Mannose-binding lectin deficiency in preterm neonates

Background: Mannose-binding lectin (MBL) is a collagenous protein that plays a role in innate immunity. MBL deficiency is associated with an opsonization defect and has been associated with recurrent infections, especially in immunocompromised individuals. Neonates are considered to be immunocompromised because adaptive immunity has not yet been developed. Objective: This study was done to evaluate the levels of MBL in premature neonates and to determine the relation between MBL deficiency and development of sepsis. Methods: This case- control study was conducted on 64 neonates classified into 2 groups; 39 preterm neonates with gestational age (G.A) <36 weeks and 25 healthy full term neonates. Measurement of mannose-binding lectin (MBL) serum level was done on the first day of life using ELISA technique. Results: Mean MBL plasma level was found to be lower in preterm than full term neonates, yet this difference did not reach statistical significance. There was a negative correlation albeit an insignificant one, between MBL level and GA. The deficient group (those with MBL level ≤0.7μg/ml) had higher incidence of sepsis, albeit an insignificant one, than the non deficient group. A highly significant positive correlation was demonstrated between MBL plasma level in neonatal and umbilical cord blood samples. Conclusion: Premature neonates have low MBL serum levels which could be measured in either their venous or umbilical cord blood efficiently. Further studies are needed to investigate the relationship between MBL deficiency and neonatal sepsis and whether measuring MBL levels might be used to identify which neonates are prone to infections.Keywords: Mannose binding lectin, neonates, preterm, sepsisEgypt J Pediatr Allergy Immunol 2010;8(2):75-8

Enteral L-Arginine and Glutamine Supplementation for Prevention of NEC in Preterm Neonates

Objective. Evaluating the efficacy and safety of arginine and glutamine supplementation in decreasing the incidence of NEC among preterm neonates. Methods. Prospective case-control study done on 75 preterm neonates ≤34 weeks, divided equally into L-arginine group receiving enteral L-arginine, glutamine group receiving enteral glutamine, and control group. Serum L-arginine and glutamine levels were measured at time of enrollment (sample 1), after 14 days of enrollment (sample 2), and at time of diagnosis of NEC (sample 3). Results. The incidence of NEC was 9.3%. There was no difference in the frequency of NEC between L-arginine and control groups (P>0.05). NEC was not detected in glutamine group; L-arginine concentrations were significantly lower in arginine group than control group in both samples while glutamine concentrations were comparable in glutamine and control groups in both samples. No significant difference was found between groups as regards number of septic episodes, duration to reach full oral intake, or duration of hospital stay. Conclusion. Enteral L-arginine supplementation did not seem to reduce the incidence of NEC. Enteral glutamine may have a preventive role against NEC if supplied early to preterm neonates. However, larger studies are needed to confirm these findings. This work is registered in ClinicalTrials.gov (ClinicalTrials.gov Identifier: NCT01263041)

Synbiotic Tarhana as a functional food

Abstract: In the present study formulated synbiotic tarhana (Turkish fermented cereal food) was produced as a functional food from the fermentation of wheat flour, some spices [salt, pepper, dill and sweet marjoram (Organum majorana)], some vegetables [tomato (Lycoprsicum esculentum), pepper (Capsicum annum) and onion (Allium cepa)], and synbiotic yoghurt which prepared with prebiotic (inulin and lactose each 3%) and different concentrations of the probiotic culture (0.5, 1.5, 3, 4.5% DVS-ABT2 containing Streptococcus thermophilus, Lactobacillus acidophilus and Bifidobacterium bifidum). After fermentation (3 days), tarhana dough was dried in the sun. The effect of the fermentation (0, 1, 2 and 3 days) and the probiotic culture concentration on the chemical composition and the probiotic population of the wet tarhana were evaluated. The effect of the probiotic culture concentration on the chemical composition, the probiotic population and the sensory attribute of dried tarhana were evaluated. Also the effect of dried tarhana (prepared from yoghurt which was fermented by 4.5% probiotic culture) on the plasma lipid profile of human subjects was studied. The results showed that the pH value decreased while the acidity increased, acetaldehyde and diacetyl values increased during the fermentation period and by increasing the probiotic culture concentration of the wet and the dried tarhana. Neither the fermentation nor the concentration of the probiotic culture of wet and dried tarhana affected the crude protein, ether extract, crude fibre, and ash values. The numbers of probiotic bacteria increased until the second day of fermentation. However, in the following day, with an increase of the acid content their number decreased. Generally the increasing of the probiotic culture concentration increased the numbers of probiotic bacteria of the wet and dried tarhana. Also the concentration of the probiotic culture didn't affect the sensory attributes of dried tarhana. Subjects supplemented with dried tarhana showed significant reduction in total plasma cholesterol, low density lipoproteins (LDL-C) and triglycerides, while high density lipoprotein (HDL-C) increased