Oligofructose and experimental model of neonatal necrotising enterocolitis.

The gut of preterm neonates is colonised with a paucity of bacterial species originating more from the environment than from the mother. Furthermore, a delayed colonisation by bifidobacteria promotes colonisation by potentially pathogenic bacteria. This may contribute towards the development of neonatal necrotising enterocolitis (NEC). The physiopathology of NEC is still unclear but immaturity of the gut, enteral feeding and bacterial colonisation are all thought to be involved. None of the current preventive treatments are considered satisfactory. Modulating the autochthonous microflora by probiotics or prebiotics could be a more reliable approach to prevention. Using gnotobiotic quails as an experimental model of NEC we have shown that onset of intestinal lesions requires a combination of low endogenous lactase activity, lactose in diet, and colonisation by lactose-fermenting bacteria such as the clostridia. The protective role of bifidobacteria was demonstrated in this model through a decrease in clostridial populations and in butyric acid. Oligofructose dietary supplementation was shown to enhance this effect with an increase in the bifidobacterial level and consequently a greater decrease in clostridia. However, oligofructose was unable to promote a bifidobacterial acquisition when the microflora was initially deprived of this group. Nevertheless, oligofructose can act as an anti-infective agent and decrease the occurrence or severity of the lesions depending on the bacteria involved. According to these results and to the fact that oligosaccharides are a major component of breast milk, the addition of oligofructose in formula milks may be a nutritional approach to favouring colonisation by a beneficial flora.

Diet, length of gestation, and fecal short chain fatty acids in healthy premature neonates.

BACKGROUND: Excretion of fecal short-chain fatty acids (SCFAs) may indicate changes in colonic or colonocyte metabolism. The aim of this study was to detect the influence of gestational age and feeding practices on SCFA concentrations and profiles in healthy preterm infants. METHODS: A total of 198 fecal samples (28 infants) were collected from 8 to 21 days of age from 3 groups of preterm infants born at 33 to 37 weeks of gestation and fed either breast milk (group I) or Nutramigen, a lactose-free formula (group II), and extremely preterm infants born before 33 weeks of gestation and fed breast milk (group III). Total SCFA concentrations and SCFA profiles were analyzed using a gas chromographic (GC) procedure. RESULTS: Total fecal SCFA excretion did not differ significantly between group I (mean, 24.0 micromol/g; range, 1.3 to 118.8 micromol/g) and group II (mean, 23.0 micromol/g; range, 3.0 to 73.3 micromol/g). Conversely, differences occurred between SCFA profiles and became significant after day 17. The main differences were a significant increase in the butyric acid concentration (12% versus 30%) with group II. Compared with group I, fecal SCFA concentrations were 3.2-fold lower (7.4 micromol/g; range, 0.3 to 37.4 micromol/g) in group III with no significant changes in the profiles. CONCLUSIONS: Fecal SCFA excretion may vary in absence of any digestive disease. During this study, in terms of gestational age, total SCFA concentrations were significantly lower in extremely premature infants compared with infants born less premature, despite their known higher deficiency in intestinal lactase activity. In terms of diet, the absence of lactose did not lead to a decrease in colonic fermentation and induced changes in SCFA patterns. These new baseline data may offer clues to further development of milk formulas.

Variations in digestive physiology of rats after short duration flights aboard the US space shuttle.

The purpose of this work was to assess the influence of microgravity on several endogenous and microbial parameters of digestive physiology. On the occasion of two Spacelab Life Sciences missions, SLS-1 (a 9-day space flight) and SLS-2 (a 14-day space flight), Sprague-Dawley rats flown aboard the US space shuttle were compared to age-matched ground-based controls. In both flights, exposure to microgravity modified cecal fermentation: concentration and profile of short-chain fatty acids were altered, whereas urea and ammonia remained unchanged. Only in SLS-1 was there an induction of intestinal glutathione-S-transferase. Additional analyses in SLS-2 showed a decrease of hepatic CYP450 and of colonic goblet cells containing neutral mucin. After a postflight recovery period equal to the mission length, only modifications of the hepatic and intestinal xenobiotic metabolizing enzymes still persisted. These findings should help to predict the alterations of digestive physiology and detoxification potential likely to occur in astronauts. Their possible influence on health is discussed.

