AUTHOR=Li Yaxuan , Shen Nan , Li Jing , Hu Rui , Mo Xi , Xu Liqing 

TITLE=Changes in Intestinal Flora and Metabolites in Neonates With Breast Milk Jaundice

JOURNAL=Frontiers in Pediatrics

VOLUME=8

YEAR=2020

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2020.00177

DOI=10.3389/fped.2020.00177

ISSN=2296-2360

ABSTRACT=<p><bold>Background:</bold> Breast milk jaundice (BMJ) is the first cause of neonatal jaundice; however, its underlying mechanism is yet to be deciphered. We conducted a study to investigate intestinal flora in neonates with BMJ and used metabolomics to decipher the possible mechanisms by which intestinal flora induces jaundice.</p><p><bold>Methods:</bold> Microbiota collected from the feces of BMJ patients and jaundice-free breastfeeding newborns was used for 16S rRNA sequencing. In addition, differences in fecal metabolites were analyzed using gas chromatography mass spectrometry (GC/MS). The relationship between intestinal microbiota and the differences in fecal metabolites was then analyzed.</p><p><bold>Results:</bold> There was no significant difference in the richness and diversity of intestinal flora between BMJ and the control group; however, there were differences in the structure. At the phylum level, the relative abundance of <italic>Firmicutes</italic> was higher in the control group compared to the BMJ group, whereas <italic>Proteobacteria</italic> was higher in the infants with BMJ. Additionally, at the genus level, the relative abundance of <italic>Haemophilus</italic> was higher in the control group, whereas the relative abundances of <italic>Escherichia, Morganella</italic>, and <italic>Rothia</italic> were lower. More remarkably, the major differences in metabolites between the two groups were glyceric acid, succinic acid, and phenylalanine. Additionally, the abundance of <italic>Escherichia</italic> was positively correlated with succinic acid and cadaverine levels.</p><p><bold>Conclusions:</bold> The intestinal flora colonization status in BMJ patients is immature. This study reports for the first time that the study of intestinal flora, especially <italic>Escherichia</italic>, plays an important role in BMJ, and found that it may be associated with the regulation of succinic acid metabolic pathways.</p>