Comparative Pediatrics and Nutrition, Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Department of Neonatology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China.
J Pediatr Gastroenterol Nutr. 2021 Aug 1;73(2):e39-e46. doi: 10.1097/MPG.0000000000003147.
Exclusive feeding with bovine colostrum (BC) protects preterm pigs against necrotizing enterocolitis (NEC) and BC has recently been tested as a supplement to a mother's own milk or formula (FOR) for very preterm infants. Using preterm pigs as a model for infants, we investigated if BC has gut- and NEC-protective effects at different proportions of the daily enteral intake given as BC.
Sixty-eight caesarean-delivered preterm piglets (90% gestation) were allocated into four groups with increasing proportions of eight daily bolus feedings as BC: BC00 (only FOR feeding), BC25 (25% BC), BC50 (50% BC), or BC75 (75% BC). On day 5, the gut was collected for biochemical analyses.
Body growth was increased in BC50 and BC75 piglets (2-fold, P < 0.05 vs BC00). The incidence of mild NEC-like lesions was similar among groups (67-86%), but BC75 reduced severe NEC-like lesions (27% vs 79% in BC00, P < 0.05). BC50 and BC75 improved hexose absorption and mucosal structure and reduced gut permeability (P < 0.05 vs BC00), while enzyme activities (lactase, aminopeptidase N and A, dipeptidyl peptidase IV) were improved in all pigs fed BC (P < 0.05). Across the measured variables, beneficial effects were most clear for the BC75 group, including reductions in colon tissue cytokine levels (interleukin 8, interleukin 1β, tumor necrosis factor α) and expression of immune- and apoptosis-related genes (LBP, TLR4, TLR2, IL8, STAT3, IL17, C3, all P < 0.05, relative to BC00).
A proportion of 50-75% of daily enteral intake as BC is required to improve the intestinal structure, function, immunology, and NEC resistance in preterm piglets also fed formula. Further studies are required to show if and how supplementary BC may support gut development in preterm infants during the immediate postnatal period. It is challenging to translate results on optimal feeding regimens between species, and preterm infants would not receive a majority of their daily enteral intake as BC.
用牛初乳（BC）进行纯母乳喂养可预防早产儿坏死性小肠结肠炎（NEC），最近已尝试将其作为早产儿母亲母乳或配方奶（FOR）的补充剂。我们使用早产儿小猪作为婴儿模型，研究了当以 BC 形式给予每日肠内摄入的不同比例时，BC 是否对肠道和 NEC 具有保护作用。
将 68 头剖宫产分娩的早产小猪（90%妊娠）分为四组，分别以 8 次每日推注喂养的增加比例给予 BC：BC00（仅 FOR 喂养）、BC25（25% BC）、BC50（50% BC）或 BC75（75% BC）。第 5 天，收集肠道进行生化分析。
BC50 和 BC75 组小猪的体重增长增加（2 倍，P<0.05 与 BC00 相比）。各组间轻度 NEC 样病变的发生率相似（67-86%），但 BC75 降低了严重 NEC 样病变（BC00 为 27%，BC75 为 79%，P<0.05）。BC50 和 BC75 改善了己糖吸收和黏膜结构，并降低了肠道通透性（P<0.05 与 BC00 相比），而所有接受 BC 喂养的小猪的酶活性（乳糖酶、氨肽酶 N 和 A、二肽基肽酶 IV）均得到改善（P<0.05）。在所有测量的变量中，BC75 组的效果最为明显，包括结肠组织细胞因子水平（白细胞介素 8、白细胞介素 1β、肿瘤坏死因子 α）和免疫与凋亡相关基因表达（LBP、TLR4、TLR2、IL8、STAT3、IL17、C3，均 P<0.05，与 BC00 相比）的降低。
在给予配方奶的同时，需要以 50-75%的每日肠内摄入比例来改善早产儿小猪的肠道结构、功能、免疫学和 NEC 抗性。需要进一步研究以确定补充 BC 是否以及如何在新生儿期支持早产儿的肠道发育。在物种之间翻译最佳喂养方案的结果具有挑战性，并且早产儿不会将大部分每日肠内摄入作为 BC。
