Breastmilk and Microbiota in Protection from NEC in Prematures

Necrotizing enterocolitis (NEC) is a devastating inflammatory condition of the intestine which affects premature infants and causes untold damage. Its pathogenesis has to do with how colonizing bacteria interact with the immature newborn intestine and immature innate immune response with increased TLR-4 on the cell surface and increased signaling molecules such as NFκB can cause the condition. This is in conjunction with a decrease in the appearance of regulatory molecules which effect the control of the innate response. Fortunately, breastmilk and probiotics can affect the condition leading to reduced inflammation. How does the synbiotic effect work? We have shown that breastmilk and Bifidobacteria infantis causes a indole-3-lactic acid response which is anti-inflammatory via inhibition of the acryl hydro receptor which stimulates an IL-8 response. We have also shown that breastmilk carbohydrates interacting with Bacteroides infantis can cause short chain fatty acids to increase which are anti-inflammatory to the newborn intestine. These could help prevent NEC if shown to be effective clinically.