Department of Neonatology, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai 201102, China.
NHC Key Laboratory of Neonatal Diseases, Fudan University, Shanghai 201102, China.
Nutrients. 2023 Nov 20;15(22):4849. doi: 10.3390/nu15224849.
Feeding intolerance (FI) is a significant concern in the care of preterm infants, impacting their growth and development. We previously reported that FI is linked to lower fecal calprotectin (FC) levels. This study aims to explore the postnatal dynamics and interplay between microbiota, metabolic profiles, and host immunity in preterm infants with and without FI.
Infants with gestational age <32 weeks or birth weight <1500 g were enrolled at the Children's Hospital of Fudan University between January 2018 and October 2020. Weekly fecal samples were analyzed for bacterial profiling, metabolome, and calprotectin levels, exploring their longitudinal development and interrelationships.
Of the 118 very preterm infants studied, 48 showed FI. These infants experienced an interrupted microbial-immune trajectory, particularly at 3-4 weeks of age, marked by a reduced bacterial abundance, alpha diversity, and FC levels. Metabolic changes in FI were pronounced between 3 and 6 weeks. Pantothenic acid and two polyamine metabolites were closely associated with bacterial abundance and FC levels and negatively correlated with the duration to attain full enteral feeding.
FI infants demonstrated compromised microbiome-immune interactions, potentially influenced by specific metabolites. This research underscored the importance of early microbial and metabolic development in the pathogenesis of FI in very preterm infants.
喂养不耐受（FI）是早产儿护理中的一个重要问题，会影响其生长和发育。我们之前的研究报告表明，FI 与粪便钙卫蛋白（FC）水平降低有关。本研究旨在探索有和无 FI 的早产儿的微生物群、代谢特征和宿主免疫之间的产后动态和相互作用。
2018 年 1 月至 2020 年 10 月，复旦大学附属儿科医院纳入胎龄<32 周或出生体重<1500 g 的婴儿。每周分析粪便样本以进行细菌分析、代谢组学和 FC 水平分析，以探索其纵向发展和相互关系。
在研究的 118 名极早产儿中，有 48 名出现 FI。这些婴儿经历了微生物-免疫轨迹中断，特别是在 3-4 周龄时，表现为细菌丰度、α多样性和 FC 水平降低。FI 之间的代谢变化在 3 至 6 周之间更为明显。泛酸和两种多胺代谢物与细菌丰度和 FC 水平密切相关，与达到完全肠内喂养所需的时间呈负相关。
FI 婴儿表现出微生物-免疫相互作用受损，这可能受到特定代谢物的影响。这项研究强调了早期微生物和代谢发育在极早产儿 FI 发病机制中的重要性。
