Transplantation of feces may protect preterm children from deadly bowel disease

Each year 5-10 per cent of all the children born in the world are born prematurely. At this stage, their organs and immune system are not mature, and the children are therefore highly susceptible to serious infections. One of the problems facing a lot of children born prematurely is the immaturity of the gastrointestinal tract, which among other things causes them to be hypersensitive to bacteria. Now a study conducted by researchers of biomedicine at the University of Copenhagen offers new hope.

In the study the researchers, using pigs born prematurely, have tested feces transplantation - a new type of treatment used on those born prematurely - and shown a drop in the incidence of the fatal bowel disease necrotizing enterocolitis (NEC) following transplantation.

'We are able to protect the bowels of pigs born prematurely by transferring feces from healthy donor pigs via the rectal opening. The composition of intestinal bacteria in these animals changes significantly, and we see 75 per cent fewer cases of NEC. And this is important, because a lot of children die from this disease. If the results can be transferred to children born prematurely, this form of treatment can save lives and possibly reduce the amount of antibiotics given to these patients', says co-author of the study, Professor Per Torp Sangild from the Department of Veterinary and Animal Sciences at the University of Copenhagen.

Fighting for Intestinal Balance

In the study the researchers examined 130 pigs born prematurely. They chose the pig as their test animal, because the gastrointestinal tract of pigs resembles that of humans and because pigs develop a severe intestinal infection that can be compared to NEC.

Scientists do not know exactly why children born prematurely develop this serious intestinal infection, which in up to 40 per cent of the cases is fatal, but they do know that intestinal bacteria play a vital role.

'The bowel is like a battlefront where the new-born and its bacteria must communicate with each other to establish peaceful coexistence. However, the immature bowel is probably not ready to take control and therefore needs good bacteria that contribute to the balance of the system. And the right composition of bacteria appears to be of vital significance. From previous studies among pigs we know that neither probiotics nor faeces from the mother are as effective as feces transplantation. A comparison of seemingly uniform donors has even shown a clear difference in the ability to prevent NEC. We would like to know why this is so', says first author of the study, PhD Student Anders Brunse from the Department of Veterinary and Animal Sciences.

The Importance of Normal Flora

In the study the researchers have measured how the intestinal bacteria composition changes in pigs born prematurely following feces transplantation. This has shown an increase in the wealth of bacteria and the introduction of bacteria that form part of the bowel's normal flora.

'Through feces transplantation immediately after birth we can probably achieve stability in the intestinal bacteria composition faster. This can help them become resistant to bowel infection', says co-author of the study, Professor with Special Responsibilities Thomas Thymann from the Department of Veterinary and Animal Sciences.