Abstract

ABSTRACTIntestinal microbiota has emerged as an important player in the health and disease of preterm infants. The interactions between intestinal flora and epithelium can lead to local injury and systemic diseases. A suitable in vitro cell model is needed to enhance our understanding of these interactions. In this study, we exposed fetal epithelial cell cultures (FHs-74 int cells, human, ATCC CCL 241) to sterile fecal filtrates derived from stool collected from preterm infants at <2 and at 3 to 4 weeks of age. We measured the cytokine levels from the culture media after 4, 24, and 48 h of exposure to the fecal filtrates. We analyzed the 16S rRNA V4 gene data of the fecal samples and transcriptome sequencing (RNA-seq) data from the fetal epithelial cells after 48 h of exposure to the same fecal filtrates. The results showed correlations between inflammatory responses (both cytokine levels and gene expression) and the Proteobacteria-to-Firmicutes ratio and between fecal bacterial genera and epithelial apoptosis-related genes. Our in vitro cell model can be further developed and applied to study how the epithelium responds to different microbial flora from preterm infants. Combining immature epithelial cells and preterm infant stool samples into one model allows us to investigate disease processes in preterm infants in a way that had not been previously reported.IMPORTANCE The gut bacterial flora influences the development of the immune system and long-term health outcomes in preterm infants. Studies of the mechanistic interactions between the gut bacteria and mucosal barrier are limited to clinical observations, animal models, and in vitro cell culture models for this vulnerable population. Most in vitro cell culture models of microbe-host interactions use single organisms or adult origin cell lines. Our study is innovative and significant in that we expose immature epithelial cells derived from fetal tissues to fecal filtrates from eight stool samples from four preterm infants to study the role of intestinal epithelial cells. In addition, we analyzed epithelial gene expression to examine multiple cellular processes simultaneously. This model can be developed into patient-derived two- or three-dimensional cell cultures exposed to their own fecal material to allow better prediction of patient physiological responses to support the growing field of precision medicine.

Highlights

  • IMPORTANCE The gut bacterial flora influences the development of the immune system and long-term health outcomes in preterm infants

  • We aimed to establish an in vitro model to study the interactions between the preterm intestinal epithelium and gut microbiota using fetal origin epithelial cells exposed to fecal filtrates of stool samples collected from preterm infants

  • And late stool samples were collected at median ages of 7 and 28 (IQR = 26 to 31) days after birth

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Summary

Introduction

IMPORTANCE The gut bacterial flora influences the development of the immune system and long-term health outcomes in preterm infants. Commonly mice and piglets, have been used extensively to study intestinal development and diseases in preterm infants [12, 13] These animal models have limitations in replicating human intestinal microbiota in terms of bacterial species, composition, and development over time. Human tissue-derived intestinal epithelial cell cultures, both monolayer and three-dimensional (3D) tube-like structures, have emerged as promising models for mechanistic studies of the intestinal epithelium [14,15,16,17] These cultured nontransformed cell models can complement clinical and animal experiments in the areas of gene expression and physiological activities when human responses are different from other animals. We aimed to establish an in vitro model to study the interactions between the preterm intestinal epithelium and gut microbiota using fetal origin epithelial cells exposed to fecal filtrates of stool samples collected from preterm infants

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