Enhancing neonatal intestinal growth, development and repair following injury. J. Odle and R.J. Harrell, North Carolina State University, Raleigh, NC 27695.

Early postnatal morbidity and mortality of mammalian neonates represent significant challenges to the agricultural and medical sciences. While many stressors come to bear on the neonate soon after birth, it is convincingly clear that gastrointestinal maladies are among the most prominent. This is not surprising given the relatively quiescent state of the intestine in utero and the rapid ontogeny required following birth. Furthermore, the intestinal mucosa, initially sterile, must be protected from viral and bacterial pathogens that are ubiquitous in the postnatal environment. Because the intestine is a "supply organ", the overall systemic health and vitality of the neonate hinges on its development and function. Therefore, understanding the role of various nutritional, hormonal and pharmacologic agents in ushering the growth, development and function of the intestine is seminal. Our studies have specifically examined rotaviral gastroenteritis, a leading cause of neonatal intestinal injury and diarrhea, with the ultimate goal of improving the rate and extent of recovery. Using rotaviral infection within a neonatal piglet model, we have shown that the level of enteral nutrition delivered post?infection can starkly affect the clinical, biochemical and immunological response during recovery. While a brief period of "gut rest" may be beneficial, if prolonged, it can significantly delay recovery. We also have documented a modest mitogenic response of damaged intestine to supplemental epidermal growth factor, and have shown attenuation of rotaviral damage to the intestine of pigs fed milk replacer formulated with plasma proteins compared with soy?protein?based formulas. However, we have been unable to measure beneficial effects of enteral glutamine or alanyl?glutamine. Our collective findings suggest several positive (but modest) effects of various enteral?treatment regimens/agents on intestinal recovery. Further research is needed to understand better the complex interplay between nutrients, growth factors, immunological, and bacterial determinants which impact intestinal health and ultimately neonatal vitality.