Metabolomics and fetal-neonatal nutrition: Between "not enough" and "too much"

Metabolomics is a new analytical technique defined as the study of the complex system of metabolites that is capable of describing the biochemical phenotype of a biological system. In recent years the literature has shown an increasing interest in paediatric obesity and the onset of diabetes and the metabolic syndrome in adulthood. Some studies show that fetal malnutrition, both excessive and insufficient, may permanently alter the metabolic processes of the fetus and increase the risk of future chronic pathologies. At present then, attention is being focused mainly on the formulation of new hypotheses, by means of metabolomics, concerning the biological mechanisms to departure from fetal-neonatal life that may predispose to the development of these diseases. © 1996-2013 MDPI AG

Congenital remnants as a cause of neonatal respiratory impairment

Neonatal respiratory distress is a potentially life-threatening condition, representing a diagnostic and therapeutic challenge for physicians, especially when it is caused by rare pathologies. Head and neck remnants are benign congenital neoplasms rarely observed in newborns. Teratoma is the most common congenital tumor in childhood, while head and neck epithelial and mesenchymal hamartomas are uncommon. We report three cases of pharyngeal congenital remnants presenting with neonatal airway obstruction. We observed a 9-month-old, 35-day-old, and 15-hour-old patients, who have been referred to our Department of Otorhinolaryngology with acute airway distress. All the patients showed a pharyngeal benign lesion, since teratomas originated from the left lateral wall of the pharynx in two cases and one “fibrovascular” hamartoma originated from the base of the tongue. Timely surgical excision through transoral CO2 laser microsurgery was curative in all the cases. Dyspnoea in newborns is a challenging condition and must be managed, when possible, by a well-trained paediatric team. When clinicians face obstructive airway congenital remnants, a timely and radical surgical excision is necessary to avoid potentially lethal asphyxia

Breast milk stem cells: four questions looking for an answer

The finding of stem/progenitor cells in the maternal milk and the discovery of their multilineage potential, associated with some evidence regarding the ability of maternal cells to cross the gastrointestinal barrier and integrate into the organs of the breastfed neonate, has opened an intriguing debate, regarding the strict relationship between mother and son in the postnatal period. In particular, thanks to the discovery of the presence in high quantities of mammary stem cells, a new vision of maternal milk is emerging, in which breastfeeding appears as an unique occasion for reinforcing the physiological development of the newborn, putting all the formulas at a different level of relevance for the neonate. In this contribution the authors try to give an answer to the following 4 questions: 1. is there heterogeneity and a hierarchy among breast milk stem cells? 2. can stem cells present in breast milk enter into the newborn organism? 3. can breast milk stem cells integrate in the neonatal organs and differentiate toward different tissues, including neurons and neuroglia? 4. could metabolomics be useful for the study of stem cells in the human milk

Exploring the effect of vitamin D and DHA supplementation on the urine metabolome of preterm infants by 1H NMR-based metabolomics

Background and objectives: Vitamin D and docosahexaenoic acid (DHA) insufficiency and deficiency could potentially have a great impact on health outcomes in preterm infant. Due to the importance of early nutrition intervention in this population and given the lack of metabolomic studies concerning the supplementations effect on the metabolome of preterm infants, 44 premature infants were studied, divided in two groups, one receiving only vitamin D (DS) and the second both vitamin D and DHA (D-DHAS) supplementation. Two were the main objectives of the study: 1) to look at changes over time in the urinary metabolic profiles of infants before and over two months of supplementation; 2) to compare the urinary metabolome of the two groups after supplementation. Methods: 1H NMR-based metabolomics approach was used to analyze urine samples obtained from preterm newborns at three different time points: at the time of hospital discharge and before supplementation (T0), 1 month (T1) and 2 months (T2) after the beginning of supplementation. Results: A clear temporal dynamics of the urinary metabolic profiles of preterm infants was highlighted by OPLS analysis. Both groups were characterized by growing levels of betaine, N,N-dimethylglycine, creatinine, creatine and guanidinoacetate and diminishing levels of myo-inositol and hydroxyproline with increasing postmenstrual age (PMA). Additionally, for D-DHAS citrate and dimethylamine increased, while lactate decreased over time. OPLS-DA clearly discriminated the two groups after two months of supplementation. Compared to DS, D-DHAS group was characterized by higher levels of betaine, N,N-dimethylglycine, creatinine and dimethylamine and lower amounts of lactate and myo-inositol. Conclusions: Metabolomic analysis of urine from the neonatal period could be a useful tool to understand metabolic processes linked to early nutrition and supplementation. According to our results, vitamin D supplementation exerts in preterm newborns positive effects evaluated with urinary metabolomics. Moreover, it seems that the supplementation with vitamin D and DHA exerts a higher antioxidant and protective action on newborns, and it could also positively affect the body fat composition

Multipotent stem cells of mother's milk

In recent years the presence of stem cells (hBSCs: human breastmilkderived stem cells) and epithelial progenitors has been demonstrated in mother’s milk (MM). Stem cells present in samples of fresh MM exhibit a high degree of vitality and this makes possible the performance of cell cultures and to evaluate the differentiation capacity of the hBSCs. The most important datum that expresses the enormous potential of the use of MM stem cells is the presence of a cell population capable of differentiating into the three mesoderm, endoderm and ectoderm lines. The small number of studies and MM samples analyzed and the different sampling methods applied suggest standardization in the collection, analysis and culture of MM in future studies, in consideration of the well-known extreme variability of MM composition, also from the standpoint of cells. The analysis of literature data confirms the uniqueness of MM and its enormous potential

