Phylogenetic and Metabolic Tracking of Gut Microbiota during Perinatal Development

The colonization and development of gut microbiota immediately after birth is highly variable and depends on several factors, such as delivery mode and modality of feeding during the first months of life. A cohort of 31 mother and neonate pairs, including 25 at-term caesarean (CS) and 6 vaginally (V) delivered neonates (DNs), were included in this study and 121 meconium/faecal samples were collected at days 1 through 30 following birth. Operational taxonomic units (OTUs) were assessed in 69 stool samples by phylogenetic microarray HITChip and inter- and intra-individual distributions were established by inter-OTUs correlation matrices and OTUs co-occurrence or co-exclusion networks. H-1-NMR metabolites were determined in 70 stool samples, PCA analysis was performed on 55 CS DNs samples, and metabolome/OTUs co-correlations were assessed in 45 CS samples, providing an integrated map of the early microbiota OTUs-metabolome. A microbiota "core" of OTUs was identified that was independent of delivery mode and lactation stage, suggesting highly specialized communities that act as seminal colonizers of microbial networks. Correlations among OTUs, metabolites, and OTUs-metabolites revealed metabolic profiles associated with early microbial ecological dynamics, maturation of milk components, and host physiology.Peer reviewe

Jejunal atresia and anterior chamber anomalies: Further delineation of the Strømme syndrome

Strømme syndrome is a rare multiple congenital malformation syndrome consisting in apple peel intestinal atresia, ocular anomalies, microcephaly and developmental delay. To date, this condition was described in a couple of sibs and 7 additional sporadic patients. We report on a 11-month-old female, who requested surgical correction for jejunal atresia shortly after birth and also presented with megalocornea and persistence of the pupillary membrane. Microcephaly and developmental delay were absent at last examination. An oligonucleotide CGH-array analysis excluded cryptic chromosome rearrangement(s). Comparison of the previously published and present patients added some details on the natural history of Strømme syndrome. Delivery is usually performed preterm possibly due to polyhydramnios. Birth parameters, especially head circumference, are commonly at the lower end of the normal range. Microcephaly is more frequently but not constantly observed in older individuals, thus suggesting a progressive course, and may relate to an underlying neuronal migration defect. Jejunal atresia has an apple peel appearance in most but not all patients and its post-surgical course is usually uneventful. The ocular phenotype comprises a wide range of anterior chamber anomalies with sclerocornea/corneal leukoma being the most common. © 2010 Elsevier Masson SAS. All rights reserved

A novel approach in the treatment of neonatal gastroschisis: a review of the literature and a single-center experience

Gastroschisis is a congenital abdominal wall defect and its management remains an issue. We performed a review of the literature to summarize its evaluation, management and outcome and we describe a new type of surgical reduction performed in our center without anesthesia (GA), immediately after birth, in the delivery room. Between January 2002 and March 2013, we enrolled all live born infants with gastroschisis referred to the third-level Division of Obstetrics and Gynecology "San Camillo" of Rome. Two groups of infants were identified: group 1 in which gastroschis reduction was performed by the traditional technique and group 2 in which reduction was immediately performed after birth in the delivery room without GA. Twelve infants were enrolled in group 1, and seven infants in group 2. Statistical significance was observed between the groups regarding the hospital stay, for the duration of parenteral nutrition and full oral feeds (p = .004). Survival was similar between two groups. The reduction without GA performed immediately after birth in a delivery room encourages the relationship between the mother and her child and appears to be a safe and feasible technique in a selected group of patients with simple gastroschisis defect; for this reason, it could represent a valid alternative to traditional approach

Pearson’s correlation heat maps for the 130 genus-like groups from the HITChip microarray.

<p>Panels A, B, and C show the correlation levels (represented by colored squares) among groups, which were calculated by Pearson’s test for all 3 groups (CS-delivered 1–3 days, CS-delivered 7–30 days, and V1-3 delivered days). Only correlations with a significance <i>p</i><0.05 are represented. The colored scale indicates the correlation values.</p

Principal Components Analysis (PCA) of metabolic profiles from 55 CS-delivered newborns.

<p>Samples were analysed over the 30 days following birth. <b>Panel A</b>: PC score plot. <b>Panel B</b>: loading plot. The first two components explained 42% of the total variance. </p

Mother-neonate clinical features and sample numbers and analysis types at each time point.

<p>Data are shown as median and interquartile range or percentage.</p><p>¹BMI, body mass index</p><p>²APGAR, appearance, pulse, grimace, activity, respiration</p><p>³FM, first- milk. or colostrum; BM, breast-milk; fM, formula-milk; MM, mixed-milk, BM plus fM.</p><p>Mother-neonate clinical features and sample numbers and analysis types at each time point.</p

Pie chart representing phyla taxa median values for 30 days following birth.

<p>Statistically significant differences in relative abundance at each time point are reported below each graph (Kruskal-Wallis). <b>Phyla correlation heat maps.</b> Correlation levels (represented as colored squares) among phyla were calculated by Pearson’s test for all 6 time points. Only squares with a significance <i>p</i><0.05 are shown. Blue squares represent a positive correlation and red squares represent a negative correlation. <b><i>Panel A</i></b> and <b><i>Panel B</i></b> report analyses for 1–3 days (phase “a”) and 7–30 days (phase “b”), respectively.</p

Correlation heat-map between OTUs and faecal metabolites.

<p>Significant correlations (p<0.05) for Actinobacteria (<b>Panel A</b>), Bacteroidetes (<b>Panel B</b>), Proteobacteria (<b>Panel C</b>). 2OH3MB: 2-hydroxy-3-methylbutyrate; Isocapr: Isocaproate; Isoval: Isovalerate; Ile: Isoleucine; Leu: Leucine; EtOH: Ethanol; Fuc: Fucose; 3OH-Isoval: 3-hydroxyisovalerate; Lac: Lactate; Ala: Alanine; But: Butyrate; Ac: Acetate; N-Ac: N-Acetyl moiety; Glu: Glutamate; Suc: Succinate; DMA: Dimethylamine; Asp: Aspartate; TMA: Trimethylamine; Cr: Creatine; MA: Malonate; Cho: choline; MeOH: Methanol; Tyr: Tyrosine; Phe: Phenylalanine; For: Formate.</p

Composition at phylum level of the gut microbiota profiles of 31 infants enrolled in the study for 30 days following birth.

<p>At each time point, the gut microbiota was characterized by HITChip-based phylogeny.</p

Graphical representation of OTUs co-occurrence networks.

<p><b>Panel A</b> shows the OTUs co-occurrence network for CS-delivered babies at 1–3 days following birth (see <b>sheet B</b> in <b><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0137347#pone.0137347.s008" target="_blank">S5 Table</a></b> for details). <b>Panel B</b> shows OTUs co-occurrence network for CS-delivered babies at 7–30 days following birth (see <b>sheet C</b> in <b><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0137347#pone.0137347.s008" target="_blank">S5 Table</a></b> for details). <b>Panel C</b> shows OTUs co-occurrence network for V-delivered babies at 1–3 days following birth (see <b>sheet D</b> in <b><a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0137347#pone.0137347.s008" target="_blank">S5 Table</a></b> for details). Red line indicates a positive correlation and a green line indicates a negative correlation. Pearson’s test was used to evaluate the correlation amongst OTUs (statistical significance was assessed with <i>p</i><0.01).</p