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Health Benefits of Pharmacological Nutrition in Neonates

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Clinical Nutrition".

Deadline for manuscript submissions: closed (15 September 2020) | Viewed by 27429

Special Issue Editors

Department of Paediatrics, Maastricht University, Maastricht, The Netherlands
Interests: fetal/neonatal development; immune modulation; pharmacological nutrition; plant sterols; cell-based therapies
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Co-Guest Editor
Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, P.O. Box 616, 6200 MD Maastricht, The Netherlands
Interests: cholesterol metabolism; lipoproteins; plant sterols; CVD; NASH
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Preterm birth and intrapartum-related complications such as asphyxia or infection are perinatal conditions that increase the risk for neonatal and long-term morbidity. Importantly, in many conditions affecting the neonate, both systemic and organ specific inflammation are involved in pathogenesis. Moreover, postnatal inflammatory triggers such as infections and mechanical ventilation can further aggravate inflammation and subsequent adverse outcomes.

Bioactive elements that promote infant health are present in the amniotic fluid, fetal circulation and breast milk. These bioactive factors are also linked to the reduction of inflammation, the protection against infections and maturation of the infants’ immune system. Along these lines, breast milk feeding protects against several adverse neonatal outcomes, including NEC, BPD, ROP and is associated with improved brain development.

During recent decades, the list of identified bioactive factors that perform wide-ranging functions to protect the fetus and neonate in the critical perinatal period is increasing. Interestingly, several components are well tested and extensively described whereas other factors with pharmacological potential remain largely unnoticed in the current scientific literature.

These combined findings support the concept that supplementation of the maternal and or neonatal diet is a promising therapeutic strategy to promote infant health and reduce neonatal morbidity and mortality.

The aim of this proposed Special Issue on “Health Benefits of Pharmacological Nutrition in Neonates" is to publish selected papers that underscore and clarify the benefits of supplementation in the diet of pregnant women and neonates.

It is my pleasure to invite you to submit a proposal for a manuscript that fits the objectives and the topics of this Special Issue.

Dr. Tim Wolfs
Guest Editor

Manuscript Submission Information

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Keywords

  • Maternal diet
  • Formula feeding
  • Neonatal health
  • Adverse neonatal outcomes
  • Nutraceuticals
  • Breast milk components

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Published Papers (5 papers)

