An interesting paper by Seki and others published in Cell Host and Microbe September 2021 tries to explain this issue. 

Premature infants are at a substantial risk of suffering from perinatal white matter injury.  

Although the gut microbiota has been implicated in early life development, a detailed understanding of the gut-microbiota-immune-brain axis in premature neonates is lacking. 

This study profiled the gut microbiota, immunological, and neurophysiological development of 16 extremely premature infants, which received standard hospital care including antibiotics and probiotics. 

The study found that maturation of electrocortical activity was suppressed in infants with severe brain damage.  This was accompanied by elevated T-cell levels and increased T-cell secretion of vascular endothelial growth factor and reduced secretion of neuroprotectants.  

Notably, Klebsiella overgrowth in the gut was highly predictive for brain damage and was associated with pro-inflammatory immunological tone.  

The study results suggested that aberrant development of the gut-microbiota-immune-brain axis could drive or exacerbate brain injury in extremely premature neonates and represented a promising target from novel intervention strategies.

Dr Paul Ettlinger

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