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Transition from parenteral to enteral nutrition induces immediate diet-dependent gut histological and immunological responses in preterm neonates. / Siggers, Jayda; Sangild, Per T.; Jensen, Tim Kåre; Siggers, Richard H.; Skovgaard, Kerstin; Støy, Ann Cathrine Findal; Jensen, Bent B.; Thymann, Thomas; Bering, Stine B.; Boye, Mette.

In: American Journal of Physiology: Gastrointestinal and Liver Physiology, Vol. 301, No. 3, 2011, p. G435-G445.

Publication: Research - peer-reviewJournal article – Annual report year: 2011

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Author

Siggers, Jayda; Sangild, Per T.; Jensen, Tim Kåre; Siggers, Richard H.; Skovgaard, Kerstin; Støy, Ann Cathrine Findal; Jensen, Bent B.; Thymann, Thomas; Bering, Stine B.; Boye, Mette / Transition from parenteral to enteral nutrition induces immediate diet-dependent gut histological and immunological responses in preterm neonates.

In: American Journal of Physiology: Gastrointestinal and Liver Physiology, Vol. 301, No. 3, 2011, p. G435-G445.

Publication: Research - peer-reviewJournal article – Annual report year: 2011

Bibtex

@article{84af34d76fe0400699ef9479a92d080c,
title = "Transition from parenteral to enteral nutrition induces immediate diet-dependent gut histological and immunological responses in preterm neonates",
publisher = "American Physiological Society",
author = "Jayda Siggers and Sangild, {Per T.} and Jensen, {Tim Kåre} and Siggers, {Richard H.} and Kerstin Skovgaard and Støy, {Ann Cathrine Findal} and Jensen, {Bent B.} and Thomas Thymann and Bering, {Stine B.} and Mette Boye",
year = "2011",
doi = "10.1152/ajpgi.00400.2010",
volume = "301",
number = "3",
pages = "G435--G445",
journal = "American Journal of Physiology: Gastrointestinal and Liver Physiology",
issn = "0193-1857",

}

RIS

TY - JOUR

T1 - Transition from parenteral to enteral nutrition induces immediate diet-dependent gut histological and immunological responses in preterm neonates

A1 - Siggers,Jayda

A1 - Sangild,Per T.

A1 - Jensen,Tim Kåre

A1 - Siggers,Richard H.

A1 - Skovgaard,Kerstin

A1 - Støy,Ann Cathrine Findal

A1 - Jensen,Bent B.

A1 - Thymann,Thomas

A1 - Bering,Stine B.

A1 - Boye,Mette

AU - Siggers,Jayda

AU - Sangild,Per T.

AU - Jensen,Tim Kåre

AU - Siggers,Richard H.

AU - Skovgaard,Kerstin

AU - Støy,Ann Cathrine Findal

AU - Jensen,Bent B.

AU - Thymann,Thomas

AU - Bering,Stine B.

AU - Boye,Mette

PB - American Physiological Society

PY - 2011

Y1 - 2011

N2 - Necrotizing enterocolitis (NEC) in preterm infants develops very rapidly from a mild intolerance to enteral feeding into intestinal mucosal hemorrhage, inflammation, and necrosis. We hypothesized that immediate feeding-induced gut responses precede later clinical NEC symptoms in preterm pigs. Fifty-six preterm pigs were fed total parenteral nutrition (TPN) for 48 h followed by enteral feeding for 0, 8, 17, or 34 h with either colostrum (Colos, n = 20) or formula (Form, n = 31). Macroscopic NEC lesions were detected in Form pigs throughout the enteral feeding period (20/31, 65%), whereas most Colos pigs remained protected (1/20, 5%). Just 8 h of formula feeding induced histopathological lesions, as evidenced by capillary stasis and necrosis, epithelial degeneration, edema, and mucosal hemorrhage. These immediate formula-induced changes were paralleled by decreased digestive enzyme activities (lactase and dipeptidylpeptidase IV), increased nutrient fermentation, and altered expression of innate immune defense genes such as interleukins (IL-1α, IL-6, IL-18), nitric oxide synthetase, tight junction proteins (claudins), Toll-like receptors (TLR-4), and TNF-α. In contrast, the first hours of colostrum feeding induced no histopathological lesions, increased maltase activity, and induced changes in gene expressions related to tissue development. Total bacterial density was high after 2 days of parenteral feeding and was not significantly affected by diet (colostrum, formula) or length of enteral feeding (8–34 h), except that a few bacterial groups (Clostridium, Enterococcus, Streptococcus species) increased with time. We conclude that a switch from parenteral to enteral nutrition rapidly induces diet-dependent histopathological, functional, and proinflammatory insults to the immature intestine. Great care is required when introducing enteral feeds to TPN-fed preterm infants, particularly when using formula, because early feeding-induced insults may predispose to NEC lesions that are difficult to revert by later dietary or medical interventions.

AB - Necrotizing enterocolitis (NEC) in preterm infants develops very rapidly from a mild intolerance to enteral feeding into intestinal mucosal hemorrhage, inflammation, and necrosis. We hypothesized that immediate feeding-induced gut responses precede later clinical NEC symptoms in preterm pigs. Fifty-six preterm pigs were fed total parenteral nutrition (TPN) for 48 h followed by enteral feeding for 0, 8, 17, or 34 h with either colostrum (Colos, n = 20) or formula (Form, n = 31). Macroscopic NEC lesions were detected in Form pigs throughout the enteral feeding period (20/31, 65%), whereas most Colos pigs remained protected (1/20, 5%). Just 8 h of formula feeding induced histopathological lesions, as evidenced by capillary stasis and necrosis, epithelial degeneration, edema, and mucosal hemorrhage. These immediate formula-induced changes were paralleled by decreased digestive enzyme activities (lactase and dipeptidylpeptidase IV), increased nutrient fermentation, and altered expression of innate immune defense genes such as interleukins (IL-1α, IL-6, IL-18), nitric oxide synthetase, tight junction proteins (claudins), Toll-like receptors (TLR-4), and TNF-α. In contrast, the first hours of colostrum feeding induced no histopathological lesions, increased maltase activity, and induced changes in gene expressions related to tissue development. Total bacterial density was high after 2 days of parenteral feeding and was not significantly affected by diet (colostrum, formula) or length of enteral feeding (8–34 h), except that a few bacterial groups (Clostridium, Enterococcus, Streptococcus species) increased with time. We conclude that a switch from parenteral to enteral nutrition rapidly induces diet-dependent histopathological, functional, and proinflammatory insults to the immature intestine. Great care is required when introducing enteral feeds to TPN-fed preterm infants, particularly when using formula, because early feeding-induced insults may predispose to NEC lesions that are difficult to revert by later dietary or medical interventions.

U2 - 10.1152/ajpgi.00400.2010

DO - 10.1152/ajpgi.00400.2010

JO - American Journal of Physiology: Gastrointestinal and Liver Physiology

JF - American Journal of Physiology: Gastrointestinal and Liver Physiology

SN - 0193-1857

IS - 3

VL - 301

SP - G435-G445

ER -