Antimicrobial and nutritional interventions in early life

Michael Ladegaard Jensen

Abstract

Necrotizing enterocolitis (NEC) is the most common gastrointestinal disorder in premature newborn infants, yet there is still no well-established prevention strategy or treatment for this disease. The pathogenesis of NEC remains to be fully elucidated; however, prematurity, enteral nutrition and microbial colonization of the gut are the three most important risk factors for the onset and development of NEC.

To investigate these issues, a well-established preterm piglet model was used. Microbial colonization is inevitable but also essential for the newborn and in Paper I we showed that prophylactic antibiotics given to premature piglets with an immature immune system dramatically decreased bacterial load and the incidence of NEC. We wanted to investigate whether similar results could be achieved with dietary manipulations including the use of natural products like breast milk and bovine colostrum.

Human milk and bovine colostrum contain an enormous diversity of bio- and immunoactive components which are tailored towards neonates with an undeveloped immune system. The incidence of NEC was reduced by feeding these two diets to premature piglets, indicating that alternatives to mother’s milk exist in the form of bovine colostrum (Paper II).

Human milk contains a high concentration of oligosaccharides, which inhibits adhesion of pathogens. To further investigate the properties and effects of these components, a special piglet model was developed. The piglets were challenged with Escherichia coli F18 (F18), a pathogen causing post-weaning diarrhea in pigs. F18 may adhere to an intestinal epithelial glycoprotein, and some oligosaccharides which are found in human milk mimic these glycoproteins. Development of this novel animal model is described in Paper III.

Further development and adjustments with regard to challenge dose and supportive nutrition was done and presented in Paper IV.

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