cholecystokinin and Infant--Premature--Diseases

Gastrointestinal hormones control gut functions in response to enteral nutrition. Diseases involving the gastrointestinal tract, such as necrotizing enterocolitis, may affect gut hormone secretion and therefore influence gut functions. Because bowel rest is an important part of the treatment, infants with this disease are especially at risk for an altered gut hormone secretion and thus for compromised gut functions.. In the current study, the gastrointestinal hormone profiles of eight preterm infants with an ileostomy after necrotizing enterocolitis (Bell stages 2 and 3) were evaluated during starvation and reintroduction of enteral nutrition. Basal and postprandial plasma concentrations of gastrin, cholecystokinin, and peptide YY were measured with sensitive and specific radioimmunoassays. The results were compared with those of 11 controls.. In the patients and the controls, plasma concentrations of all hormones were higher postprandially. The increases in cholecystokinin and peptide YY were significant in the patients. Compared with the controls, all concentrations were higher in the patients, and changes were significant for basal and postprandial cholecystokinin and postprandial peptide YY.. Enteral nutrition stimulates the secretion of gastrointestinal hormones, also in premature infants with a diseased distal small bowel and colon, as in necrotizing enterocolitis. The postprandial increase of peptide YY in patients with an ileostomy indicates that enteral substrate in the colon is not necessary for stimulation of peptide YY secretion.

Topics: Cholecystokinin; Enteral Nutrition; Enterocolitis, Necrotizing; Gastrins; Gastrointestinal Hormones; Humans; Ileostomy; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Peptide YY; Postprandial Period; Radioimmunoassay; Starvation

Deterioration in the respiratory function of a newborn infant with a repaired diaphragmatic hernia and respiratory insufficiency followed administration of cholecystokinin for cholestatic jaundice. The possible mode of action is discussed and a vasoactive/bronchoactive effect is proposed.

Topics: Cholecystokinin; Cholestasis; Fatal Outcome; Hernia, Diaphragmatic; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Lung; Parenteral Nutrition; Respiratory Insufficiency

The present study reports the levels of plasma somatostatin and cholecystokinin in 19 preterm infants with asphyxia [n = 10, GA (median; range) 26; 23-30 weeks] and respiratory distress syndrome (n = 14, GA 27; 23-29 weeks) compared with preterm infants without any of these conditions (reference group, n = 59, GA 33; 25-36 weeks). In the reference group 37 infants received phototherapy and their peptide levels were compared with those not receiving phototherapy (n = 22). Plasma somatostatin and cholecystokinin were analysed by specific radioimmunoassays on day 1, day 3-4 and at 6 weeks of life. Plasma somatostatin levels, but not cholecystokinin levels, of reference infants were inversely related to gestational age on day 1 and day 3-4. Asphyxiated infants and infants with respiratory distress syndrome had significantly higher somatostatin levels than reference infants on day 1 and day 3-4. These differences disappeared when the levels were adjusted for gestational age. Plasma cholecystokinin levels were not influenced by respiratory distress syndrome and asphyxia. Phototherapy did not affect plasma somatostatin and cholecystokinin levels.

Topics: Asphyxia Neonatorum; Cholecystokinin; Female; Gestational Age; Humans; Infant; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Jaundice, Neonatal; Male; Phototherapy; Radioimmunoassay; Respiratory Distress Syndrome, Newborn; Somatostatin

Topics: Acid-Base Equilibrium; Bicarbonates; Carbon Dioxide; Cholecystokinin; Cholestasis; Humans; Infant, Newborn; Infant, Premature; Infant, Premature, Diseases; Partial Pressure