Am J Perinatol 2019; 36(S 02): S139-S148
DOI: 10.1055/s-0039-1693264
Selected Abstracts
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Transcriptomics and Metabolomics Analyses of the Effect of Parenteral Nutrition Arginine Supplementation in Very Preterm Infants

L. Burgess
1   Neonatal Intensive Care Unit, Liverpool Women’s Hospital, Liverpool, United Kingdom
2   Department of Women’s and Children’s Health, University of Liverpool, Liverpool, United Kingdom
,
B. Flanagan
2   Department of Women’s and Children’s Health, University of Liverpool, Liverpool, United Kingdom
,
E. Caamano-Gutierrez
2   Department of Women’s and Children’s Health, University of Liverpool, Liverpool, United Kingdom
,
H. Wright
2   Department of Women’s and Children’s Health, University of Liverpool, Liverpool, United Kingdom
,
C. Slupsky
3   Department of Nutrition, University of California, Davis, Davis, California
,
M. Turner
1   Neonatal Intensive Care Unit, Liverpool Women’s Hospital, Liverpool, United Kingdom
2   Department of Women’s and Children’s Health, University of Liverpool, Liverpool, United Kingdom
,
C. Morgan
2   Department of Women’s and Children’s Health, University of Liverpool, Liverpool, United Kingdom
› Author Affiliations
Further Information

Publication History

Publication Date:
25 June 2019 (online)

 
 

    Introduction: The Preterm Arginine INTake (PAINT) study was an exploratory physiological study using transcriptomics and metabolomics to assess the impact of parenteral nutrition (PN) arginine supplementation on the immune system and metabolism of very preterm infants.

    Materials and Methods: Very preterm infants born <29 weeks’ gestation and/or <1,200 g were eligible for PN. Infants were assigned to receive standard PN only or standard PN alongside a range of doses of arginine supplementation until day 10 (D10) of life. Blood samples were taken on day 3 (D3) and D10 of life for amino acid (AA) levels, microarray, and metabolomics. Plasma AA levels were measured using ion exchange chromatography, RNA was extracted and used for microarray and quantitative polymerase chain reaction (qPCR), and plasma metabolomics were analyzed by hydrogen-1 nuclear magnetic resonance spectroscopy.

    Results: The study included 26 infants with a mean gestational age at birth of 264/7 weeks and a mean birth weight of 855 g. Eight infants received standard PN only (6% arginine), 12 received 12% arginine, and 6 received 15% arginine. Plasma arginine levels were significantly higher on D10 of life in the supplemented infants (mean 72.8 vs. 45.5 µmol/L, p = 0.03). Microarray and qPCR validation experiments showed significant changes in gene expression associated with immune system development between D3 and D10 of life. Gene expression profiling indicates expression changes between infants with low versus normal plasma arginine levels to be similar to changes from D3 to D10 of life. Metabolomics analysis showed different metabolomics profiles on D10 of life for infants with normal arginine levels following supplementation versus nonsupplemented infants.

    Conclusion: Arginine supplementation can reduce arginine deficiency in PN-dependent very preterm infants. Arginine supplemented infants with normal plasma arginine levels exhibit different D10 metabolomics profiles to unsupplemented infants. Infants with normal (vs. low) plasma arginine levels exhibit changes in immune pathways similar to the temporal changes seen from D3 to D10 of life. These gene expression changes are consistent with the development of a functional immune system.

    Keywords: parenteral nutrition; arginine supplementation; immune system; metabolomics; transcriptomics

    Conflict of Interest: None declared.


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    No conflict of interest has been declared by the author(s).