Being fed with breast milk may protect infants against the potentially lethal gastrointestinal disease necrotizing enterocolitis (NEC), which particularly strikes premature children. The findings are from a study conducted at the Children’s Hospital Los Angeles, which showed that a protein called neuregulin-4 (NRG4), found in breast milk but not in formula feeding, may protect the intestine against the destruction caused by NEC.
“Our research suggests that without the NRG4 protein found in breast milk, a normal protection mechanism for the immature gut may be missing,” explained the study’s principal investigator at The Saban Research Institute of Children’s Hospital Los Angeles, Mark R. Frey, PhD. “If a baby on formula encounters an NEC trigger such as intestinal infection or injury, he or she may be at increased risk for a life-threatening condition.”
The research team used rodent models and in vitro analysis, as well as conducted exams involving human breast milk and infant intestinal tissue to study the disease. Formula feeding is a known risk factor for the disease, and the scientists verified that while the group of rats fed with formula developed a condition similar to NEC, the ones who received formula and the NRG4 protein were protected against intestinal damages, as were cultured intestinal cells challenged with bacteria related to strains that may induce NEC in humans.
The scientists were able to demonstrate that NRG4 binds specifically with ErbB4, a receptor found in the intestine, in order to block damage caused by intestinal inflammation. Human NEC causes losses of Paneth cells, which are specialized cells present throughout the small intestine that protect the organ from microbial damage and support the intestinal stem cells needed for ongoing renewal of the intestinal lining. NRG4 also prevents from the loss of Paneth cells, as observed in the mouse model of NEC. The findings of the study were published online at the American Journal of Pathology. entitled, “The ErbB4 Ligand Neuregulin-4 Protects against Experimental Necrotizing Enterocolitis.”
“We’re finding a protective protein in breast milk, with its receptor in the intestine,” said Frey, who is also an assistant professor of Pediatrics and Biochemistry & Molecular Biology at the Keck School of Medicine of the University of Southern California. “Given that NEC is a significant clinical problem without an effective treatment, we plan to evaluate NRG4 for its therapeutic potential in this disease.”
The disease is fatal in 30 percent of the cases. Even babies that survive NE, often face lifelong consequences, which may include removal of part of their intestine and dependence upon intravenous nutrition. The discovery may mean a way of preventing the disease.
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