Developmental programming of auditory learning

The basic structures involved in the development of auditory function and consequently in language acquisition are directed by genetic code, but the expression of individual genes may be altered by exposure to environmental factors, which if favorable, orient it in the proper direction, leading its development towards normality, if unfavorable, they deviate it from its physiological course. Early sensorial experience during the foetal period (i.e. intrauterine noise floor, sounds coming from the outside and attenuated by the uterine filter, particularly mother’s voice) and modifications induced by it at the cochlear level represent the first example of programming in one of the earliest critical periods in development of the auditory system. This review will examine the factors that influence the developmental programming of auditory learning from the womb to the infancy. In particular it focuses on the following points: • the prenatal auditory experience and the plastic phenomena presumably induced by it in the auditory system from the basilar membrane to the cortex; • the involvement of these phenomena on language acquisition and on the perception of language communicative intention after birth; • the consequences of auditory deprivation in critical periods of auditory development (i.e. premature interruption of foetal life)

Breast Milk and COVID-19: From Conventional Data to “Omics” Technologies to Investigate Changes Occurring in SARS-CoV-2 Positive Mothers

In this context of COVID-19 pandemic, great interest has been aroused by the potential maternal transmission of SARS-CoV-2 by transplacental route, during delivery, and, subsequently, through breastfeeding. Some open questions still remain, especially regarding the possibility of finding viable SARS-CoV-2 in breast milk (BM), although this is not considered a worrying route of transmission. However, in BM, it was pointed out the presence of antibodies against SARS-CoV-2 and other bioactive components that could protect the infant from infection. The aim of our narrative review is to report and discuss the available literature on the detection of anti-SARS-CoV-2 antibodies in BM of COVID-19 positive mothers, and we discussed the unique existing study investigating BM of SARS-CoV-2 positive mothers through metabolomics, and the evidence regarding microbiomics BM variation in COVID-19. Moreover, we tried to correlate metabolomics and microbiomics findings in BM of positive mothers with potential effects on breastfed infants metabolism and health. To our knowledge, this is the first review summarizing the current knowledge on SARS-CoV-2 effects on BM, resuming both “conventional data” (antibodies) and “omics technologies” (metabolomics and microbiomics)

Stem cells from glomerulus to distal tubule: a never-ending story?

The growing interest of research in the field of renal stem cells and kidney regeneration aims to get results that allow its clinical application, favoring the birth and development of regenerative medicine. Nephrogenesis requires differentiation into epithelial cells of a population of progenitor mesenchymal cells. Since this process ends at 36-38 weeks of gestational age, it is quite likely to imagine that such a population disappears in the human kidney after birth. However, several studies have identified in different parts of the adult kidney cells having the characteristics of stem cells that would be involved in renal regenerative processes. They may be classified as resident mesenchymal/epithelial progenitors and often share the same genetic and epigenetic profile as progenitor stem cells active during embryonic life, thus suggesting a common origin. Current literature includes two lines of thought: one attributes to stem cells a fundamental role in renal regeneration processes while the other sustains the intervention of other mechanisms. The aim of this review is to report on progress made in research in the field of kidney regeneration starting from the past century and arriving at the present, with an analysis of scientific works that have produced the most important results in this field.   Proceedings of the 2nd International Course on Perinatal Pathology (part of the 11th International Workshop on Neonatology · October 26th-31st, 2015) · Cagliari (Italy) · October 31st, 2015 · Stem cells: present and future Guest Editors: Gavino Faa, Vassilios Fanos, Antonio Giordan

Impaired central arterial elasticity in young adults born with intrauterine growth restriction

BACKGROUND: Intrauterine growth retardation and prematurity at birth constitute risk factors for future cardiovascular adverse events. Some previous reports have highlighted that subjects born preterm may develop peripheral arterial dysfunction. However, central (aortic) arterial distensibility has not yet been fully investigated in these subjects. METHODS: Sixty subjects were enrolled: thirty were high grade ex-preterm subjects (10 males [M] and 20 females [F], aged 17-28, mean 20.1±2.5 years). They were compared with 30 healthy, age-matched subjects born at term (C, 10 M and 20 F). Central aortic elasticity was assessed non-invasively by calculating two indexes derived from echocardiographic and blood pressure measures: aortic root distensibility and aortic stiffness index. RESULTS: Aortic distensibility was significantly lower (P<0.0001), and aortic stiffness index was significantly higher (P<0.0001) in former preterm individuals than in controls. The above stated indexes were correlated with birth weight (r=0.78, P<0.0001 and r=-0.41, P=0.02, respectively), as well as with gestational age (r=0.54, P=0.002 and r=-0.37, P=0.04, respectively). When excluding the influence of body mass index, intrauterine growth restriction -expressed as birth weight -remains the only determinant of impaired central arterial elasticity. CONCLUSIONS: Since aortic distensibility usually impairs in time, former preterm subjects appear to have a "vascular age" older than their healthy born at term peers. This finding may have important implications for cardiovascular morbidity in later life