Oligofructose contributes to the protective role of bifidobacteria in experimental necrotising enterocolitis in quails.

Bifidobacteria are dominant in the gut of full-term infants, although colonisation by them is often delayed in preterm neonates. Bifidobacteria are recognised to have beneficial effects on digestive disorders and they might prevent neonatal necrotising enterocolitis (NEC), a gastrointestinal disease that predominantly affects premature infants. They have been shown to protect gnotobiotic quails against NEC-like lesions when the birds were inoculated with faecal flora from preterm infants, decreasing the clostridial population. The present study was designed to investigate whether oligofructose, which stimulates the activity of bifidobacteria, may enhance their protective role. Experiments were done in eight groups of germ-free quails for 28 days. The groups differed as to their bacterial status, diet and environment. Quails were inoculated with one of two flora from premature twins. The first flora included Bifidobacterium pseudo-catenulatum, Escherichia coli and no clostridia. The second flora included clostridial species and was associated with B. infantis-longum. Caecal bacterial population and metabolism changes were investigated with a lactose (6%) diet versus a lactose-oligofructose (3%-3%) diet, either in a gnotobiotic environment or in an ordinary environment permitting post-colonisation by exogenous bacteria. In both environments and with both flora, oligofructose significantly increased the level of bifidobacteria and this was associated with a decrease of E. coli or C. perfringens and C. ramosum. The bacterial changes in the ordinary environment depended on the initial composition of the microflora and the colonisation resistance against exogenous bacteria was more efficient with the flora that included B. pseudo-catenulatum. The changes in caecal pH and short-chain fatty acids were minimal. It was demonstrated that, irrespective of the environmental conditions, the use of oligofructose helped to prevent the overgrowth of bacteria implicated in necrotising enterocolitis in preterm neonates.

Fecal short-chain fatty acids predict digestive disorders in premature infants.

BACKGROUND: Excretion of fecal short-chain volatile fatty acids (SCFAs) may indicate changes in colonic or colonocyte metabolism. The aim of this study was to detect the existence of an average fecal SCFA profile and to define which changes were associated with clinical events that occurred during the survey period. METHODS: SCFA profiles of 185 stool samples collected from 46 fed preterm neonates (mean birth weight, 1920 g; mean gestational age, 32.8 weeks) were evaluated and their association with digestive disorders or therapy was explored. RESULTS: Total SCFA concentration increased from 0 to 80 micromol/g feces wet weight over the first 20 days of life. A basic SCFA profile revealed the existence of a highly sensitive period between the second and the third week of life. In the absence of any digestive problem (n = 15), the butyric acid (C4) ratio increased from 7% to 24%. Phototherapy (n = 13) enhanced the SCFA concentration but decreased the ratios of C4 and minor acids. Digestive disorders reported included abdominal distention (n = 6) or bleeding (n = 8). Only in the case of bleeding was the SCFA profile changed by an enhancement of C4 by >50%. Antibiotic therapy (n = 3) suppressed SCFA production. CONCLUSIONS: This study supports a hypothesis that changes in the SCFA profile could offer a noninvasive method to anticipate functional modifications of the gastrointestinal tract before the first clinical signs of pathologic events, including necrotizing enterocolitis.

Physiological effects of a pea protein isolate in gnotobiotic rats: comparison with a soybean isolate and meat.

Pea proteins have been considered for the introduction into the human diet only recently. This protein source was tested on nutritional and digestive parameters in heteroxenic male Fischer rats inoculated with a human faecal microflora from a methane producer. Compared to soybean proteins, pea proteins have similar effects on the rat's endogenous and bacterial digestive patterns. Compared to the pea proteins, a diet containing a standard meat meal enhanced the pH and the production of ammonia, while a lyophilized beef meat enhanced that of urea. The diet containing the standard meat decreases short-chain fatty acids and modifies the ratio of caecal short-chain fatty acids. Both animal diets decreased the specific activities of pancreatic proteases such as chymotrypsin (EC 3.4.21.1), trypsin (EC 3.4.21.4), and carboxypeptidase A (EC 3.4.17.1) when compared to the diet containing the pea isolate. In conclusion, the whole composition of the diet, more than the origin of the dietary protein, influences the rat's digestive pattern.

