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The administration of a pre-digested fat-enriched formula prevents necrotising enterocolitis-induced lung injury in
Chhinder P Sodhi1,2, Andres J Gonzalez Salazar1,2, Mark L Kovler1,2
1Division of General Pediatric Surgery, Johns Hopkins University and Johns Hopkins Children's Center, Baltimore, MD21287, USA.
Insights
A novel pre-digested fat (PDF) system in infant formula reduces necrotising enterocolitis (NEC)-associated lung injury. This nutritional approach enhances lung maturation and decreases reactive oxygen species (ROS), offering protection against lung inflammation in premature infants.
Area of Science:
- Neonatal nutrition
- Gastroenterology
- Pulmonology
Background:
- Necrotising enterocolitis (NEC) is a severe gastrointestinal disease in premature infants, often linked to infant formula.
- NEC frequently leads to significant lung injury, a major complication.
- Previous research indicated that a pre-digested fat (PDF) system reduces NEC severity in a mouse model.
Purpose of the Study:
- To investigate if the PDF system can mitigate NEC-associated lung injury.
- To evaluate the impact of the PDF system on lung development and maturation in the context of NEC.
Main Methods:
- Newborn mice were fed a nutritional formula based on the PDF system.
- Lung development was assessed by examining tight junctions and surfactant protein expression.
- Mice were exposed to NEC-inducing conditions to evaluate lung inflammation and protection.
- Mechanisms of protection, including lung maturation and reactive oxygen species (ROS) production, were analyzed.
Main Results:
- The PDF system promoted lung development, indicated by increased tight junctions and surfactant protein expression.
- Mice receiving the PDF system showed reduced vulnerability to NEC-induced lung inflammation.
- The PDF system conferred significant protection against lung injury in NEC models.
- Administration of the PDF system enhanced lung maturation and decreased ROS production in the lungs.
Conclusions:
- The PDF system offers protection against NEC-induced lung injury by enhancing lung maturation and reducing oxidative stress.
- This nutritional strategy holds promise for improving outcomes in premature infants at risk for NEC and associated lung complications.
- The PDF system also appears to promote lung maturation independently of NEC.
Abstract:
Necrotising enterocolitis (NEC) is a devastating gastrointestinal disease of prematurity that typically develops after the administration of infant formula, suggesting a link between nutritional components and disease development. One of the most significant complications that develops in patients with NEC is severe lung injury. We have previously shown that the administration of a nutritional formula that is enriched in pre-digested Triacylglyceride that do not require lipase action can significantly reduce the severity of NEC in a mouse model. We now hypothesise that this 'pre-digested fat (PDF) system' may reduce NEC-associated lung injury. In support of this hypothesis, we now show that rearing newborn mice on a nutritional formula based on the 'PDF system' promotes lung development, as evidenced by increased tight junctions and surfactant protein expression. Mice that were administered this 'PDF system' were significantly less vulnerable to the development of NEC-induced lung inflammation, and the administration of the 'PDF system' conferred lung protection. In seeking to define the mechanisms involved, the administration of the 'PDF system' significantly enhanced lung maturation and reduced the production of reactive oxygen species (ROS). These findings suggest that the PDF system protects the development of NEC-induced lung injury through effects on lung maturation and reduced ROS in the lung and also increases lung maturation in non-NEC mice.
