Document Detail

Platelet-activating factor concentration in the stool of human newborns: effects of enteral feeding and neonatal necrotizing enterocolitis.
MedLine Citation:
PMID:  14646336     Owner:  NLM     Status:  MEDLINE    
Epidemiologic studies have identified enteral feedings as a risk factor for necrotizing enterocolitis (NEC). Enteral feedings provide the substrate for colonization of the newborn gut with gram-negative bacteria with endotoxin production, which may trigger the production of endogenous inflammatory mediators, including platelet-activating factor (PAF). In this prospective study, we examined the effect of enteral feeding on PAF concentration in the stool of preterm and full-term human newborns. The concentration of PAF levels in stool was measured at the following times: at passage of first meconium, within 24 h prior to the onset of feedings, at the 3rd and 14th day of feeding and at any time confirmed NEC developed. Stool samples also were analyzed for levels of acetylhydrolase, the PAF breakdown enzyme. Stool PAF concentration rose significantly following the start of enteral feedings. The mean PAF concentration for day 14 samples was significantly higher than the mean concentration of meconium samples (4.90 +/- 1.03 vs. 1.81 +/- 0.38 ng/g, p < 0.05) and day 0 samples (4.90 +/- 1.03 vs. 1.79 +/- 0.39 ng/g, p < 0.05). For the 7 patients diagnosed with definite NEC, the mean stool PAF concentration was 12.42 +/- 0.77 ng/g, significantly elevated compared to the mean PAF levels in stool from healthy infants at all sampling times (p < 0.01). There was no significant change in acetylhydrolase activity at any of the sampling times. Stool PAF concentration increases with the provision of enteral feedings and rises further with the development of NEC. Since stool acetylhydrolase activity remained unchanged, we speculate the increase of PAF in stool likely represents increased PAF production at the local level following the provision of enteral feedings or the development of neonatal necrotizing enterocolitis.
Michael D Amer; Erik Hedlund; Jeremy Rochester; Michael S Caplan
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.     Date:  2003-11-28
Journal Detail:
Title:  Biology of the neonate     Volume:  85     ISSN:  0006-3126     ISO Abbreviation:  Biol. Neonate     Publication Date:  2004  
Date Detail:
Created Date:  2004-03-30     Completed Date:  2004-10-28     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0247551     Medline TA:  Biol Neonate     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  159-66     Citation Subset:  IM    
Copyright Information:
Copyright 2004 S. Karger AG, Basel
Department of Pediatrics, Evanston Hospital and Northwestern University Medical School, Evanston, IL 60201, USA.
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MeSH Terms
1-Alkyl-2-acetylglycerophosphocholine Esterase / metabolism
Enteral Nutrition / adverse effects*
Enterocolitis, Necrotizing / etiology,  metabolism*
Feces / chemistry
Gestational Age
Infant, Newborn
Infant, Premature / metabolism*
Platelet Activating Factor / metabolism*
Prospective Studies
Grant Support
Reg. No./Substance:
0/Platelet Activating Factor; EC Esterase

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