Ação anti-inflamatória da administração orofaríngea de colostro em recém-nascidos pré-termo de muito baixo peso ao nascer

Abstract

Introduction and objective: Infections consist in one of the main causes of morbi-mortality in very low birth weight infants (VLBW). Oropharyngeal administration of own mother's milk (OMM), specially colostrum, has been prescribed as means of immunomodulatory protection against neonatal sepsis. As urine biomarkers, have been studied in systemic inflammation as well as in neonatal sepsis, our goal was to assess the effect of colostrum's oropharyngeal administration on secretion of pro- and anti-inflammatory cytokines in VLBW infants' urine. Method: From a randomized, double-blind, placebo controlled trial were randomly selected urine samples of 55 VLBW infants of which 29 received oropharyngeal administration of colostrum and 26 received only sterile water. Urine samples were collected before and 24 hours after the end of oropharyngeal administration and analyzed by means of Milliplex-27 kit using MagPix (Luminex) equipment. Results: A significant reduction of pro-inflammatory cytokines [IFN - y (35.8 -24.1pg/ml; p=0.005), TNF - a (17.0 - 9.5pg/ml; p=0.002), IL - 8 (22.1 - 12.9pg/ml; p=0.012), IL - 9 (14.8 - 10.5pg/ml; p=0.011), IL -15 (568.2 - 397.7pg/ml; p=0.012) e IL - 17a (1089.4 - 730.8pg/ml; p=0.001) e RANTES (6.7 - 5.4pg/ml; p= 0.018)] was observed in the group submitted to oropharyngeal administration of colostrum. However, it was demonstrated no statistically significant difference in clinical and confirmed sepsis incidence in VLBW infants from both groups. Conclusion: Oropharyngeal administration of colostrum promoted an anti-inflammatory state, characterized by reduction of proinflammatory cytokines, which can result in a decrease of neonatal sepsis incidence.