Gastrointesinal function and microbiota development in preterm infants

June 11 2018, Romy D. Zwittink will publicly defend her PhD thesis highlighting the gastrointestinal function and microbiota development in preterm infants during early life. In addition, insights in which host and environmental factors play a key role in this development will be discussed.

Functioning of the gastrointestinal tract, and of the the intestinal microbiota, is central to our overall health and well-being, with a role that extends beyond digestion and absorption of nutrients and fluid.

A healthy GI and microbiota development and function during early life coincides with the development and function of the immune system.

In early life, the intestinal microbiota is relatively unstable and responsive to perturbations. Compared with full-term neonates, preterm infants are more vulnerable since they are born with an immature gut and immune system. Additionally, they are frequently exposed to interventions during hospitalisation, such as caesarean section delivery, antibiotics and respiratory support, which likely affect the development of their microbiota. This makes them prone to health complications, including infections, sepsis and growth retardation. More information on preterm infants and its dietary management can be found here.

Exploration of the gut microbiota and its metabolic traits is particularly relevant in this specific group of infants. It is therefore important to understand how the preterm infant gastrointestinal tract is functioning, which bacteria colonise, what the bacteria are doing and how microbiota establishment is affected. For this, a study in preterm infants called EIBER study was initiated in the Netherlands: a close collaboration between the Wageningen University & Research, the Isala Clinics in Zwolle and Danone Nutricia Research. In this study, the investigators studied how the bacterial community developed during the first six postnatal weeks in extremely and very preterm infants. Secondly, the impact of antibiotics on microbiota development in late preterm infants was investigated.

In her thesis, Romy describes the outcomes of the EIBER study. Via a metaproteomics approach, she demonstrated which proteins are most abundant in the gastric aspirates and fecal samples of preterm infants. These proteins served as an indication for functioning of the gastrointestinal tract and its microbiota. The outcomes reveal that gestational and postnatal age were associated with quantity of specific markers for gut function and maturation, as well as with composition of the gut microbiota. A Bifidobacterium-dominated bacterial community was associated with an increase in proteins involved in carbohydrate and energy metabolism, including those involved in the degradation of complex carbohydrates like human milk oligosaccharides. This might aid energy harvest from milk feedings and subsequent growth of the infant.

Moreover, the thesis describes that antibiotic treatment during the first week of life impacts microbiota development, particularly by increasing Enterococcus species, while decreasing beneficial Bifidobacterium species. In addition, the longer the treatment with antibiotics, the longer the disturbance of the microbiota.

This interesting thesis highlights several factors acknowledged for their influence on microbiota development, such as antibiotics, delivery mode and feeding strategy, as well as a potential influence of gender, respiratory support and maternal preeclampsia.

Romy’s promotor is prof. dr. J Knol, Special Professor intestinal microbiology of early Life, Wageningen University & Research and Research Director Gut Biology & Microbiology, Danone Nutricia Research, The Netherlands. Co-promotor is Dr Clara Belzer, Assistant professor, Laboratory of Microbiology, Wageningen University & Research. Dr. Ingrid Renes, Senior Team Leader & Principal Scientist Gut Biology, Danone Nutricia Research co-investigated and scientifically managed this collaborative study

Details PhD Defence:

  • Date and time:      Monday June 11 2018 at 16:00 hrs.
  • Location:     Auditorium, Wageningen, The Netherlands.
  • Find out more about the defence here

Find out more about Danone Nutricia Research’s work on gut and microbiology here