Researchers have discovered a biomarker that may help prevent a devastating intestinal disease that occurs in one of every 10 early preterm infants.
The Cincinnati Children's Hospital Medical Center study may help prevent necrotizing enterocolitis (NEC), a condition primarily seen in preemies in which bowel tissue dies. The death rate approaches 30 percent. Survivors are at risk for short-bowel syndrome (caused by surgical removal of the small intestine) and neurodevelopmental disability.
The study is published in the journal Microbiome.
The research, led by Ardythe Morrow, PhD, shows that NEC is preceded by two distinct microbial imbalances in the digestive tract, suggesting that these imbalances "may provide highly predictive biomarkers of NEC," she says.
"Using a combination of early microbial factors, we obtained a predictive value for NEC exceeding 80 percent," says Dr. Morrow. "This requires validation in larger studies, but the findings are striking."
Dr. Morrow's main analysis looked at stool and urine samples collected from 32 infants prior to the onset of disease. The infants were born at less than 29 weeks gestational age.
Eleven of the 32 went on to develop NEC. In all of these cases, NEC was preceded by a dominance of certain types of bacteria in the intestinal tract – either firmicutes in the first week of life or proteobacteria in the second week. Dominance of proteobacteria also occurred in half of those who did not develop NEC.
The team of investigators led by Dr. Morrow also identified a potential simple urine analysis that could help detect the bacterial dominance that occurs in advance of NEC. The research team will attempt to validate its findings in a national study and is studying approaches to prevent the occurrence of NEC in preterm infants.
The study was funded in whole or in part with awards from the National Institute of Child Health and Human Development, National Institutes of Health (grant numbers R01HD059140, P01HD13021, and HD27853); National Center for Research Resources, National Institutes of Health (grant numbers 5UL1RR026314-03, U54HG004969); National Human Genome Research Institute, National Institutes of Health (HG005969); Danone Research (PLF-5972-GD); and the National Institute of Allergy and Infectious Diseases, National Institutes of Health, Department of Health and Human Services, under contract number HHSN272200900018C.
About Cincinnati Children's
Cincinnati Children's Hospital Medical Center is third in the nation in U.S. News and World Report's 2012 Best Children's Hospitals ranking. It is ranked #1 for neonatology and in the top 10 for all pediatric specialties. Cincinnati Children's is one of the top two recipients of pediatric research grants from the National Institutes of Health. It is internationally recognized for improving child health and transforming delivery of care through fully integrated, globally recognized research, education and innovation. Additional information can be found at http://www.cincinnatichildrens.org.
Journal
Microbiome