Dynamics and Crosstalk between Gut Microbiota, Metabolome, and Fecal Calprotectin in Very Preterm Infants: Insights...

Area of Science:

• Neonatal Medicine
• Microbiome Research
• Immunology

Background:

• Feeding intolerance (FI) significantly affects preterm infant growth and development.
• Previous research linked FI to lower fecal calprotectin (FC) levels.
• Understanding the interplay of gut microbiota, metabolism, and immunity in FI is crucial.

Purpose of the Study:

• To investigate the postnatal development of microbiota, metabolic profiles, and host immunity in preterm infants.
• To explore the differences in these factors between infants with and without feeding intolerance.
• To identify potential mechanisms underlying feeding intolerance in this population.

Main Methods:

• Longitudinal analysis of weekly fecal samples from very preterm infants (<32 weeks gestation or <1500g birth weight).
• Assessment of bacterial profiling, metabolome, and calprotectin levels.
• Exploration of the interrelationships and longitudinal development of these parameters.

Main Results:

• 48 out of 118 very preterm infants experienced feeding intolerance.
• FI infants showed an interrupted microbial-immune trajectory, with reduced bacterial abundance, diversity, and FC levels at 3-4 weeks.
• Metabolic alterations were observed between 3-6 weeks, with specific metabolites (pantothenic acid, polyamines) associated with bacterial abundance, FC levels, and time to full enteral feeding.

Conclusions:

• Feeding intolerance in preterm infants is associated with compromised microbiome-immune interactions.
• Specific metabolites may play a role in the pathogenesis of FI.
• Early microbial and metabolic development is critical in very preterm infants and influences feeding tolerance.