Milk fermented with yogurt cultures and Lactobacillus casei compared with yogurt and gelled milk: influence on intestinal microflora in healthy infants.

Ingestion of fermented dairy products induces changes in the equilibrium and metabolism of the intestinal microflora and may thus exert a healthful influence on the host. We compared the effects of consumption of a traditional yogurt, a milk fermented with yogurt cultures and Lactobacillus casei (YC), and a nonfermented gelled milk on the fecal microflora of healthy infants. Thirty-nine infants aged 10-18 mo were randomly assigned to one of three groups in which they received 125 g/d of one of the three products for 1 mo. The following indexes were not modified during the supplementation period or for 1 wk after the end of supplementation: total number of anaerobes, bifidobacteria, bacteroides, and enterobacteria; pH; water content; concentrations of acetate, butyrate, propionate, and lactate; and bacterial enzyme activity of beta-galactosidase and alpha-glucosidase. In contrast, in the yogurt group the number of enterococci in fecal samples increased (P < 0.05), whereas the percentage of branched-chain and long-chain fatty acids, which are markers of proteolytic fermentation, decreased (P < 0.05). In the YC group, the percentage of children with > 6 log10 colony-forming units lactobacilli/g feces increased (P < 0.05), whereas the potentially harmful enzyme activity of beta-glucuronidase and beta-glucosidase decreased (P < 0.05). These decreases were particularly marked in those infants in the YC group in whom activity of the enzymes was initially unusually high.

Clostridial pathogenicity in experimental necrotising enterocolitis in gnotobiotic quails and protective role of bifidobacteria.

The pathogenesis of neonatal necrotising enterocolitis (NEC) remains unclear. Gnotobiotic quails fed a lactose diet have been used to investigate the role of clostridial strains originating from faecal specimens of neonates through the intestinal lesions, the changes in microflora balance and the production of bacterial metabolites, i.e., short-chain fatty acids and hydrogen. Bifidobacteria are thought to exert various beneficial effects on host health, including interaction with the colonic microflora. Therefore, it was hypothesised that a protective role could be exercised through bifidobacterial colonisation. A Clostridium butyricum strain (CB 155-3) and a whole faecal flora including three clostridial species (C. butyricum, C. perfringens, C. difficile), each from premature infants suffering from NEC, caused caecal lesions in quails similar to those observed in man, i.e., thickening of the caecal wall with gas cysts, haemorrhagic ulceration and necrotic areas. Conversely, a whole faecal flora including bifidobacteria (identified as Bifidobacterium pseudo-catenulatum) and no clostridia, isolated from a healthy premature infant, was unable to produce NEC-like lesions. When the two clostridial groups were associated with a Bifidobacterium strain (B. infantis-longum, CUETM 89-215, isolated from a healthy infant), bifidobacterial colonisation suppressed all pathological lesions. This study is the first demonstration of a protective role for bifidobacteria against NEC via the inhibition of growth of C. butyricum or the disappearance of C. perfringens. C. difficile was not found to be responsible for the aetiology of the caecal lesions in quails. The main effect of bifidobacteria on lactose fermentation was either a dramatic decrease or a disappearance of butyric acid. The protective role was not associated with changes in H2 production. Therefore, a new step between colonic colonisation and its relevance to NEC is thought to involve the fermentation of unabsorbed lactose into butyric acid at the onset of the disease.

The association of yogurt starters with Lactobacillus casei DN 114.001 in fermented milk alters the composition and metabolism of intestinal microflora in germ-free rats and in human flora-associated rats.

