Fecal human #x3B2;defensin2 (hBD2) levels and gut microbiota patterns in preterm neonates with different feeding patterns

Background and Objectives: Human #x3B2;defensin2 (hBD2) is an essential antibacterial peptide involved in innate immunity and is expressed in breast milk and intestinal mucosa. The aim of this study was to investigate fecal hBD2 levels and gut microbiota in preterm neonates with different feeding patterns. #xD; Materials and Methods: This study was crosssectionally designed and included 44 preterm neonates categorized into four groups as follows: breast milk only, breast milk predominant, formula milk predominant, formula milk only. The study was conducted at the Neonatology Ward, National Center Hospital Cipto Mangunkusumo, Jakarta from November 2016 to April 2017. hBD2 levels were measured by ELISA. Intestinal bacteria were quantified by qPCR. #xD; Results: hBD2 levels were significantly different between groups (oneway ANOVA, p=0.004) and the highest value of hBD2 was found in the formula milk predominant group (344.87 #xB1;61.2 ng/mL). hBD2 levels were positively correlated with feeding pattern (Spearman correlation test, p=0.009, r=0.391). There were no significant differences in the total number of specific intestinal microbiota (Bifidobacterium, Lactobacillus and Klebsiella) among groups (oneway ANOVA, p gt;0.05). Interestingly, the formula milk only group had the highest amount of Klebsiella compared with other groups. hBD2 levels were not correlated with the quantity of Bifidobacterium, Lactobacillus and Klebsiella (Pearson correlation test, p gt;0.05). #xD; Conclusion: hBD2 levels were significantly higher in the formula milk predominant group compared with the breast milk only group. Gut microbiota patterns showed that Bifidobacterium and Lactobacillus were higher in the breast milk only group, while Klebsiella was higher in formula milk group, although this difference was not statistically significant.