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Intestinal permeability and carrier-mediated monosaccharide absorption in preterm neonates during the early postnatal
Ellen V Rouwet1, Erik Heineman, Wim A Buurman
1Department of Surgery, University Hospital Maastricht, 6202 AZ, The Netherlands.
Insights
Preterm neonates show decreased intestinal barrier function and sugar absorption in the first week after birth. This immaturity, especially in very preterm infants, may increase their risk of intestinal complications.
Area of Science:
- Neonatology
- Gastroenterology
- Pediatric Physiology
Background:
- Intestinal epithelial barrier immaturity is implicated in neonatal intestinal complications.
- Understanding early postnatal intestinal function is crucial for preterm infants.
Purpose of the Study:
- To assess intestinal permeability and monosaccharide absorption in preterm neonates during the first two weeks of life.
- To identify potential correlations between gestational age, feeding methods, and intestinal function.
Main Methods:
- Intestinal permeability assessed using the lactulose-to-rhamnose ratio.
- Monosaccharide absorption measured via urinary excretion of D-xylose and 3-O-methyl-D-glucose.
- Evaluations conducted at 1, 4, 7, and 14 days post-birth in 59 preterm neonates (25-32 weeks gestation).
Main Results:
- Intestinal permeability significantly increased between days 1 and 7 in all neonates.
- Carrier-mediated monosaccharide absorption improved from day 1 to 14 in neonates aged 28-30 weeks.
- Neonates <28 weeks gestation exhibited higher intestinal permeability at day 7 and lower absorption at day 14 compared to those ≥28 weeks.
Conclusions:
- Intestinal barrier function transiently decreases in the first postnatal week for non-enterally fed preterm neonates.
- Impaired barrier function and reduced absorptive capacity, particularly in the most premature infants, may predispose them to intestinal complications.
Abstract:
Immaturity of intestinal epithelial barrier function and absorptive capacity may play a role in the pathophysiology of intestinal complications in preterm neonates during the early postnatal period. We determined the intestinal permeability and carrier-mediated absorption of monosaccharides in preterm neonates during the first 2 wk after birth. Fifty-nine preterm neonates born between 25 and 32 wk gestation were included within 24 h of birth. Neonates received exclusively parenteral nutrition during the first 7 d after birth; enteral feeding was initiated at d 8. An intestinal permeability-absorption test was performed at 1, 4, 7, and 14 d after birth. The lactulose-to-rhamnose ratio was determined as a marker of intestinal permeability. Urinary excretion percentages of D-xylose and 3-O-methyl-D-glucose were determined as markers of passive and active carrier-mediated monosaccharide absorption, respectively. Intestinal permeability transiently increased between d 1 and 7 in all neonates (p < 0.05). Carrier-mediated monosaccharide absorption increased between d 1 and 14 in neonates of 28-30 wk (p < 0.05) to the level observed in the neonates of 30-32 wk gestation. In neonates <28 wk, intestinal permeability at d 7 was higher (p < 0.05) and carrier-mediated monosaccharide absorption at d 14 was lower (p < 0.01) as compared with neonates >or=28 wk. The barrier function of the intestinal epithelium transiently decreases during the first week after birth in preterm neonates who are not enterally fed. Diminished barrier function and low monosaccharide absorptive capacity, particularly in neonates <28 wk, may predispose these patients to the development of intestinal complications during the early postnatal period.