The aim of this study was to compare the effects of milk and of various fermented milks on the composition and metabolic activities of the intestinal microflora. Groups of eight rats were fed for 6 wk a diet containing 30% nonfermented milk (M), yogurt (Y), milk fermented with Lactobacillus casei (LcFM) or milk fermented with the association of L. casei DN 114.001 and yogurt starters (LcYFM). In the first study, the survival of the lactic acid bacteria from the fermented milks was assessed by bacterial enumeration in feces of germ-free rats (GF rats) fed milk or fermented milks. The metabolic activities of the lactic acid bacteria were studied in these rats by the measurement of glycolytic activities and products of bacterial fermentation, i.e., acetate and lactate (isoforms L and D). In a second study, the effects of fermented milks on the composition and metabolism [gas, glycolytic activities, short-chain fatty acids (SCFA), alcohol and ammonia] of human flora were studied using human flora-associated rats (HF rats). In GF rats, the survival of L. casei in the feces did not differ between those fed the LcFM and LcYFM diets. L. bulgaricus was detected in the feces of the rats fed Y, whereas Streptoccus thermophilus was found in the feces of the LcYFM group. In HF rats, fecal concentration of Bifidobacteria was greater in the LcFM group than in the others. beta-Glucuronidase (EC 3.2.1.31) activity was lower in rats fed LcFM and Y than in those fed M and LcYFM, whereas beta-galactosidase (3.2.1.23), alpha-glucosidase (EC 3.2.1 20) and beta-glucosidase (EC 3.2.1.21) activities were higher in the LcYFM group compared with the others. Methane excretion was higher in rats fed Y than in other groups. Cecal SCFA concentrations did not differ in LcFM, Y and M groups, but total SCFA, acetate, propionate and butyrate were significantly greater in the LcYFM group. These results suggest that milk fermented with the combination of L. casei and yogurt starters leads to specific effects that are different from the simple addition of the effects found with yogurt and milk fermented with L. casei. These specific effects are potentially beneficial to human health.

Pattern of metabolism and composition of the fecal microflora in infants 10 to 18 months old from day care centers.

BACKGROUND: From 5 months of age, infants are progressively introduced to a variety of foods which influence the equilibrium of the intestinal microflora. METHODS: Thirty-five children age 10-18 months from 8 day care centers in France were studied. Fecal specimens were examined for their biochemical and microbiological criteria. RESULTS: Bifidobacteria and Bacteroides belong to the predominant populations (9.7 and 8.6 log 10 cfu/g, respectively). The mean level of enterobacteria and enterococci were 8.0 and 7.8 log 10 cfu/g, respectively. Only 10% of the infants presented a lactobacilli amount above 6 log 10 cfu/g. Most feces had similar pH values (mean 6.4), percentage of water (mean 76.4%), and short chain fatty acid, ammonia and lactic acid concentrations (means 77, 6.7 and 2.3 mumol/g, respectively). beta-galactosidase had the highest activity (106 IU/g of protein) and nitroreductase, the lowest (0.1 IU/g of protein). alpha-glucosidase and nitrate reductase showed intermediate values of 17 and 4 IU/g of protein, respectively. With the exception of 4 infants, beta-glucosidase and beta-glucuronidase values were low (4 and 2 IU/g of protein). Age and day care center were not significant factors for most parameters studied, except that rotavirus was related to day care center, with detection in 5 infants from the same center. CONCLUSIONS: Many biochemical parameters were comparable to those found in adults, with the exception of ammonia concentration and beta-galactosidase activity. The fecal bacterial profile was different than in adults, with more Bifidobacteria than Bacteroides and higher levels of facultative anaerobes. One infant suffering from gastroenteritis had distinctive biochemical and bacterial parameters.

Effects of chair-restraint on gastrointestinal transit time and colonic fermentation in male rhesus monkey (Macaca mulatta).

The incidence of an 18 day chair-restraint on the digestive physiology of male rhesus monkey was investigated for space research purposes, comparing four trained restraint subjects with two vivarium controls. Chair-restraint induced a 2.5-fold acceleration of the gastrointestinal transit time, which persisted throughout the 7 day postrestraint period, and an increase of the fecal dry matter content, which mean value rose from 40.7% to 69.6%. Fecal pH remained unaltered throughout the experiment. Modifications of fermentative metabolites produced by the colonic microflora and excreted through the breath (hydrogen and methane) or in the feces (short chain fatty acids and ammonia) could not be reliably related to chair-restraint and probably involved side-stress factors. On the whole, alterations due to chair-restraint are shown to be different from those reported in the literature, following a modification of the dietary composition. These data may help to predict the alterations of digestive physiology likely to occur in immobilized human patients.

