Journal article
Enteral feeding induces diet-dependent mucosal dysfunction, bacterial proliferation, and necrotizing enterocolitis in preterm pigs on parenteral nutrition
University of Copenhagen1
Maastricht University2
Agricultural Research Service Children's Nutrition Research Center3
Aarhus University4
Microbial Ecology, Division of Veterinary Diagnostics and Research, National Veterinary Institute, Technical University of Denmark5
Division of Veterinary Diagnostics and Research, National Veterinary Institute, Technical University of Denmark6
National Veterinary Institute, Technical University of Denmark7
Preterm neonates have an immature gut and metabolism and may benefit from total parenteral nutrition (TPN) before enteral food is introduced. Conversely,delayed enteral feeding may inhibit gut maturation and sensitize to necrotizing enterocolitis (NEC). Intestinal mass and NEC lesions were first recorded in preterm pigs fed enterally (porcine colostrum, bovine colostrum, or formula for 20–40 h), with or without a preceding 2- to 3-day TPN period (n 435).
Mucosal mass increased during TPN and further after enteral feeding to reach an intestinal mass similar to that in enterally fed pigs without TPN (60–80% relative to birth). NEC developed only after enteral feeding but more often after a preceding TPN period for both sow’s colostrum (26 vs. 5%) and formula (62 vs. 39%, both P 0.001, n 43–170).
Further studies in 3-day-old TPN pigs fed enterally showed that formula feeding decreased villus height and nutrient digestive capacity and increased luminal lactic acid and NEC lesions, compared with colostrum (bovine or porcine, P 0.05). Mucosal microbial diversity increased with enteral feeding, and Clostridium perfringens density was related to NEC severity.
Formula feeding decreased plasma arginine, citrulline, ornithine, and tissue antioxidants, whereas tissue nitric oxide synthetase and gut permeability increased, relative to colostrum (all P 0.05). In conclusion, enteral feeding is associated with gut dysfunction, microbial imbalance, and NEC in preterm pigs, especially in pigs fed formula after TPN.
Conversely, colostrum milk diets improve gut maturation and NEC resistance in preterm pigs subjected to a few days of TPN after birth.
Language: | English |
---|---|
Publisher: | American Physiological Society |
Year: | 2008 |
Pages: | G1092-103 |
ISSN: | 15221547 and 01931857 |
Types: | Journal article |
DOI: | 10.1152/ajpgi.00414.2007 |
ORCIDs: | 0000-0002-2876-1667 , 0000-0001-7480-6064 and 0000-0003-0449-0839 |