Ehlers Greta, Tödtmann Annika Marie, Holsten Lisa, Willers Maike, Heckmann Julia, Schöning Jennifer, Richter Maximilian, Heinemann Anna Sophie, Pirr Sabine, Heinz Alexander, Dopfer Christian, Händler Kristian, Becker Matthias, Büchel Johanna, Wöckel Achim, von Kaisenberg Constantin, Hansen Gesine, Hiller Karsten, Schultze Joachim L, Härtel Christoph, Kastenmüller Wolfgang, Vaeth Martin, Ulas Thomas, Viemann Dorothee
Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.
Department of Pediatrics, University Hospital Würzburg, Würzburg, Germany.
Nat Commun. 2025 Mar 6;16(1):2239. doi: 10.1038/s41467-025-57357-w.
Neonates primarily rely on innate immune defense, yet their inflammatory responses are usually restricted compared to adults. This is controversially interpreted as a sign of immaturity or essential programming, increasing or decreasing the risk of sepsis, respectively. Here, combined transcriptomic, metabolic, and immunological studies in monocytes of healthy individuals reveal an inverse ontogenetic shift in metabolic pathway activities with increasing age. Neonatal monocytes are characterized by enhanced oxidative phosphorylation supporting ongoing myeloid differentiation. This phenotype is gradually replaced during early childhood by increasing glycolytic activity fueling the inflammatory responsiveness. Microbial stimulation shifts neonatal monocytes to an adult-like metabolism, whereas ketogenic diet in adults mimicking neonatal ketosis cannot revive a neonate-like metabolism. Our findings disclose hallmarks of innate immunometabolism during healthy postnatal immune adaptation and suggest that premature activation of glycolysis in neonates might increase their risk of sepsis by impairing myeloid differentiation and promoting hyperinflammation.
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