been hampered for many reasons. Included among these is the fact that what we are calling "NEC" is likely to represent different disease processes, which need to be delineated before evaluating individual pathogenic mechanisms and attempting to develop predictive and diagnostic biomarkers. Treatment is also likely to be hampered because not all of the different entities called "NEC" will respond to the same regimen. In this review, some of these entities will be discussed in more detail, with suggestions for refining our approach toward improving methods for their diagnosis, prevention and treatment.

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Preterm neonatal immunology at the intestinal interface

Cited by 36 publications

References 201 publications

Changes in Human Milk Immunoglobulin Profile During Prolonged Lactation

Changes in Human Milk Immunoglobulin Profile During Prolonged Lactation

Dysregulated Mucosal Immunity and Associated Pathogeneses in Preterm Neonates

Necrotizing Enterocolitis: The Future

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