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Research

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21 pages, 3116 KiB  
Article
Perinatal Docosahexaenoic Acid Supplementation Improves Cognition and Alters Brain Functional Organization in Piglets
by Xi Fang, Wenwu Sun, Julie Jeon, Michael Azain, Holly Kinder, Jeongyoun Ahn, Hee Cheol Chung, Ryan S. Mote, Nikolay M. Filipov, Qun Zhao, Srujana Rayalam and Hea Jin Park
Nutrients 2020, 12(7), 2090; https://doi.org/10.3390/nu12072090 - 15 Jul 2020
Cited by 12 | Viewed by 4115
Abstract
Epidemiologic studies associate maternal docosahexaenoic acid (DHA)/DHA-containing seafood intake with enhanced cognitive development; although, it should be noted that interventional trials show inconsistent findings. We examined perinatal DHA supplementation on cognitive performance, brain anatomical and functional organization, and the brain monoamine neurotransmitter status [...] Read more.
Epidemiologic studies associate maternal docosahexaenoic acid (DHA)/DHA-containing seafood intake with enhanced cognitive development; although, it should be noted that interventional trials show inconsistent findings. We examined perinatal DHA supplementation on cognitive performance, brain anatomical and functional organization, and the brain monoamine neurotransmitter status of offspring using a piglet model. Sows were fed a control (CON) or a diet containing DHA (DHA) from late gestation throughout lactation. Piglets underwent an open field test (OFT), an object recognition test (ORT), and magnetic resonance imaging (MRI) to acquire anatomical, diffusion tensor imaging (DTI), and resting-state functional MRI (rs-fMRI) at weaning. Piglets from DHA-fed sows spent 95% more time sniffing the walls than CON in OFT and exhibited an elevated interest in the novel object in ORT, while CON piglets demonstrated no preference. Maternal DHA supplementation increased fiber length and tended to increase fractional anisotropy in the hippocampus of offspring than CON. DHA piglets exhibited increased functional connectivity in the cerebellar, visual, and default mode network and decreased activity in executive control and sensorimotor network compared to CON. The brain monoamine neurotransmitter levels did not differ in healthy offspring. Perinatal DHA supplementation may increase exploratory behaviors, improve recognition memory, enhance fiber tract integrity, and alter brain functional organization in offspring at weaning. Full article
(This article belongs to the Special Issue Health Benefits of Pharmacological Nutrition in Neonates)
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11 pages, 1599 KiB  
Article
Prophylactic Intra-Uterine β-Cyclodextrin Administration during Intra-Uterine Ureaplasma parvum Infection Partly Prevents Liver Inflammation without Interfering with the Enterohepatic Circulation of the Fetal Sheep
by Cathelijne Heymans, Lara R. Heij, Kaatje Lenaerts, Marcel den Dulk, Mhamed Hadfoune, Chantal van Heugten, Owen B. Spiller, Michael L. Beeton, Sarah J. Stock, Alan H. Jobe, Matthew S. Payne, Matthew W. Kemp, Boris W. Kramer, Jogchum Plat, Wim G. van Gemert and Tim G.A.M. Wolfs
Nutrients 2020, 12(5), 1312; https://doi.org/10.3390/nu12051312 - 5 May 2020
Cited by 5 | Viewed by 3436
Abstract
Chorioamnionitis can lead to inflammation and injury of the liver and gut, thereby predisposing patients to adverse outcomes such as necrotizing enterocolitis (NEC). In addition, intestinal bile acids (BAs) accumulation is causally linked to NEC development. Plant sterols are a promising intervention to [...] Read more.
Chorioamnionitis can lead to inflammation and injury of the liver and gut, thereby predisposing patients to adverse outcomes such as necrotizing enterocolitis (NEC). In addition, intestinal bile acids (BAs) accumulation is causally linked to NEC development. Plant sterols are a promising intervention to prevent NEC development, considering their anti-inflammatory properties in the liver. Therefore, we investigated whether an intra-amniotic (IA) Ureaplasma parvum (UP) infection affected the liver and enterohepatic circulation (EHC) and evaluated whether an IA administered plant sterol mixture dissolved in β-cyclodextrin exerted prophylactic effects. An ovine chorioamnionitis model was used in which liver inflammation and the EHC were assessed following IA UP exposure in the presence or absence of IA prophylactic plant sterols (a mixture of β-sitosterol and campesterol dissolved in β-cyclodextrin (carrier)) or carrier alone. IA UP exposure caused an inflammatory reaction in the liver, histologically seen as clustered and conflated hepatic erythropoiesis in the parenchyma, which was partially prevented by IA administration of sterol + β-cyclodextrin, or β-cyclodextrin alone. In addition, IA administration of β-cyclodextrin prior to UP caused changes in the expression of several hepatic BAs transporters, without causing alterations in other aspects of the EHC. Thereby, the addition of plant sterols to the carrier β-cyclodextrin did not have additional effects. Full article
(This article belongs to the Special Issue Health Benefits of Pharmacological Nutrition in Neonates)
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Review

