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Hellström A, Kermorvant-Duchemin E, Johnson M, Sáenz de Pipaón M, Smith LE, Hård AL. Nutritional interventions to prevent retinopathy of prematurity. Pediatr Res 2024:10.1038/s41390-024-03208-1. [PMID: 38684884 DOI: 10.1038/s41390-024-03208-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 03/08/2024] [Accepted: 03/23/2024] [Indexed: 05/02/2024]
Abstract
Very preterm infants are at high risk of growth failure. Poor weight gain is a prominent risk factor for retinopathy of prematurity (ROP) and optimizing nutrition could potentially promote growth and reduce ROP. Most infants at risk of ROP need parenteral nutrition initially and studies of enhanced parenteral provision of lipids and amino acids have suggested a beneficial effect on ROP. Higher amino acid intake was associated with lower incidence of hyperglycemia, a risk factor for ROP. For very preterm infants, providing unpasteurized fortified raw maternal breast milk appears to have a dose-dependent preventive effect on ROP. These infants become deficient in arachidonic acid (ArA) and docosahexaenoic acid (DHA) after birth when the maternal supply is lost. Earlier studies have investigated the impact of omega-3 fatty acids on ROP with mixed results. In a recent study, early enteral supplementation of ArA 100 mg/kg/d and DHA 50 mg/kg/d until term equivalent age reduced the incidence of severe ROP by 50%. IMPACT: Previous reviews of nutritional interventions to prevent morbidities in preterm infants have mainly addressed bronchopulmonary dysplasia, brain lesions and neurodevelopmental outcome. This review focusses on ROP. Neonatal enteral supplementation with arachidonic acid and docosahexaenoic acid, at levels similar to the fetal accretion rate, has been found to reduce severe ROP by 50% in randomized controlled trials.
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Affiliation(s)
- Ann Hellström
- Department of Clinical Neuroscience, Institution of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Elsa Kermorvant-Duchemin
- Université Paris Cité, AP-HP, Hôpital Necker-Enfants Malades, Department of Neonatal Medicine, Paris, 75015, France
| | - Mark Johnson
- Department of Neonatal Medicine, University Hospital Southampton NHS Trust, Southampton, UK
- National Institute for Health Research Biomedical Research Centre Southampton, University Hospital Southampton NHS Trust and University of Southampton, Southampton, UK
| | - Miguel Sáenz de Pipaón
- Neonatology Hospital La Paz Institute for Health Research - IdiPAZ, (Universidad Autónoma de Madrid), Madrid, Spain
| | - Lois E Smith
- The Department of Ophthalmology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Anna-Lena Hård
- Department of Clinical Neuroscience, Institution of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Karadayi R, Pallot C, Cabaret S, Mazzocco J, Gabrielle PH, Semama DS, Chantegret C, Ternoy N, Martin D, Donier A, Gregoire S, Creuzot-Garcher CP, Bron AM, Bretillon L, Berdeaux O, Acar N. Modification of erythrocyte membrane phospholipid composition in preterm newborns with retinopathy of prematurity: The omegaROP study. Front Cell Dev Biol 2022; 10:921691. [PMID: 36158214 PMCID: PMC9504055 DOI: 10.3389/fcell.2022.921691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 07/11/2022] [Indexed: 11/15/2022] Open
Abstract
N-3 polyunsaturated fatty acids (PUFAs) may prevent retinal vascular abnormalities observed in oxygen-induced retinopathy, a model of retinopathy of prematurity (ROP). In the OmegaROP prospective cohort study, we showed that preterm infants who will develop ROP accumulate the n-6 PUFA arachidonic acid (ARA) at the expense of the n-3 PUFA docosahexaenoic acid (DHA) in erythrocytes with advancing gestational age (GA). As mice lacking plasmalogens ―That are specific phospholipids considered as reservoirs of n-6 and n-3 PUFAs― Display a ROP-like phenotype, the aim of this study was to determine whether plasmalogens are responsible for the changes observed in subjects from the OmegaROP study. Accordingly, preterm infants aged less than 