[Digestive amines of bacterial origin and behavior disorders. Apropos of a case]. / Amines digestives d'origine bactérienne et troubles comportementaux. A propos d'une observation.

Implication of amines in central nervous system diseases such as migraine, Parkinson disease, epilepsy and depressive illness, is well established. On an other hand, intestinal flora is responsible for the production of specific metabolites such as amines, particularly histamine, tyramine, putrescine and cadaverine. These amines can be absorbed in situ and, through unknown mechanisms, may affect the host's behavior. Most of the data about the pathological activities of bacterial amines concern animals. The concentrations of histamine, tyramine, putrescine and cadaverine in the feces of the studied "controls" appeared steady over time. For the patient presenting clastic crisis without any starting factor, variations appear to overcome the "controls" values, with a great variability. At least tyramine, putrescine and cadaverine concentrations variations are striking by superposed and seem associated to the arising hyper agressivity crisis.

Effect of two levels of transgalactosylated oligosaccharide intake in rats associated with human faecal microflora on bacterial glycolytic activity, end-products of fermentation and bacterial steroid transformation.

The effects of two levels of transgalactosylated oligosaccharide (TOS) intake on bacterial glycolytic activity, end products of fermentation and bacterial steroid transformation were studied in rats associated with a human faecal flora. Rats were fed a human-type diet containing 0, 5 or 10% TOS. Caecal pH decrease correlated with the amount of TOS in the diet. Intake of the TOS diet induced a decrease in blood cholesterol and a strong increase in beta-galactosidase activity in the hindgut. TOS fermentation led to production of hydrogen and short chain fatty acids, whereas ammonia and branched-chain fatty acids were decreased. A diet containing 10% TOS increased caecal lactic acid concentrations and reduced beta-glucuronidase activities and steroid transformation.

Influence of caecal microflora and of two dietary protein levels on the adaptation of the exocrine pancreas: comparative study in germ-free and conventional rats.

Dietary proteins are degraded by both endogenous enzymes and the caecal microflora. In conventional rats the enzyme content of the pancreas depends on the amount of dietary protein. The influence of the caecal microflora on this process is unknown. We report here the effect of the caecal microflora on pancreatic enzymes (proteases, amylase (EC 3.2.1.1), lipase (EC 3.1.1.3)) and on colonic metabolites (NH3, urea, short-chain fatty acids). Germ-free and conventional male Fischer rats were fed for 3 weeks with a diet containing 220 or 450 g protein/kg provided as a mixture of fish concentrate and soyabean isolate. The excretion of NH3 and the pH were specifically increased by the high-protein diet in the germ-free rats. The higher production of isobutyrate, valerate and isovalerate in conventional rats fed on the high-protein diet reflected a high bacterial proteolytic activity since these short-chain fatty acids are specific indicators of this activity. The microflora hydrolysed urea to NH3 and maintained the pH at neutrality whatever the amount of protein in the diet since there were changes in germ-free rats but not in conventional ones. In germ-free rats, amylase, trypsin (EC 3.4.21.4), elastase (EC 3.4.21.36) and carboxypeptidase A (EC 3.4.17.1) specific activities were significantly lower than in conventional rats. The adaptation of the pancreas to the 450 g protein/kg diet was not impaired by the bacterial status except for the specific activity of chymotrypsin (EC 3.4.21.1) which was more increased by this diet in germ-free than in conventional rats. Moreover, the specific activity of lipase increased only in conventional rats fed on the 450 g protein/kg diet. In conclusion, we observed a relationship between the enzyme content of the pancreas and the presence or absence of the caecal microflora suggesting that bacterial fermentation influences pancreatic function.

Comparative study of the fermentative characteristics of inulin and different types of fibre in rats inoculated with a human whole faecal flora.