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67 pages, 1241 KiB  
Review
Enteral Feeding Interventions in the Prevention of Necrotizing Enterocolitis: A Systematic Review of Experimental and Clinical Studies
by Ilse H. de Lange, Charlotte van Gorp, Laurens D. Eeftinck Schattenkerk, Wim G. van Gemert, Joep P. M. Derikx and Tim G. A. M. Wolfs
Nutrients 2021, 13(5), 1726; https://doi.org/10.3390/nu13051726 - 19 May 2021
Cited by 15 | Viewed by 5305
Abstract
Necrotizing enterocolitis (NEC), which is characterized by severe intestinal inflammation and in advanced stages necrosis, is a gastrointestinal emergency in the neonate with high mortality and morbidity. Despite advancing medical care, effective prevention strategies remain sparse. Factors contributing to the complex pathogenesis of [...] Read more.
Necrotizing enterocolitis (NEC), which is characterized by severe intestinal inflammation and in advanced stages necrosis, is a gastrointestinal emergency in the neonate with high mortality and morbidity. Despite advancing medical care, effective prevention strategies remain sparse. Factors contributing to the complex pathogenesis of NEC include immaturity of the intestinal immune defense, barrier function, motility and local circulatory regulation and abnormal microbial colonization. Interestingly, enteral feeding is regarded as an important modifiable factor influencing NEC pathogenesis. Moreover, breast milk, which forms the currently most effective prevention strategy, contains many bioactive components that are known to support neonatal immune development and promote healthy gut colonization. This systematic review describes the effect of different enteral feeding interventions on the prevention of NEC incidence and severity and the effect on pathophysiological mechanisms of NEC, in both experimental NEC models and clinical NEC. Besides, pathophysiological mechanisms involved in human NEC development are briefly described to give context for the findings of altered pathophysiological mechanisms of NEC by enteral feeding interventions. Full article
(This article belongs to the Special Issue Health Benefits of Pharmacological Nutrition in Neonates)
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19 pages, 372 KiB  
Review
Impact of Parenteral Lipid Emulsion Components on Cholestatic Liver Disease in Neonates
by Gregory Guthrie and Douglas Burrin
Nutrients 2021, 13(2), 508; https://doi.org/10.3390/nu13020508 - 4 Feb 2021
Cited by 17 | Viewed by 4260
Abstract
Total parenteral nutrition (TPN) is a life-saving intervention for infants that are unable to feed by mouth. Infants that remain on TPN for extended periods of time are at risk for the development of liver injury in the form of parenteral nutrition associated [...] Read more.
Total parenteral nutrition (TPN) is a life-saving intervention for infants that are unable to feed by mouth. Infants that remain on TPN for extended periods of time are at risk for the development of liver injury in the form of parenteral nutrition associated cholestasis (PNAC). Current research suggests the lipid component of TPN is a factor in the development of PNAC. Most notably, the fatty acid composition, vitamin E concentration, and presence of phytosterols are believed key mediators of lipid emulsion driven PNAC development. New emulsions comprised of fish oil and medium chain triglycerides show promise for reducing the incidence of PNAC in infants. In this review we will cover the current clinical studies on the benefit of fish oil and medium chain triglyceride containing lipid emulsions on the development of PNAC, the current constituents of lipid emulsions that may modulate the prevalence of PNAC, and potential new supplements to TPN to further reduce the incidence of PNAC. Full article
(This article belongs to the Special Issue Health Benefits of Pharmacological Nutrition in Neonates)
13 pages, 710 KiB  
Review
The Role of Human Milk Oligosaccharides and Probiotics on the Neonatal Microbiome and Risk of Necrotizing Enterocolitis: A Narrative Review
by Lila S. Nolan, Jamie M. Rimer and Misty Good
Nutrients 2020, 12(10), 3052; https://doi.org/10.3390/nu12103052 - 6 Oct 2020
Cited by 75 | Viewed by 9656
Abstract
Preterm infants are a vulnerable population at risk of intestinal dysbiosis. The newborn microbiome is dominated by Bifidobacterium species, though abnormal microbial colonization can occur by exogenous factors such as mode of delivery, formula feeding, and exposure to antibiotics. Therefore, preterm infants are [...] Read more.
Preterm infants are a vulnerable population at risk of intestinal dysbiosis. The newborn microbiome is dominated by Bifidobacterium species, though abnormal microbial colonization can occur by exogenous factors such as mode of delivery, formula feeding, and exposure to antibiotics. Therefore, preterm infants are predisposed to sepsis and necrotizing enterocolitis (NEC), a fatal gastrointestinal disorder, due to an impaired intestinal barrier, immature immunity, and a dysbiotic gut microbiome. Properties of human milk serve as protection in the prevention of NEC. Human milk oligosaccharides (HMOs) and the microbiome of breast milk are immunomodulatory components that provide intestinal homeostasis through regulation of the microbiome and protection of the intestinal barrier. Enteral probiotic supplements have been trialed to evaluate their impact on establishing intestinal homeostasis. Here, we review the protective role of HMOs, probiotics, and synbiotic combinations in protecting a vulnerable population from the pathogenic features associated with necrotizing enterocolitis. Full article
(This article belongs to the Special Issue Health Benefits of Pharmacological Nutrition in Neonates)
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