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Fanos V.,Puericulture Institute and Neonatal Section | Cristina Pintus M.,Puericulture Institute and Neonatal Section | Lussu M.,University of Cagliari | Atzori L.,University of Cagliari | And 14 more authors.
Journal of Maternal-Fetal and Neonatal Medicine

Objective: Bronchopulmonary dysplasia (BPD) or chronic lung disease is one of the principal causes of mortality and morbidity in preterm infants. Early identification of infants at the greater risk of developing BPD may allow a targeted approach for reducing disease severity and complications. The trigger cause of the disease comprehends the impairment of the alveolar development and the increased angiogenesis. Nevertheless, the molecular pathways characterizing the disease are still unclear. Therefore, the use of the metabolomics technique, due to the capability of identifying instantaneous metabolic perturbation, might help to recognize metabolic patterns associated with the condition.Methods: The purpose of this study is to compare urinary metabolomics at birth in 36 newborns with a gestational age below 29 weeks and birth weight <1500 g (very low birth weight-VLBW), admitted in Neonatal Intensive Care Unit (NICU) divided into two groups: the first group (18 cases) consisting of newborns who have not yet developed the disease, but who will subsequently develop it and the second group (18 controls) consisting of newborns not affected by BPD. Urine samples were collected within 24-36 h of life and immediately frozen at-80 °C.Results: The 1H-NMR spectra were analyzed using a partial least squares discriminant analysis (PLS-DA) model coupled with orthogonal Signal Correction. Using this approach it was possible with urine at birth to discriminate newborns that will be later have a diagnosis of BPD with a high statistics power. In particular, we found five important discriminant metabolites in urine in BPD newborns: lactate, taurine, TMAO, myoinositol (which increased) and gluconate (which decreased).Conclusion: These preliminary results seem to be promising for the identification of predictor's biomarkers characterizing the BPD condition. These data may suggest that BPD is probably the result of an abnormal development (respiratory bud, vascular tree, hypodysplasia of pneumocytes) and could be considered a congenital disease (genetics plus intrauterine epigenetics). Early identification of infants at the greater risk of developing BPD may allow a targeted approach for reducing disease severity and complications. © 2014 Informa UK Ltd. Source

Lombardi G.,Neonatal Intensive Care Unit | Garofoli F.,Neonatal Unit and Neonatal Intensive Care Unit | Manzoni P.,Neonatal Intensive Care Unit | Stronati M.,Neonatal Intensive Care Unit
Journal of Maternal-Fetal and Neonatal Medicine

Perinatal transmission of human cytomegalovirus (HCMV) infection in very low birth weight (VLBW) premature infants can lead to serious clinical symptoms and it has ben increasingly recognized that breast milk is the most frequent route of transmission. Breast milk is considered ideal food for newborns because of its nutritional value and anti-infectious components, but it can also be vehicle for viral and bacterial infection. The majority of HCMV seropositive mothers shed the virus into their breast milk and can transmit infection to their offspring. Perinatally acquired infections in full-term neonates are usually asymptomatic without sequelae due to protective maternal HCMV-specific antibodies received during pregnancy. In contrast, VLBW preterm infants are at risk of symptomatic infection with neutropaenia, thrombocytopaenia, sepsis-like syndrome and, less frequently, pneumonia and enteric infection. Postnatally acquired infection seems to spontaneously resolve without altering the clinical outcome. Ganciclovir treatment is restricted to severe symptomatic infections. Preterm infants with a gestational age <30 weeks, or with a birth weight <1000g, are at greater risk of severe postnatal symptomatic HCMV infection, transmitted via maternal milk. The pasteurization of breast milk entirely eliminates infectivity and prevents virus transmission but alters nutritional and immunological milk properties, and freezing reduces, but does not eradicate, infectivity. Most authors encourage fresh maternal breastfeeding because its beneficial effects outweigh the risk of a transient infection, sequelae-free. Nevertheless, an individual decision based on the condition of health of the infant is important. © 2012 Informa UK, Ltd. Source

Dessi A.,University of Cagliari | Liori B.,University of Cagliari | Caboni P.,University of Cagliari | Corsello G.,University of Palermo | And 7 more authors.
Journal of Maternal-Fetal and Neonatal Medicine

The objective of our study was to evaluate the capability of the metabolomics approach to identify the variations of urine metabolites over time related to the neonatal fungal septic condition. The study population included a clinical case of a preterm neonate with invasive fungal infection and 13 healthy preterm controls. This study showed a unique urine metabolic profile of the patient affected by fungal sepsis compared to urine of controls and it was also possible to evaluate the efficacy of therapy in improving patient health. © 2014 Informa UK Ltd. Source

Dessi A.,University of Cagliari | Corsello G.,University of Palermo | Stronati M.,Neonatal Unit and Neonatal Intensive Care Unit | Gazzolo D.,Fetal and Neonatal Health | And 3 more authors.
Early Human Development

Systemic neonatal infection is a serious complication in preterm and term infants and is defined as a complex clinical syndrome caused by bacteria, fungi and virus. Sepsis remains among the leading causes of death in both developed and underdeveloped countries above all in the neonatal period. Earlier diagnosis may offer the ability to initiate treatment to prevent adverse outcomes. There have been many studies on various diagnostic haematological markers like acute phase reactants, C-reactive protein, procalcitonin, interleukins and presepsin. However, there is still no single test that satisfies the criteria as being the ideal marker for the early diagnosis of neonatal sepsis. In this regard, metabolomic analysis seems to be a promising method for determining metabolic variations correlated with systemic neonatal infections. © 2014 Elsevier Ireland Ltd. Source

Civardi E.,Neonatal Unit and Neonatal Intensive Care Unit | Garofoli F.,Neonatal Intensive Care Unit | Mazzucchelli I.,Neonatal Intensive Care Unit | Mazzucchelli I.,University of Pavia | And 4 more authors.
Early Human Development

Human milk (HM) is known as the best nutrition for newborns and support the optimal growth of infants, providing essential substances, nutrients, bioactive and immunologic constituents. HM also grants a favorable microbial colonization with attendant priming/maturation of the gut. The bioactive and immunologic elements of HM demonstrated to protect offspring against infection and inflammation and contribute to immune maturation. Some of these elements are being investigated in order to be used to ameliorate formula milk. A formula milk similar to breast milk may help neonatal gut to build a microbiota near to the one of the breast fed infants, improving the neonate's protection against pathogens.The aim of this review is to summarize the most significant bioactive constituents of HM that own natural anti-infectious properties and contribute to neonatal immune defense. © 2014 Elsevier Ireland Ltd. Source

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