Early life protein-enriched human milk diets to increase lean body mass accretion and diversity of the gut microbiome in extremely preterm infants: a randomized trial

生命早期富含蛋白质的母乳饮食可增加极早产儿的去脂体重增加和肠道微生物组的多样性：一项随机试验

• 批准号: 10664900
• 负责人: Ariel Salas
• 金额: $ 14.1万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-10 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10664900
• 关键词: Acceleration; Active Learning; Advisory Committees; Age; Air; Birth; Body Composition; Clinical; Clinical Research; Critical Illness; Data; Development; Development Plans; Diet; Dietary Intervention; Enteral Feeding; Enteral Nutrition; Failure; Fatty acid glycerol esters; Foundations; Future; Gastrointestinal Diseases; Gastrointestinal tract structure; Goals; Growth; Head circumference; Health; Hospitals; Human; Human Milk; Knowledge; Lead; Length; Length of Stay; Life; Measures; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Multi-Institutional Clinical Trial; Neonatal; Nutrient; Nutritional; Nutritional Study; Outcome; Pathogenesis; Pattern; Plethysmography; Pregnancy; Premature Infant; Proteins; Randomized; Records; Reporting; Research; Research Methodology; Research Priority; Research Project Grants; Risk; Sampling; Scientist; Shapes; Testing; Time; Training; United States; United States National Institutes of Health; Weight; Work; career; career development; critical period; design; evidence base; experience; extreme prematurity; gastrointestinal; gut dysbiosis; gut microbiome; high risk; improved; individual response; innovation; insight; lean body mass; longitudinal analysis; neurodevelopment; novel; novel marker; novel therapeutics; patient oriented research; pilot trial; postnatal; precision nutrition; prevent; programs; protein intake; randomized trial; recruit; research and development; response; skill acquisition; skills; translational study; trial design

SUMMARY The purpose of this Mentored Patient-Oriented Research Career Development Award (K23) is to provide Ariel A. Salas, MD, MSPH, with the mentorship, training, and research experience needed to become an independent clinician scientist and leader in neonatal nutrition research. His long-term career goal is to reduce the burden of postnatal growth failure through novel translational studies and large scale, multi-center clinical trials of promising dietary interventions that optimize growth, reduce dysbiosis of the gut microbiome, and ultimately improve neurodevelopment. His immediate goal is to acquire the skills needed to conduct a clinical research program to study the effects of the protein intake and gut microbiome on growth and body composition of extremely preterm infants (28 weeks of gestation or less). To achieve these goals and transition to independence, Dr. Salas and his mentors have developed a comprehensive research and career development plan that includes mentorship from an exceptional team of scientists with proven track records of successful mentorship; intensive didactic training; and a research plan that is purposefully designed to provide experiential learning in advanced research methods to study postnatal growth failure and the gut microbiome of extremely preterm infants. Postnatal growth failure occurs in approximately 60% of the nearly 26,000 extremely preterm infants born every year in the United States. Postnatal growth failure is associated with a higher risk of adverse health outcomes, particularly when fat mass (FM) gains are higher than fat-free mass (FFM) gains. Recent work by Dr. Salas suggests that extremely preterm infants unable to tolerate early progression of enteral feeding volumes during the first 2 weeks after birth have an increased risk of disrupted maturation of the gut microbiome and an increased risk of postnatal growth failure. In the research plan outlined in this K23 proposal, Dr. Salas will expand upon this work by 1) investigating the effects of early postnatal life protein-enriched diets on FFM accretion in extremely preterm infants and 2) identifying maturation patterns of the gut microbiome that differentiate preterm infants with postnatal growth failure and reduced FFM accretion from preterm infants with appropriate postnatal growth and normal FFM accretion. This work will produce novel insights into the pathogenesis of postnatal growth failure in preterm infants and will serve as the foundation for Dr. Salas to inform his future R01 proposals and discover new, evidence-based approaches to prevent postnatal growth failure. His career development plan outlines a clear path to gain the knowledge, skills, and experience needed to become an independent clinician scientist, leader, and innovator in neonatal nutrition research.

总结

项目成果

The gut microbiome of extremely preterm infants randomized to the early progression of enteral feeding.

• DOI: 10.1038/s41390-021-01831-w
• 发表时间: 2022-09
• 期刊: PEDIATRIC RESEARCH
• 影响因子: 3.6
• 作者: Salas, Ariel A.;Willis, Kent A.;Carlo, Waldemar A.;Yi, Nengjun;Zhang, Li;Van der Pol, William J.;Younge, Noelle E.;Lefkowitz, Elliot J.;Lal, Charitharth, V
• 通讯作者: Lal, Charitharth, V

Early career investigator highlight biocommentary.

早期职业研究者强调生物评论。

• DOI: 10.1038/s41390-020-01129-3
• 发表时间: 2020
• 期刊: Pediatric research
• 影响因子: 3.6
• 作者: Salas,ArielA

Early Human Milk Fortification in Infants Born Extremely Preterm: A Randomized Trial.

极早产婴儿的早期母乳强化：一项随机试验。

• DOI: 10.1542/peds.2023-061603
• 发表时间: 2023
• 期刊: Pediatrics
• 影响因子: 8
• 作者: Salas,ArielA;Gunawan,Emily;Nguyen,Kelly;Reeves,Audrey;Argent,Victoria;Finck,Amber;Carlo,WaldemarA
• 通讯作者: Carlo,WaldemarA

Total Fluid Administration and Weight Loss during the First 2 Weeks in Infants Randomized to Early Enteral Feeding after Extremely Preterm Birth.

极早产后随机接受早期肠内喂养的婴儿前两周的总液体摄入量和体重减轻。

• DOI: 10.1159/000527430
• 发表时间: 2023
• 期刊: Neonatology
• 影响因子: 2.5
• 作者: Durham,Leandra;Gunawan,Emily;Nguyen,Kelly;Reeves,Audrey;Shukla,Vivek;Salas,ArielA
• 通讯作者: Salas,ArielA

The Practice of Enteral Nutrition: Clinical Evidence for Feeding Protocols.

• DOI: 10.1016/j.clp.2023.04.005
• 发表时间: 2023-09
• 期刊: CLINICS IN PERINATOLOGY
• 影响因子: 2.1
• 作者: Salas, Ariel A.;Travers, Colm P.
• 通讯作者: Travers, Colm P.