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Published on: April 2, 2021
Gut Microbiome and Retinopathy of Prematurity
Jason Y Zhang1, Mark J Greenwald2, Sarah H Rodriguez2
1Pritzker School of Medicine, University of Chicago, Chicago, Illinois; Department of Ophthalmology and Visual Science, University of Chicago, Chicago, Illinois.
Insights
The gut microbiome may influence retinopathy of prematurity (ROP), a leading cause of childhood blindness. Investigating the neonatal gut environment could reveal new ROP prevention and treatment strategies.
Area of Science:
- Neonatal ophthalmology
- Microbiome research
- Pediatric health
Background:
- Retinopathy of prematurity (ROP) is a major cause of childhood blindness, linked to premature birth.
- Many preterm infants do not develop ROP, suggesting other contributing factors.
- The neonatal gut microbiome is dynamic and can be disrupted by prematurity.
Purpose of the Study:
- To explore the potential role of the early gut microbiome in retinopathy of prematurity (ROP) pathophysiology.
- To review the literature on the gut-retina axis and its implications for ROP.
- To identify potential mechanisms linking the gut microbiome to ROP development.
Main Methods:
- Literature review of studies on ROP, neonatal gut microbiome, and the gut-retina axis.
- Analysis of potential mechanisms involving dysregulated growth factors (VEGF, IGF-1).
- Examination of how ROP risk factors (hypoxia, sepsis, antibiotics) impact the gut microbiome.
Main Results:
- Prematurity is associated with gut dysbiosis and conditions like necrotizing enterocolitis.
- Evidence supports a gut-retina axis influencing ROP.
- Known ROP risk factors can alter the gut microbiome composition.
Conclusions:
- The early intestinal environment, specifically the gut microbiome, may play a significant role in ROP.
- Further research into the gut-retina axis is warranted to understand ROP pathogenesis.
- Targeting the gut microbiome could offer novel therapeutic avenues for preventing ROP.
Abstract:
Retinopathy of prematurity (ROP), a leading cause of childhood blindness worldwide, is strongly associated with gestational age and weight at birth. Yet, many extremely preterm infants never develop ROP or develop only mild ROP with spontaneous regression. In addition, a myriad of other factors play a role in the retinal pathology, one of which may include the early gut microbiome. The complications associated with early gestational age include dysbiosis of the dynamic neonatal gut microbiome, as evidenced by the development of often concomitant conditions, such as necrotizing enterocolitis. Given this, alongside growing evidence for a gut-retina axis, there is an increasing interest in how the early intestinal environment may play a role in the pathophysiology of ROP. Potential mechanisms include dysregulation of vascular endothelial growth factor and insulin-like growth factor 1. Furthermore, the gut microbiome may be impacted by other known risk factors for ROP, such as intermittent hypoxia and sepsis treated with antibiotics. This mini-review summarizes the literature supporting these proposed avenues, establishing a foundation to guide future studies.
