Influence of enteral feeding initiation time on intestinal flora and metabolites in very low birth weight infants: a prospective study
SHEN Yu-Jie, LI Lu-Quan, WEI Lu, ZHANG Xian-Hong, ZHAO Wen-Jing, LIU Xiao-Chen, WU Li-Ping
Department of Neonatology, Children's Hospital of Chongqing Medical University/National Clinical Research Center for Child Health and Disorders/Ministry of Education Key Laboratory of Child Development and Disorders/Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China
Abstract：Objective To study the influence of enteral feeding initiation time on intestinal flora and metabolites in very low birth weight (VLBW) infants. Methods A total of 29 VLBW infants who were admitted to the Department of Neonatology, Children's Hospital of Chongqing Medical University, from June to December, 2020, were enrolled as subjects. According to the enteral feeding initiation time after birth, the infants were divided into two groups: <24 hours (n=15) and 24-72 hours (n=14). Fecal samples were collected at weeks 2 and 4 of hospitalization, and 16S rDNA high-throughput sequencing and gas chromatography-mass spectrometry were used to analyze the microflora and short-chain fatty acids (SCFAs) respectively in fecal samples. Results The analysis of microflora showed that there was no significant difference between the two groups in Chao index (reflecting the abundance of microflora) and Shannon index (reflecting the diversity of microflora) at weeks 2 and 4 after birth (P>0.05). The analysis of flora composition showed that there was no significant difference in the main microflora at the phylum and genus levels between the two groups at weeks 2 and 4 after birth (P>0.05). The comparison of SCFAs between the two groups showed that the <24 hours group had a significantly higher level of propionic acid than the 24-72 hours group at week 4 (P<0.05), while there was no significant difference in the total amount of SCFAs and the content of the other SCFAs between the two groups (P>0.05). Conclusions Early enteral feeding has no influence on the diversity and abundance of intestinal flora in VLBW infants, but enteral feeding within 24 hours can increase the level of propionic acid, a metabolite of intestinal flora.
SHEN Yu-Jie,LI Lu-Quan,WEI Lu et al. Influence of enteral feeding initiation time on intestinal flora and metabolites in very low birth weight infants: a prospective study[J]. CJCP, 2022, 24(4): 433-439.
2 Salas AA, Willis KA, Carlo WA, et al. The gut microbiome of extremely preterm infants randomized to the early progression of enteral feeding[J]. Pediatr Res, 2021. PMID: 34775476. DOI: 10.1038/s41390-021-01831-w. Epub ahead of print.
Tewari VV, Dubey SK, Kumar R, et al. Early versus late enteral feeding in preterm intrauterine growth restricted neonates with antenatal doppler abnormalities: an open-label randomized trial[J]. J Trop Pediatr, 2018, 64(1): 4-14. PMID: 28369652. DOI: 10.1093/tropej/fmx018.
Nakubulwa C, Musiime V, Namiiro FB, et al. Delayed initiation of enteral feeds is associated with postnatal growth failure among preterm infants managed at a rural hospital in Uganda[J]. BMC Pediatr, 2020, 20(1): 86. PMID: 32093661. PMCID: PMC7038603. DOI: 10.1186/s12887-020-1986-5.
Ahmed F, Dey SK, Shahidullah M, et al. Early versus delayed enteral feeding for achieving full feeding in preterm growth-restricted infants: a randomized clinical trial[J]. Mymensingh Med J, 2020, 29(3): 638-645. PMID: 32844806.
Gil A, Rueda R, Ozanne SE, et al. Is there evidence for bacterial transfer via the placenta and any role in the colonization of the infant gut?—a systematic review[J]. Crit Rev Microbiol, 2020, 46(5): 493-507. PMID: 32776793. DOI: 10.1080/1040841X.2020.1800587.
Liu PY, Wang YB, Yang G, et al. The role of short-chain fatty acids in intestinal barrier function, inflammation, oxidative stress, and colonic carcinogenesis[J]. Pharmacol Res, 2021, 165: 105420. PMID: 33434620. DOI: 10.1016/j.phrs.2021.105420.
Tong LC, Wang Y, Wang ZB, et al. Propionate ameliorates dextran sodium sulfate-induced colitis by improving intestinal barrier function and reducing inflammation and oxidative stress[J]. Front Pharmacol, 2016, 7: 253. PMID: 27574508. PMCID: PMC4983549. DOI: 10.3389/fphar.2016.00253.
Li JJ, Zhang L, Wu T, et al. Indole-3-propionic acid improved the intestinal barrier by enhancing epithelial barrier and mucus barrier[J]. J Agric Food Chem, 2021, 69(5): 1487-1495. PMID: 33356219. DOI: 10.1021/acs.jafc.0c05205.
Pace F, Rudolph SE, Chen Y, et al. The short-chain fatty acids propionate and butyrate augment adherent-invasive Escherichia coli virulence but repress inflammation in a human intestinal enteroid model of infection[J]. Microbiol Spectr, 2021, 9(2): e0136921. PMID: 34612688. PMCID: PMC8510176. DOI: 10.1128/Spectrum.01369-21.
Dupraz L, Magniez A, Rolhion N, et al. Gut microbiota-derived short-chain fatty acids regulate IL-17 production by mouse and human intestinal γδ T cells[J]. Cell Rep, 2021, 36(1): 109332. PMID: 34233192. DOI: 10.1016/j.celrep.2021.109332.
Chen D, Gao ZQ, Wang YY, et al. Sodium propionate enhances Nrf2-mediated protective defense against oxidative stress and inflammation in lipopolysaccharide-induced neonatal mice[J]. J Inflamm Res, 2021, 14: 803-816. PMID: 33732006. PMCID: PMC7957230. DOI: 10.2147/JIR.S303105.
