Growth and neurodevelopment in very preterm infants receiving a high enteral volume-feeding regimen - a population-based cohort study

Aim: The aim of this study is to evaluate a feeding regimen routinely providing >180 ml/kg/d fortified human milk to very preterm infants and impact on in-hospital growth, osteopenia, and neurodevelopment. Method: Retrospective population-based descriptive study of infants Results: Ninety-nine infants below 30-week gestation were admitted within 24 h of birth during the 6-year period, of which 84 (85%) survived to discharge. Two infants had surgical necrotizing enterocolitis, both survived to 2 years follow up. Seventy-eight infants (mean 27 weeks) had complete growth data until discharge. Full enteral feeds were tolerated after mean 10 d. Average milk volumes were 193 ml/kg/d from 15 to 42 d of life. Rates of weight below 10th centile were 10% at birth and 14% at discharge. Head circumference Z-scores were stable from birth to discharge. Blood values did not indicate osteopenia. Increasing head circumference Z-scores were associated with improved language development. Conclusions: This high enteral feeding volume regimen was associated with low rates of in-hospital growth restriction and good head growth. High enteral volume intake seems safe and may improve nutritional status of very preterm infants

Lipid antigens in bile from patients with chronic liver diseases activate natural killer T cells

Natural killer T (NKT) cells are an abundant subset of liver lymphocytes activated by lipid antigens presented on CD1d molecules that are expressed by cholangiocytes. We aimed to determine if bile from patients with chronic liver diseases contains antigenic lipids that can activate NKT cells. Using murine invariant (24.7, 24.8 and DN32.D3) and non‐invariant (14S.6, 14S.7 and 14S.10) NKT hybridomas we investigated the presence of lipid antigens in bile collected from the gallbladder of patients undergoing liver transplantation due to end‐stage liver disease. Biliary microbiota profiles were generated using 16S rRNA amplicon sequencing. We found that the patient bile samples contain antigens that activate both invariant and non‐invariant NKT hybridomas (24.7, 24.8, DN32.D3, 14S.6, 14S.7 and 14S.10), as demonstrated by activation of at least one hybridoma by eight of 10 bile samples. Activation at high dilutions suggests that some antigens are highly potent. We used the non‐invariant NKT hybridoma 14S.6 to screen 21 additional patient bile samples for NKT‐reactivity and demonstrated that 12 of 21 bile samples resulted in activation, three of which gave a strong activation. Four of 12 activating bile samples contained microbial DNA. Our results reveal an immunological pathway that could be of critical importance in biliary immunology