Untargeted and Targeted Metabolomic Profiling of Preterm Newborns with EarlyOnset Sepsis: A Case-Control Study

Mardegan, Veronica; Giordano, Giuseppe; Stocchero, Matteo; Pirillo, Paola; Poloniato, Gabriele; Donadel, Enrica; Salvadori, Severo; Giaquinto, Carlo; Priante, Elena; Baraldi, Eugenio

doi:10.3390/metabo11020115

Cited by 20 publications

(25 citation statements)

References 43 publications

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“…After birth, sick neonates or preterm infants have reduced antioxidant defenses. Regarding neonatal sepsis, pathogenic invasion represents the initiation of sepsis, but the sepsis syndrome is subsequently maintained by a cascade of oxidative mechanisms and a marked disruption of the antioxidant metabolic pathways [6] which, once activated, act independently from the pathogens themselves. On the other hand, since premature birth interrupts antioxidant defense mechanisms that mature during late gestation, preterm infants are also highly sensitive to oxidative stress [7].…”

Section: Introductionmentioning

confidence: 99%

Human Milk Feeding for Septic Newborn Infants Might Minimize Their Exposure to Ventilation Therapy

Moliner¹,

Verd²,

Leiva³

et al. 2022

Preprint

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Background. It is well established that human milk feeding contributes in limiting lung disease among vulnerable neonates. The primary aim of this research was to compare the need for mechanical ventilation of human milk-fed sick neonates with that of formula-fed sick neonates. Methods. All late preterm and full term infants from a single center with findings of sepsis, from 2002 to 2017, were identified. Data regarding infant feeding during hospital admission were recorded. Multivariate logistic regression analyses were performed to assess the impact of the type of milk on ventilation support and main neonatal morbidities. Results. The total number of participants was 322 (human milk group = 260, exclusive formula group = 62). On bivariate analysis, 72% of human milk-fed neonates did not need oxygen therapy nor respiratory support versus 55% of their formula-fed counterparts (P<0.0001). Accordingly, invasive mechanical ventilation was required by 9.2% of human milk-fed infants versus 32% of their formula-fed counterparts (P=0.0085). These results hold true in multivariate analysis, indeed human milk-fed neonates were more likely to require less respiratory support (OR=0.44; 95% CI: 0.22, 0.89) when compared to those who were exclusively formula-fed. Conclusion. Human milk feeding might minimize exposure to mechanical ventilation.

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Section: Introductionmentioning

confidence: 99%

Human Milk Feeding for Septic Newborn Infants Might Minimize Their Exposure to Ventilation Therapy

Moliner¹,

Verd²,

Leiva³

et al. 2022

Preprint

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show abstract

“…Functions of glutamate products are well established, including antioxidant defense (glutathione) and inhibitory neurotransmission (GABA). Glutathione metabolism was markedly altered in preterm infants with early-onset sepsis (268). Glutamate concentrations are increased and decreased in urine and stool samples, respectively, in preterm infants with LOI (221,269).…”

Section: Amino Acidsmentioning

confidence: 97%

Influence of innate immune activation on endocrine and metabolic pathways in infancy

O’Connor

Ashoori

Dias

et al. 2021

American Journal of Physiology-Endocrinology and Metabolism

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Prematurity is the leading cause of neonatal morbidity and mortality worldwide. Premature infants often require extended hospital stays, with increased risk of developing infection compared with term infants. A picture is emerging of wide-ranging deleterious consequences resulting from innate immune system activation in the newborn infant. Those who survive infection have been exposed to a stimulus that can impose long-lasting alterations into later life. In this review, we discuss sepsis-driven alterations in integrated neuroendocrine and metabolic pathways and highlight current knowledge gaps in respect of neonatal sepsis. We review established biomarkers for sepsis and extend the discussion to examine emerging findings from human and animal models of neonatal sepsis that propose novel biomarkers for early identification of sepsis. Future research in this area is required to establish a greater understanding of the distinct neonatal signature of early and late-stage infection, to improve diagnosis, curtail inappropriate antibiotic use and promote precision medicine through a biomarker-guided empirical and adjunctive treatment approach for neonatal sepsis. There is an unmet clinical need to decrease sepsis-induced morbidity in neonates, to limit and prevent adverse consequences in later life and decrease mortality.

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“…The IDO-mediated tryptophan catabolism is associated with immune dysfunction and impaired microvascular reactivity in sepsis [32]. Interestingly, tryptophan's intestinal ora metabolism also seems to be related to metabolic abnormalities caused by sepsis [33].…”

Section: Amino Acid Metabolismmentioning

confidence: 99%

Construction of the Metabolomics-Based Prognosis-Prediction Models for ICU Septic Patients

Ding

Tong²,

Song³

et al. 2022

SSRN Journal

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Background: Global mortality related to sepsis remains unacceptably high in intensive care units (ICUs). Accurate prognostic evaluation of sepsis could effectively reduce the mortality of septic patients. Our goal is to present an effective and rapid method to assess the prognosis of sepsis.Methods: We included 96 septic patients according to the sepsis 3.0 in ICU, who were grouped into survival and death groups according to 28-day, hospital, and 90-day prognosis. Liquid chromatography/mass spectrometry was performed to detect the metabolite changes in plasma. Multivariate logistic regression models, using differential metabolites and clinical indicators within 24 h after diagnosis of sepsis, were used to construct the prediction models for 28-day, hospital, and 90-day prognosis in sepsis.Results: Metabolic pro les related to 28-day, hospital, and 90-day prognosis were signi cantly different between the survival and the death group. Speci cally, 13, 4, and 29 primary differential metabolites related to amino acid metabolism and fatty acid metabolism were identi ed between the survival and death group at 28-day, hospital, and 90-day prognosis, respectively. Further, we found that model 1 including indoleacetic acid, 3-methylene-indolenine, heart rate, respiratory support, and application of pressure drugs; model 2 including lymphocyte count, alkaline phosphatase, SOFA, and L-alpha-amino-1H-pyrrole-1-hexanoic acid; model 3 including pyrrolidine, dopamine, heart rate, respiratory support, and application of pressure drugs, could predict 28-day, hospital, and 90-day prognosis of sepsis with a sensitivity of 75.51%, 73.58%, and 83.33%, speci city of 78.72%, 72.09%, and 76.19%, the area under the receiver operating characteristics curve of 0.881, 0.830, 0.892, respectively.Conclusions: This research could be used to predict the 28-day, hospital, and 90-day prognosis of septic patients based on differential metabolites and clinical parameters, and could also be used to develop novel sepsis-treatment methods.

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Untargeted and Targeted Metabolomic Profiling of Preterm Newborns with EarlyOnset Sepsis: A Case-Control Study

Cited by 20 publications

References 43 publications

Human Milk Feeding for Septic Newborn Infants Might Minimize Their Exposure to Ventilation Therapy

Human Milk Feeding for Septic Newborn Infants Might Minimize Their Exposure to Ventilation Therapy

Influence of innate immune activation on endocrine and metabolic pathways in infancy

Construction of the Metabolomics-Based Prognosis-Prediction Models for ICU Septic Patients

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