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Published on: July 28, 2023
Lactobacillus reuteri in Its Biofilm State Improves Protection from Experimental Necrotizing Enterocolitis
Ameer Al-Hadidi1, Jason Navarro2, Steven D Goodman2
1Department of Pediatric Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Center for Perinatal Research, The Research Institute at Nationwide Children's Hospital, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA.
Insights
A novel biofilm probiotic formulation significantly reduces necrotizing enterocolitis (NEC) incidence and severity in infants. This new delivery method enhances probiotic survival and adherence, offering improved outcomes for this critical neonatal condition.
Area of Science:
- Neonatal Medicine
- Gastroenterology
- Microbiology
Background:
- Necrotizing enterocolitis (NEC) is a severe intestinal disease in premature infants, leading to high morbidity and mortality.
- Current NEC treatments, including antibiotics and bowel rest, have shown limited efficacy.
- Gastrointestinal dysbiosis is a key factor in NEC development, highlighting the potential of probiotics.
Purpose of the Study:
- To develop and evaluate a novel enteral probiotic formulation for NEC prevention and treatment.
- To overcome limitations of current probiotic delivery methods, such as daily administration.
Main Methods:
- A single enteral dose of *Lactobacillus reuteri* was delivered in a novel biofilm formulation.
- The formulation's impact on probiotic survival in gastric conditions and adherence to intestinal cells was assessed.
- The incidence, severity, and neurocognitive effects of NEC were evaluated in experimental models.
Main Results:
- The biofilm formulation enhanced probiotic survival in acidic environments.
- Increased probiotic adherence to gastrointestinal epithelial cells was observed.
- The novel formulation significantly reduced NEC incidence, severity, and associated neurocognitive deficits in models.
Conclusions:
- A single enteral dose of biofilm-encased *Lactobacillus reuteri* is a promising new strategy for managing NEC.
- This innovative delivery system improves probiotic efficacy and addresses limitations of conventional probiotic therapies.
- Further research into this formulation could lead to improved outcomes for premature infants at risk of NEC.
Abstract:
Necrotizing enterocolitis (NEC) is a devastating disease predominately found in premature infants that is associated with significant morbidity and mortality. Despite decades of research, medical management with broad spectrum antibiotics and bowel rest has remained relatively unchanged, with no significant improvement in patient outcomes. The etiology of NEC is multi-factorial; however, gastrointestinal dysbiosis plays a prominent role in a neonate's vulnerability to and development of NEC. Probiotics have recently emerged as a new avenue for NEC therapy. However, current delivery methods are associated with potential limitations, including the need for at least daily administration in order to obtain any improvement in outcomes. We present a novel formulation of enterally delivered probiotics that addresses the current limitations. A single enteral dose of Lactobacillus reuteri delivered in a biofilm formulation increases probiotic survival in acidic gastric conditions, increases probiotic adherence to gastrointestinal epithelial cells, and reduces the incidence, severity, and neurocognitive sequelae of NEC in experimental models.
