Similar efficacy of human banked milk and bovine colostrum to decrease incidence of necrotizing enterocolitis in preterm piglets

Abstract

BB, Thymann T. Similar efficacy of human banked milk and bovine colostrum to decrease incidence of necrotizing enterocolitis in preterm piglets. Am J Physiol Regul Integr Comp Physiol 305: R4 -R12, 2013. First published May 8, 2013 doi:10.1152/ajpregu.00094.2013.-Preterm birth and formula feeding predispose to necrotizing enterocolitis (NEC) in infants. As mother's milk is often absent following preterm delivery, infant formula (IF) and human donor milk (HM) are frequently used as alternatives. We have previously shown that porcine and bovine colostrum (BC) provide similar NEC protection in preterm piglets relative to IF. We hypothesized that HM exerts similar effects and that this effect is partly species-independent. Preterm piglets (n ϭ 40) received 2 days of total parenteral nutrition, followed by a rapid transition to full enteral feeding (15 ml·kg Ϫ1 ·2 h Ϫ1 ) for 2 days using BC (n ϭ 13), HM (n ϭ 13), or IF (n ϭ 14). Intestinal passage time and hexose absorption were tested in vivo. Body and organ weights were recorded on day 5, and macroscopic NEC lesions in the gastrointestinal tract were assessed. Intestinal samples were collected for determination of histomorphology, histopathology, tissue IL-6 and IL-8, organic acids, bacterial adherence by fluorescence in situ hybridization score, and digestive enzyme activities. Relative to IF, pigs from BC and HM showed longer intestinal passage time; higher weight gain, hexose absorptive capacity, mucosal proportion, and enzyme activities; lower NEC incidence, organic acid concentration, and IL-8 concentration; and reduced histopathology lesions. Tissue IL-6 concentration and bacterial adherence score were lower for HM, relative to both BC and IF groups. We conclude that BC and HM are both superior to IF in stimulating gut structure, function, and NEC resistance in preterm piglets.

Transforming growth factor-β2 and endotoxin interact to regulate homeostasis via interleukin-8 levels in the immature intestine

“…IF pigs, as reported previously (13,16). Hence, the moderate IL-8 production may help to control inflammation and protect against NEC in COLOS pigs.…”

“…The animal protocol was approved by the Danish National Committee of Animal Experimentation and was performed as described in our previous work on the same animals (13,14,16). In brief, preterm pigs delivered at 105-106 days of gestation (term 116 -117 days) were fed with parenteral nutrition with or without minimal enteral nutrition for 2 days followed by 2 days of full enteral nutrition before euthanasia on day 5.…”

“…Tissue samples from the distal small intestine or colon were snap-frozen at Ϫ80°C before further analysis. In the present study, intestinal and colonic tissues and contents from these earlier studies (13,14,16) were used to measure TGF-␤2 and IL-8 in the present study and to relate this to NEC incidence and severity across treatments.…”

“…TGF-␤2 content in the two diets (colostrum and infant formula) was determined by Western blot with the protocol as indicated previously (3). Bovine colostrum used for the pig study was the pooled colostrum from various colostrum samples obtained from different healthy cows while formula was produced from commercial products (13,16). The intestinal tissues from pig studies were homogenized in 1% Triton X-100 solution (10 ml/g tissue) with the addition of protease inhibitor cocktail (Sigma-Aldrich, Copenhagen, Denmark) before Western blot analysis.…”

Physical activity level is impaired and diet dependent in preterm newborn pigs

“…This deficit may further compromise maturation of many organs, including the brain. Conversely, a slow transition to enteral feeding, using an optimal milk diet such as human milk (HM, either mother's own milk or donor milk) or bovine colostrum (BC), is required to avoid feeding intolerance and serious gut complications, such as necrotizing enteritis (NEC) in both infants and animal models (18)(19)(20). Incidence of NEC generally increases with rapid progression of enteral feeding, especially using infant formula (IF), although the optimal feeding procedure remains debated.…”