PREPARE: The impact of synbiotics on the preterm gut microbiota and its connection to gut- and neuro- development.
Despite predominantly technological advances the last two decades, about 30-40% of extremely preterm infants
exhibiting neurodevelopmental deficits and as such put a notable burden on the health care system and society
remains. Dysbiosis of the gut microbiome in preterm infants predisposes the neonate to various major
morbidities and adverse neurological outcomes later in life.
It is hypothesised that the combination of probiotics, prebiotics, and L-glutamine may act synergistically in
premature infants. These three nutritional concepts were tested together in the randomized, double-blind,
controlled, clinical trial NutriBrain (ISRCTN96620855). Using fecal samples from NutriBrain, the main objective of
this PPS is to investigate the gut metaproteome and metagenome and to characterize the impact of the combined
nutrition intervention on gut microbiota composition, microbiota activity, host proteins and dietary proteins. The
fecal metaproteomics approach will be used to identify specific markers for the activity of the probiotic strain
and other microbiota members in the neonatal gut. Moreover, this PPS aims to get mechanistic insight on the
supplemented probiotic, prebiotics and L-glutamine on gut functioning
The secondary objective of this study is to prospectively determine mechanistic links between the microbiome
and neurodevelopment of preterm infants. This will be done by connecting the generated metaproteome data
to data collected within this same study on brain development generated by MRI imaging. The scientific
knowledge generated by this project will help better understand the role of prebiotics, probiotics, and Lglutamine
in the start-up of a microbiome-infant symbiosis in a developmental window prior to a normal termborn
situation. As such, it could allow manufacturers like Danone-Nutricia to develop safe and more optimal
health-stimulating nutritional products tailored to the specific needs in the growing population of (extreme)
premature infants. Ultimately, this research could provide insight in the development, as well as the
interdependencies, of both the gut and neurological system in early life.