Influence of Gestational Age, Cesarean Section, and Type of Feeding on Fecal Human β-Defensin 2 and Tumor Necrosis Factor-α

Objective: Development of the mucosal immune system is essential for controlling antigenic response. External factors are known to influence the immune system, such as breast-feeding or the mode of delivery. The aim of the present study was to investigate maturation of the enteric immune system. Patients and Methods: In stool samples of 59 preterm and term-born infants we measured the concentration of human β-defensin 2 (HBD 2), an endogenous antimicrobial peptide, and tumor necrosis factor-α (TNF-α), a cytokine playing a central role in mucosal inflammation, by enzyme-linked immunosorbent assay. Results: Mode of delivery as well as nutrition (breast-feeding or formula) had no influence on the fecal concentration of HBD-2 or TNF-α, but there was a significant increase in the concentration of HBD-2 in correlation with gestational age. TNF-α showed no change in concentration. Conclusions: Low fecal HBD-2 may be a risk factor in preterm infants to develop neonatal enteric disease, such as necrotizing enterocolitis.