385 Effect of Enteral Supplementation of Neutral and Acidic Oligosaccharides on Serum Cytokine Levels in Preterm Infants

Abstract

Introduction: Preterm have an immature immune system. Aim of this study was to determine the effect of a prebiotic mixture consisting of neutral and acidic oligosaccharides (SCGOS/LCFOS/AOS) on cytokine levels in the blood of preterm infants. Methods: In a RCT, preterm infants (gestational age < 32 weeks and/or birth weight < 1500 g) received SCGOS/LCFOS/AOS or maltodextrin (placebo) between days 3 and 30 of life. Cytokine levels (IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, IL-17, IFN-γ, TNF-α) were analysed by a fluorescent bead-based multiplex immuno assay at 3 time points: before the start of the study, day 7 and day 14. Results: In total, 113 infants were included. Baseline patient and nutritional characteristics were not different in the SCGOS/LCFOS/AOS (n=55) and the placebo group (n=58). Enteral supplementation of SCGOS/LCFOS/AOS did not change cytokine levels. There was a trend toward lower levels of IL- 1β (P=0.05, 95% CI 0.15-1.01) and TNF-α (P=0.14, 95% CI 0.18-1.26) in SCGOS/LCFOS/AOS group compared with the placebo group. Adjustment for serious infectious morbidity did not change the results of the primary analysis. Conclusions: There is a trend toward decreased levels of the pro-inflammatory cytokines IL-1β and TNF-α after enteral supplementation with a prebiotic mixture consisting of neutral and acidic oligosaccharides. Increased pro-inflammatory cytokines are associated with multi-organ failure, chronic lung disease and white matter damage and therefore we speculate that a prebiotic mixture consisting of neutral and acidic oligosaccharides may improve clinical outcome in preterm infants.