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Enhancement of immune response mediated by oropharyngeal colostrum administration in preterm neonates
Jorge Moreno-Fernandez1,2, Belén Sánchez-Martínez3, Laura Serrano-López3
1Department of Physiology, University of Granada, Granada, Spain.
Insights
Administering oropharyngeal colostrum to preterm infants safely enhances their immune system. This method boosts immunoglobulin and lactoferrin levels, showing potential as an immunomodulatory aid for vulnerable neonates.
Area of Science:
- Neonatal immunology
- Immunomodulation
- Infant nutrition
Background:
- Preterm infants possess immature immune systems, contributing to significant morbidity and mortality.
- Oropharyngeal colostrum administration is explored as a potential immunomodulatory strategy.
- This study investigates the impact of oropharyngeal colostrum on preterm infants' immune markers and clinical outcomes.
Purpose of the Study:
- To evaluate the effect of oropharyngeal colostrum on serum immunoglobulin (IgA, IgM, IgG1), lactoferrin, and resistin levels in preterm neonates.
- To assess the clinical outcomes of preterm neonates receiving oropharyngeal colostrum during the first month of life.
Main Methods:
- A study involving 100 preterm neonates (<32 weeks gestation or <1500g) in a Neonatal Intensive Care Unit.
- Two groups were formed: colostrum group (n=48) receiving 0.2 mL oropharyngeal colostrum every 4 hours for 15 days, and a control group (n=52).
- Serum samples were collected at 1, 3, 15, and 30 days to measure IgA, IgM, IgG1, lactoferrin, and resistin. Clinical data were also recorded.
Main Results:
- Oropharyngeal colostrum administration led to increased IgA and IgM levels at 15 and 30 days.
- Serum lactoferrin levels increased after 30 days, and resistin levels increased after 15 days.
- The colostrum group achieved full enteral nutrition earlier, with no observed differences in common neonatal morbidities compared to the control group.
Conclusions:
- Oropharyngeal colostrum administration is a safe intervention for preterm neonates.
- This method effectively improves the immunologic profile of preterm infants.
- Oropharyngeal colostrum shows promise as an immunomodulatory agent in neonatal care.
Background:
The immune system of preterm infants is immature, being a significant cause of morbidity and mortality, particularly in the preterm infant. Oropharyngeal colostrum administration could be an immunomodulatory aid. Our aim was to evaluate the effect of oropharyngeal colostrum on the serum levels of immunoglobulins, lactoferrin, and resistin during the first month of life and to track the clinical outcome of the neonates.
Methods:
One hundred preterm neonates born at <32 weeks of gestation and/or weighing < 1500 g and assisted in the Neonatal Intensive Care Unit were enrolled and divided into two groups: colostrum (n = 48) and control (n = 52). The subjects assigned to the colostrum group received 0.2 mL of colostrum (oropharyngeal route) every 4 hours for the first 15 days of life, and if mothers have inability to breastfeed, they were included in the control group (no oropharyngeal colostrum). Serum concentrations of IgA, IgM, and IgG1, lactoferrin, and resistin were assessed in both groups at 1, 3, 15, and 30 days of life. Clinical data during hospitalization were collected.
Results:
IgA and IgM increased in preterm neonates who were administered colostrum for 15 and 30 days. Lactoferrin increased after 30 days, and resistin increased after 15 days of supplying oropharyngeal colostrum. The colostrum group underwent full enteral nutrition before, and no differences were observed in the common neonatal morbidities.
Conclusion:
Oropharyngeal colostrum administration is safe in preterm neonates and improves their immunologic profile, showing a potential role as an immunomodulatory agent.
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