It is known that the physico-chemical characteristics of fibre modify their fermentation characteristics in the colon. Previously we showed the varying effects of inulin and different types of fibre on the hepatic and intestinal xenobiotic-metabolizing enzymes (XME) in initially germ-free rats inoculated with a human, methanogenic, whole-faecal flora (Roland et al. 1994). The aim of the present work was to assess whether or not these effects could be related to differences in production of fermentation metabolites (gases excreted in vivo and caecal metabolites) due to the different compositions of fibre. The different types of fibres were analysed with regard to their solubility and their composition of neutral monomers and uronic acids. Inulin was totally soluble, carrot (Daucus carota), cocoa (Theobroma cacao) and wheat bran were partially soluble; pea (Pisum sativum) and oat were nearly totally insoluble. Uronic acids were found mostly in carrot and cocoa fibre. Glucose was present as the main neutral monomer in each fibre type. Xylose was found also in wheat bran, pea and oat fibres, and arabinose was found in wheat bran. Inulin consumption led to high levels of H2 production but no CH4 production, to a 4-fold greater caecal concentration of butyrate than with the other fibres and to a decrease in caecal pH. Conversely, rats fed on carrot or cocoa fibre produced a large amount of CH4 but no H2 and generated a different profile of short-chain fatty acids (SCFA). The lowest amounts of gases and SCFA were found in rats fed on wheat bran, pea and oat fibre. We observed a relationship between the caecal concentration of SCFA and the activity of hepatic glutathione-S-transferase (EC 2.5.1.18) but no direct link was shown between the other XME and the fermentation profile.

Degradation and fermentation of alpha-gluco-oligosaccharides by bacterial strains from human colon: in vitro and in vivo studies in gnotobiotic rats.

The ability of several human gut bacteria to break down alpha-1,2 and alpha-1,6 glycosidic linkages in alpha-gluco-oligosaccharides (GOS) was investigated in vitro in substrate utilization tests. Bacteroides thetaiotaomicron, Bifidobacterium breve and Clostridium butyricum, which are usually found in the infant gut and have been associated with both beneficial and deleterious effects on health, were studied. Alpha-Gluco-oligosaccharide degradation was compared in vitro and in vivo in gnotobiotic rats associated with these organisms, inoculated alone or in combination. Oligomer breakdown and short chain fatty acid and gas production indicated hydrolysis and fermentation of the substrate. In vitro and in vivo, Cl. butyricum was the least efficient in utilizing GOS, whereas Bact. thetaiotaomicron was the most efficient. Kinetic studies on GOS hydrolysis in pH-regulated fermenters showed that alpha-1,2 glucosidic bonds, which characterize the substrate, were more resistant than alpha-1,6 linkages. Adaptation of gnotobiotic rats to a diet containing 2% (w/w) GOS significantly increased the hydrolysis of alpha-1,2 glucosidic bonds. Combination of bacteria in trixenic rats improved GOS degradation and inhibited Cl. butyricum metabolism. This inhibition was confirmed in pH-regulated fermenters containing GOS as the principal carbon source. The association of beneficial bacteria and GOS may therefore have a potential health-promoting effect in human neonates.

Rape-seed meal toxicity in gnotobiotic rats: influence of a whole human faecal flora or single human strains of Escherichia coli and Bacteroides vulgatus.

Gnotobiotic growing rats harbouring either a whole human faecal flora or single human strains of Escherichia coli (EM0) or Bacteroides vulgatus (BV8H1) were fed for 7 weeks on semi-synthetic diets in which the protein source was either soya-bean meal (SM) or rape-seed meal (RM). For each bacterial status the RM-diet group was compared with the control group fed on the SM diet. The association of human faecal flora with the RM diet was responsible for reduced feed intake and reduced weight gain, an enlargement of the liver and thyroid and a decrease in both thyroxine and triiodothyronine plasma levels. The association of the B. vulgatus BV8H1 strain with the RM diet reproduced all these effects, except that triiodothyronine plasma levels were not significantly modified. Rats inoculated with the E. coli EM0 strain and fed on the RM diet exhibited a goitre and lowered thyroxine and triiodothyronine plasma levels. These results show that the human intestinal microflora may be involved in glucosinolate metabolism when cruciferous vegetables are consumed by man. The specificity of the symptoms observed according to the rat bacterial status supports the hypothesis that bacteria yield specific toxic glucosinolate derivatives according to their enzymic potential.