The role of polyunsaturated fatty acid supplementation in intestinal inflammation and neonatal necrotizing enterocolitis

Caplan, Michael S.; Jilling, Tamás

doi:10.1007/s11745-001-0816-3

Cited by 44 publications

(30 citation statements)

References 36 publications

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“…Breastfeeding has an advantage over infant formula feeding in the reduction of both human (39) and experimental NEC (17). Arachidonic acid (AA) and docosahexaenoic acid (DHA) have been shown to reduce NEC (1,11), whereas the effect of conjugated FAs on the developing intestine and NEC pathogenesis have not been studied yet.…”

Section: Discussionmentioning

confidence: 99%

Pomegranate seed oil reduces intestinal damage in a rat model of necrotizing enterocolitis

Coursodon-Boyiddle

Snarrenberg

Adkins-Rieck

et al. 2012

American Journal of Physiology-Gastrointestinal and Liver Physi

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Section: Discussionmentioning

confidence: 99%

Pomegranate seed oil reduces intestinal damage in a rat model of necrotizing enterocolitis

Coursodon-Boyiddle

Snarrenberg

Adkins-Rieck

et al. 2012

American Journal of Physiology-Gastrointestinal and Liver Physi

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“…A clinical trial of formula feeds with or without supplementation with PUFA in the form of egg phospholipids in preterm neonates showed that the supplemented formula contained 7-fold more arachidonic acid and docosahexanoic acid and reduced the incidence of stage Ⅱ and Ⅲ NEC [188]. Recent evidence from an experimental study indicates that the protective effect of long chain PUFA is mediated by modulation of PAF metabolism and endotoxin translocation [189] .…”

Section: Polyunsaturated Fatty Acidsmentioning

confidence: 99%

Necrotizing enterocolitis: A multifactorial disease with no cure

Schnabl

Aerde²,

Thomson³

et al. 2008

WJG

163

120

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INTRODUCTIONNecrotizing enterocolitis (NEC) is an inflammatory bowel disease of neonates and remains one of the most common gastrointestinal emergencies in newborn infants [1] . Onset of NEC is often within the first three months of life and neonates who are of extremely low birth weight (< 1000 g) and under 28 wk gestation are the most susceptible [2] . Full term neonates account for 10% of all NEC cases while premature infants account for 90% [3] . With an incidence rate of 1%-5% for all newborns admitted to the NICU [1] , a prevalence of 7%-14% of very low birth weight infants (VLBW, 500-1500 g) [4] and a mortality rate approaching 20%-50% [5] , NEC continues to represent a significant clinical problem. In Canada, the incidence rate is 1.8 per 100 live births with a prevalence of 7% of VLBW infants [1] . Advances in obstetric and neonatal care have improved survival rates for smaller, more immature infants, and as more VLBW preterm infants survive the neonatal period, the population at risk for NEC increases [1] .No consistent association between sex, race, and rates of NEC has been identified. However, male VLBW infants and black infants are at greater risk of death [6] . Due to inadequate treatments and no effective preventative strategy, an estimated 20%-40% of babies with NEC require surgery [1] and 10%-30% experience significant morbidity including neurodevelopmental impairment, vision and hearing impairment, failure to thrive, feeding abnormalities, diarrhea, bowel obstruction, and short bowel syndrome [1,2,7] . The case fatality rate with surgical intervention is as high as 50% [1] . NEC is also a financial burden to the health care system with yearly hospital charges reported to be as high as $6.5 million in the US [8] . Thus, NEC continues to be an important health issue for preterm neonates. DIAGNOSIS Clinical signs and symptomsThe onset of NEC can occur suddenly within a few AbstractNecrotizing enterocolitis is an inflammatory bowel disease of neonates with significant morbidity and mortality in preterm infants. Due to the multifactorial nature of the disease and limitations in disease models, early diagnosis remains challenging and the pathogenesis elusive. Although preterm birth, hypoxic-ischemic events, formula feeding, and abnormal bacteria colonization are established risk factors, the role of genetics and vasoactive/inflammatory mediators is unclear. Consequently, treatments do not target the specific underlying disease processes and are symptomatic and surgically invasive. Breast-feeding is the most effective preventative measure. Recent advances in the prevention of necrotizing enterocolitis have focused on bioactive nutrients and trophic factors in human milk. Development of new disease models including the aspect of prematurity that consistently predisposes neonates to the disease with multiple risk factors will improve our understanding of the pathogenesis and lead to discovery of innovative therapeutics.

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“…21 Gangliosides and some long-chain polyunsaturated fatty acids are also known to play a role in preventing NEC. 22,23 To date, no investigations on the impact of pasteurization on these immunoactive compounds relevant to NEC have been reported.…”

Section: Introductionmentioning

confidence: 99%

Effect of pasteurization on selected immune components of donated human breast milk

et al. 2011

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Objective: Pasteurized, donated milk is increasingly provided to preterm infants in the absence of mother's own milk. The aim of this study was to determine the effect of pasteurization on the concentration of selected components in donated human breast milk.Study Design: Donated milk from 34 mothers was pooled into 17 distinct batches (4 mothers per batch). Aliquots of each batch were then Holder pasteurized (62.5 1C for 30 min). Interferon-g (IFN-g), tumor necrosis factor-a (TNF-a), interleukin-1b (IL-1b), IL-2, IL-4, IL-5, IL-8, IL-10, IL-12p70 and IL-13 were measured in a multiplex enzyme-linked immunosorbent assay (ELISA). Granulocyte colony-stimulating factor (G-CSF), heparin-binding epidermal-like growth factor (HB-EGF) and hepatocyte growth factor (HGF) were measured by ELISA. Lipids were assessed by gas chromatography and gangliosides by the resorcinol-HCl reaction.Result: IFN-g, TNF-a, IL-1b, IL-10 and HGF were significantly reduced by pasteurization (P<0.05). Gangliosides were not affected, but the proportion of medium-chain saturated fats was increased (P<0.05) with a trend towards a decreased proportion of oleic acid (P ¼ 0.057). Conclusion:Pasteurization significantly reduced the concentration of several immunoactive compounds present in breast milk, but did not have an impact on others.

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The role of polyunsaturated fatty acid supplementation in intestinal inflammation and neonatal necrotizing enterocolitis

Cited by 44 publications

References 36 publications

Pomegranate seed oil reduces intestinal damage in a rat model of necrotizing enterocolitis

Pomegranate seed oil reduces intestinal damage in a rat model of necrotizing enterocolitis

Necrotizing enterocolitis: A multifactorial disease with no cure

Effect of pasteurization on selected immune components of donated human breast milk

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