Noninvasive Fecal Cytokine and Microbiota Profiles Predict Commencement of Necrotizing Enterocolitis in a Proof-of-Concept Study

Overview

Journal Gastro Hep Adv

Specialty Gastroenterology

Date 2023 Jul 20

PMID 37469521

Authors

Christian Zenner

Lisa Chalklen

Helena Adjei

Matthew J Dalby

Suparna Mitra

Emma Cornwell

Alexander G Shaw

Kathleen Sim

J Simon Kroll

Lindsay J Hall

Affiliations

Soon will be listed here.

Abstract

Background And Aims: Necrotizing enterocolitis (NEC) is a life-threatening disease and the most common gastrointestinal emergency in premature infants. Accurate early diagnosis is challenging. Modified Bell's staging is routinely used to guide diagnosis, but early diagnostic signs are nonspecific, potentially leading to unobserved disease progression, which is problematic given the often rapid deterioration observed. We investigated fecal cytokine levels, coupled with gut microbiota profiles, as a noninvasive method to discover specific NEC-associated signatures that can be applied as potential diagnostic markers.

Methods: Premature babies born below 32 weeks of gestation were admitted to the 2-site neonatal intensive care unit (NICU) of Imperial College hospitals (St. Mary's or Queen Charlotte's & Chelsea) between January 2011 and December 2012. During the NICU stay, expert neonatologists grouped individuals by modified Bell's staging (healthy, NEC1, NEC2/3) and fecal samples from diapers were collected consecutively. Microbiota profiles were assessed by 16S rRNA gene amplicon sequencing and cytokine concentrations were measured by V-Plex multiplex assays.

Results: Early evaluation of microbiota profiles revealed only minor differences. However, at later time points, significant changes in microbiota composition were observed for Bacillota (adj. = .0396), with being the least abundant in Bell stage 2/3 NEC. Evaluation of fecal cytokine levels revealed significantly higher concentrations of IL-1α ( = .045), IL-5 ( = .0074), and IL-10 ( = .032) in Bell stage 1 NEC compared to healthy individuals.

Conclusion: Differences in certain fecal cytokine profiles in patients with NEC indicate their potential use as diagnostic biomarkers to facilitate earlier diagnosis. Additionally, associations between microbial and cytokine profiles contribute to improving knowledge about NEC pathogenesis.

Citing Articles

Characterising the metabolic functionality of the preterm neonatal gut microbiome prior to the onset of necrotising enterocolitis: a pilot study.

Chapman J, Wroot E, Brown T, Beck L, Embleton N, Berrington J BMC Microbiol. 2024; 24(1):533.

PMID: 39716092 PMC: 11665080. DOI: 10.1186/s12866-024-03701-x.

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