29 weeks GA were recruited at birth in the Neonatal Intensive Care Unit of University Hospital Dijon, France. Blood was sampled very early after birth to avoid any nutritional influence on its lipid composition. The lipid composition of erythrocytes and the structure of phospholipids including plasmalogens were determined by global lipidomics using liquid chromatography coupled to high-resolution mass spectrometry (LC-HRMS). LC-HRMS data confirmed our previous observations by showing a negative association between the erythrocyte content in phospholipid esterified to n-6 PUFAs and GA in infants without ROP (rho = −0.485, p = 0.013 and rho = −0.477, p = 0.015 for ethanolamine and choline total phospholipids, respectively). Phosphatidylcholine (PtdCho) and phosphatidylethanolamine (PtdEtn) species with ARA, namely PtdCho16:0/20:4 (rho = −0.511, p < 0.01) and PtdEtn18:1/20:4 (rho = −0.479, p = 0.015), were the major contributors to the relationship observed. On the contrary, preterm infants developing ROP displayed negative association between PtdEtn species with n-3 PUFAs and GA (rho = −0.380, p = 0.034). They were also characterized by a positive association between GA and the ratio of ethanolamine plasmalogens (PlsEtn) with n-6 PUFA to PlsEtn with n-3 PUFAs (rho = 0.420, p = 0.029), as well as the ratio of PlsEtn with ARA to PlsEtn with DHA (rho = 0.843, p = 0.011). Altogether, these data confirm the potential accumulation of n-6 PUFAs with advancing GA in erythrocytes of infants developing ROP. These changes may be partly due to plasmalogens.
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Affiliation(s)
- Rémi Karadayi
- Centre des Sciences du Goût et de l’Alimentation, Institut Agro, CNRS, INRAE, Université Bourgogne Franche-Comté, Eye and Nutrition Research Group, Dijon, France
| | - Charlotte Pallot
- Centre des Sciences du Goût et de l’Alimentation, Institut Agro, CNRS, INRAE, Université Bourgogne Franche-Comté, Eye and Nutrition Research Group, Dijon, France
- University Hospital, Department of Ophthalmology, Dijon, France
| | - Stéphanie Cabaret
- Centre des Sciences du Goût et de l’Alimentation, Institut Agro, CNRS, INRAE, Université Bourgogne Franche-Comté, ChemoSens Platform, Dijon, France
| | - Julie Mazzocco
- Centre des Sciences du Goût et de l’Alimentation, Institut Agro, CNRS, INRAE, Université Bourgogne Franche-Comté, Eye and Nutrition Research Group, Dijon, France
| | | | - Denis S. Semama
- University Hospital, Neonatal Intensive Care Unit, Dijon, France
| | | | - Ninon Ternoy
- University Hospital, Neonatal Intensive Care Unit, Dijon, France
| | - Delphine Martin
- University Hospital, Neonatal Intensive Care Unit, Dijon, France
| | - Aurélie Donier
- University Hospital, Neonatal Intensive Care Unit, Dijon, France
| | - Stéphane Gregoire
- Centre des Sciences du Goût et de l’Alimentation, Institut Agro, CNRS, INRAE, Université Bourgogne Franche-Comté, Eye and Nutrition Research Group, Dijon, France
| | - Catherine P. Creuzot-Garcher
- Centre des Sciences du Goût et de l’Alimentation, Institut Agro, CNRS, INRAE, Université Bourgogne Franche-Comté, Eye and Nutrition Research Group, Dijon, France
- University Hospital, Department of Ophthalmology, Dijon, France
| | - Alain M. Bron
- Centre des Sciences du Goût et de l’Alimentation, Institut Agro, CNRS, INRAE, Université Bourgogne Franche-Comté, Eye and Nutrition Research Group, Dijon, France
- University Hospital, Department of Ophthalmology, Dijon, France
| | - Lionel Bretillon
- Centre des Sciences du Goût et de l’Alimentation, Institut Agro, CNRS, INRAE, Université Bourgogne Franche-Comté, Eye and Nutrition Research Group, Dijon, France
| | - Olivier Berdeaux
- Centre des Sciences du Goût et de l’Alimentation, Institut Agro, CNRS, INRAE, Université Bourgogne Franche-Comté, ChemoSens Platform, Dijon, France
| | - Niyazi Acar
- Centre des Sciences du Goût et de l’Alimentation, Institut Agro, CNRS, INRAE, Université Bourgogne Franche-Comté, Eye and Nutrition Research Group, Dijon, France
- *Correspondence: Niyazi Acar,
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