Abstract

Necrotizing enterocolitis (NEC) is a life-threatening disease for premature infants with low body weight. Due to its fragile gut microbiome and successful treatment of fecal microbiota transplantation (FMT) for intestinal disease, we aimed to reveal the multiple-omics changes after FMT and/or sulperazone treatment. In this study, 2-week-old newborn rabbits were used to simulate the NEC model and grouped into healthy control, NEC, sulperazone treatment, FTM treatment, and FMT and sulperazone combination treatment. We evaluated the intestinal pathology and survival to define the benefit from each treatment and performed microbiome and transcriptome analysis to reveal the changes in microcosmic level, which could be helpful to understand the pathogenesis of NEC and develop new strategy. We found NEC rabbits benefit more from the combination of FMT and sulperazone treatment. Combination treatment reverses a lot of microorganisms dysregulated by NEC and showed the most similar transcript profiler with healthy control. Moreover, a combination of FMT and sulperazone significantly prolonged the survival of NEC rabbits. Function enrichment showed that metabolism and viral life cycle are the most significant changes in NEC. FMT is a common therapy method for NEC. Meanwhile, in the severe situation of NEC with intestinal infection, the first therapy strategy is preferred the third-generation cephalosporin, among which sulperazone is used widely and the effect is remarkable. So, we used sulperazone to treat the rabbits with the NEC. In this research, we aim to explore the different effects on NEC between FMT and sulperazone as well as the combination. Considering the microbiome and transcriptome result, we make a conclusion that the Enterococcus and Subdoligranulum benefits NEC by influencing the bacterial phages and butyrate production, respectively.

Highlights

  • Necrotizing enterocolitis (NEC) is a life-threatening intestinal disease associated with an increased risk of morbidity and mortality (Papillon et al, 2017; Alganabi et al, 2019)

  • Fecal microbiota transplantation (FMT) is an emerging and beneficial strategy to treat disease caused by gut microbiome chaos, such as chronic diarrhea, by transferring of fecal matter from healthy individuals to patients with dysbiosis to adjust the gut microbiome (Goyal et al, 2018; Antushevich, 2020; Liu et al, 2020)

  • We found that NEC is characterized by metabolism dysregulation, and the FMT and sulperazone combination treatment showed the highest benefits for the NEC

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Summary

Introduction

Necrotizing enterocolitis (NEC) is a life-threatening intestinal disease associated with an increased risk of morbidity and mortality (Papillon et al, 2017; Alganabi et al, 2019). The microorganisms from the mother’s vagina, breast milk, food, and environment will shape the gut colonized by microorganisms during the first 2 weeks of life and form the gut microbiome (Plaza-Díaz et al, 2018; Shao et al, 2019; Pilla and Suchodolski, 2020). This process of gut bacteria colonization and diversity is essential for the healthy gut of infants. The mechanisms remain to be demonstrated, especially the interactions between the microorganisms and host

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