@article{HaertelSpieglerFortmannetal.2020,
  author    = {H{\"a}rtel, Christoph and Spiegler, Juliane and Fortmann, Ingmar and Astiz, Mariana and Oster, Henrik and Siller, Bastian and Viemann, Dorothee and Keil, Thomas and Banaschewski, Tobias and Romanos, Marcel and Herting, Egbert and G{\"o}pel, Wolfgang},
  title     = {Breastfeeding for 3 months or longer but not probiotics is associated with reduced risk for inattention/hyperactivity and conduct problems in very-low-birth-weight children at early primary school age},
  series = {Nutrients},
  volume    = {12},
  journal   = {Nutrients},
  number    = {11},
  issn      = {2072-6643},
  doi       = {10.3390/nu12113278},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-216319},
  year      = {2020},
  abstract  = {(1) Background: We aimed to evaluate the effect of proposed "microbiome-stabilising interventions", i.e., breastfeeding for ≥3 months and prophylactic use of Lactobacillus acidophilus/ Bifidobacterium infantis probiotics on neurocognitive and behavioral outcomes of very-low-birthweight (VLBW) children aged 5-6 years. (2) Methods: We performed a 5-year-follow-up assessment including a strength and difficulties questionnaire (SDQ) and an intelligence quotient (IQ) assessment using the Wechsler Preschool and Primary Scale of Intelligence (WPPSI)-III test in preterm children previously enrolled in the German Neonatal Network (GNN). The analysis was restricted to children exposed to antenatal corticosteroids and postnatal antibiotics. (3) Results: 2467 primary school-aged children fulfilled the inclusion criteria. In multivariable linear regression models breastfeeding ≥3 months was associated with lower conduct disorders (B (95\% confidence intervals (CI)): -0.25 (-0.47 to -0.03)) and inattention/hyperactivity (-0.46 (-0.81 to -0.10)) as measured by SDQ. Probiotic treatment during the neonatal period had no effect on SDQ scores or intelligence. (4) Conclusions: Prolonged breastfeeding of highly vulnerable infants may promote their mental health later in childhood, particularly by reducing risk for inattention/hyperactivity and conduct disorders. Future studies need to disentangle the underlying mechanisms during a critical time frame of development.},
  language  = {en}
}
@article{HumbergFortmannSilleretal.2020,
  author    = {Humberg, Alexander and Fortmann, Ingmar and Siller, Bastian and Kopp, Matthias Volkmar and Herting, Egbert and G{\"o}pel, Wolfgang and H{\"a}rtel, Christoph},
  title     = {Preterm birth and sustained inflammation: consequences for the neonate},
  series = {Seminars in Immunopathology},
  volume    = {42},
  journal   = {Seminars in Immunopathology},
  organization    = {German Neonatal Network, German Center for Lung Research and Priming Immunity at the beginning of life (PRIMAL) Consortium},
  issn      = {1863-2297},
  doi       = {10.1007/s00281-020-00803-2},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-235019},
  pages     = {451-468},
  year      = {2020},
  abstract  = {Almost half of all preterm births are caused or triggered by an inflammatory process at the feto-maternal interface resulting in preterm labor or rupture of membranes with or without chorioamnionitis ("first inflammatory hit"). Preterm babies have highly vulnerable body surfaces and immature organ systems. They are postnatally confronted with a drastically altered antigen exposure including hospital-specific microbes, artificial devices, drugs, nutritional antigens, and hypoxia or hyperoxia ("second inflammatory hit"). This is of particular importance to extremely preterm infants born before 28 weeks, as they have not experienced important "third-trimester" adaptation processes to tolerate maternal and self-antigens. Instead of a balanced adaptation to extrauterine life, the delicate co-regulation between immune defense mechanisms and immunosuppression (tolerance) to allow microbiome establishment is therefore often disturbed. Hence, preterm infants are predisposed to sepsis but also to several injurious conditions that can contribute to the onset or perpetuation of sustained inflammation (SI). This is a continuing challenge to clinicians involved in the care of preterm infants, as SI is regarded as a crucial mediator for mortality and the development of morbidities in preterm infants. This review will outline the (i) role of inflammation for short-term consequences of preterm birth and (ii) the effect of SI on organ development and long-term outcome.},
  language  = {en}
}
@article{PagelTwisselmannRauschetal.2020,
  author    = {Pagel, Julia and Twisselmann, Nele and Rausch, Tanja K. and Waschina, Silvio and Hartz, Annika and Steinbeis, Magdalena and Olbertz, Jonathan and Nagel, Kathrin and Steinmetz, Alena and Faust, Kirstin and Demmert, Martin and G{\"o}pel, Wolfgang and Herting, Egbert and Rupp, Jan and H{\"a}rtel, Christoph},
  title     = {Increased Regulatory T Cells Precede the Development of Bronchopulmonary Dysplasia in Preterm Infants},
  series = {Frontiers in Immunology},
  volume    = {11},
  journal   = {Frontiers in Immunology},
  issn      = {1664-3224},
  doi       = {10.3389/fimmu.2020.565257},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-212409},
  year      = {2020},
  abstract  = {Regulatory T cells (Tregs) are important for the ontogenetic control of immune activation and tissue damage in preterm infants. However, the role of Tregs for the development of bronchopulmonary dysplasia (BPD) is yet unclear. The aim of our study was to characterize CD4+ CD25+ forkhead box protein 3 (FoxP3)+ Tregs in peripheral blood of well-phenotyped preterm infants (n = 382; 23 + 0 - 36 + 6 weeks of gestational age) with a focus on the first 28 days of life and the clinical endpoint BPD (supplemental oxygen for longer than 28 days of age). In a subgroup of preterm infants, we characterized the immunological phenotype of Tregs (n = 23). The suppressive function of Tregs on CD4+CD25- T cells was compared in preterm, term and adult blood. We observed that extreme prematurity was associated with increased Treg frequencies which peaked in the second week of life. Independent of gestational age, increased Treg frequencies were noted to precede the development of BPD. The phenotype of preterm infant Tregs largely differed from adult Tregs and displayed an overall na{\"i}ve Treg population (CD45RA+/HLA-DR-/Helios+), especially in the first days of life. On day 7 of life, a more activated Treg phenotype pattern (CCR6+, HLA-DR+, and Ki-67+) was observed. Tregs of preterm neonates had a higher immunosuppressive capacity against CD4+CD25- T cells compared to the Treg compartment of term neonates and adults. In conclusion, our data suggest increased frequencies and functions of Tregs in preterm neonates which display a distinct phenotype with dynamic changes in the first weeks of life. Hence, the continued abundance of Tregs may contribute to sustained inflammation preceding the development of BPD. Functional analyses are needed in order to elucidate whether Tregs have potential as future target for diagnostics and therapeutics.},
  language  = {en}
}