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Title: Improved gut barrier function via increased threonine utilization may explain enhanced resistance to necrotizing enterocolitis in preterm pigs fed colostrum

Author
item JENSEN, M - University Of Copenhagen
item PUIMAN, P - Erasmus Medical Center
item STOLL, B - Children'S Nutrition Research Center (CNRC)
item DORST, K - Erasmus Medical Center
item RENES, I - Erasmus Medical Center
item SANGILD, P - University Of Copenhagen
item VAN GOUDOEVER, J - Erasmus Medical Center

Submitted to: Acta Paediatrica
Publication Type: Abstract Only
Publication Acceptance Date: 10/9/2009
Publication Date: 10/9/2009
Citation: Jensen, M., Puiman, P., Stoll, B., Dorst, K., Renes, I., Sangild, P., Van Goudoever, J. 2009. Improved gut barrier function via increased threonine utilization may explain enhanced resistance to necrotizing enterocolitis in preterm pigs fed colostrum [abstract]. Acta Paediatrica. 98(Suppl.460):44.

Interpretive Summary:

Technical Abstract: Threonine is an essential amino acid necessary for synthesis of gut mucins that form the protective intestinal mucous layer. In premature infants, this function might be compromised leading to necrotizing enterocolitis (NEC). We hypothesized that enteral feeding with colostrum, relative to infant formula, would stimulate intestinal threonine utilization, and thereby protect against necrotizing enterocolitis (NEC) in preterm neonates. Preterm piglets were delivered at 90% of gestation and received 2 days of total parenteral nutrition, followed by 3 days of formula (n = 7; threonine intake 4 mg/ml) or bovine colostrum (n = 7; threonine intake 3.8 mg/ml). Prior to euthanasia, piglets were infused with U-13C threonine intravenously and 1-15N threonine intragastrically to measure intestinal threonine and protein metabolism. Plasma and tissues were collected for histology and mass spectrometry. In the formula group, 57% (4/7) developed NEC compared to 14% (1/7) in the colostrum group, while body weight and intestinal weight were not affected. Histological analysis showed a higher density of goblet cells in the colon of colostrum piglets (P < 0.05). Protein contents of the small intestine and colon were similar between groups. Plasma concentrations of threonine were lower in colostrum pigs (P < 0.01), while intestinal uptake of threonine in first pass was increased (27 mg/kg/d vs. 21 mg/kg/d; P < 0.05). Colostrum feeding stimulated the fractional intestinal threonine utilization, increased goblet cell density, and improved NEC resistance in preterm pigs. This suggests that impaired barrier function plays an important role for NEC development in preterm neonates.