Potential method for better treatment of premature babies

Potential method for better treatment of premature babies

By Dr. Liji Thomas, MD Feb 18 2020 A new study published in the journal Immunology in February 2020 reports the discovery of a process that occurs in the body naturally, but which enhances the production of type 3 innate lymphoid cells (ILCs) in the lung alveoli of premature babies. These are sentinel cells that keep the mucosal surfaces clean and healthy. They are crucial to building resistance to infection within the human body. Premature baby. Image Credit: Kristina Bessolova / Shutterstock The problem Even as medical science advances and technology comes up with new ways to assist human life, preterm birth remains the Number 1 reason why babies die in their first year of life. For instance, 2018 marked the fourth consecutive year when the rate of preterm birth increased. So far, it had moved up from 9.6% in 2015 to 10.2% in 2018. This is since statistics began. Bacterial pneumonia is still among the dreaded complications of prematurity, and over 1 million infants with bacterial pneumonia die each year. Type 3 ILCs and the gut-lung axis Babies born prematurely are at risk of not being able to breathe independently because of the incomplete development of their lungs. The lack of type 3 ILCs also predisposes them to develop bacterial infections of the lungs, including bacterial pneumonia. Those who eventually make it past this stage may end up with permanently damaged lungs, being prone to respiratory infections their whole lives, and the associated illnesses. The study builds on earlier research showing that the presence of beneficial gut bacteria, the processes which lead to the maturation of the lungs, and the growth of innate immune cells are all interlinked to form a "gut-lung axis." This axis forms very early in newborn life, which is, therefore, a critical period of development of the lung. The researchers have already published data showing the vital role played by the gut-lung axis in human development and how giving too many antibiotics too early could disrupt this crucial process in premature babies. In 2017, they showed how the interactions between the commensals living in the host intestine shaped the range of responses possible to the immune cells in other body sites, including the lungs. The initial stimulus for this process is the presence of gut commensals, which stimulate dendritic cells within the intestine. Colonization of the gut with commensal bacteria occurs at birth and moves through a predefined succession of species to reach a stable equilibrium during the very first month after birth. They thus have a vital role in programming immune cells to meet bacterial challenges. The dendritic cells are immune cells that are good at presenting antigens, or cell-related molecules, on their cell surface. This is done to alert other immune cells to the presence of antigens. In the early period of human development, the presentation of these antigens is essential to teach the body which antigens are harmless or friendly, and which are not. This image from a study in the journal Immunity shows fluoresced cells in the developing perinatal lung of a baby mouse as it forms air sacs called alveolar. The areas highlighted by dotted circles show the molecular components that form Type 3 innate lymphoid cells, which help the lungs develop a durable immune defense against microbial infections. Not shown is a companion comparison image that shows dysfunctional development in the lung of a premature baby mouse. The illustrations at left diagram normal and premature development of air sacs. Image Credit: Cincinnati Children's New light on the role of IGF1 Related Stories



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