Role of the gut-microbiota-metabolite-brain axis in the pathogenesis of preterm brain injury

Brain injury, a common complication in preterm infants, includes the destruction of the key structural and functional connections of the brain and causes neurodevelopmental disorders; it has high morbidity and mortality rates. The exact mechanism underlying brain injury in preterm infants is unclear. Intestinal flora plays a vital role in brain development and the maturation of the immune system in infants; however, detailed understanding of the gut microbiota-metabolite-brain axis in preterm infants is lacking. In this review, we summarise the key mechanisms by which the intestinal microbiota contribute to neurodevelopment and brain injury in preterm infants, with special emphasis on the influence of microorganisms and their metabolites on the regulation of neurocognitive development and neurodevelopmental risks related to preterm birth, infection and neonatal necrotising enterocolitis (NEC). This review provides support for the development and application of novel therapeutic strategies, including probiotics, prebiotics, synbiotics, and faecal bacteria transplantation targeting at brain injury in preterm infants.

Automated summary

Brain injury is a common complication in preterm infants, causing destruction of brain connections and leading to neurodevelopmental disorders with high morbidity and mortality rates. The role of intestinal flora in brain development and immune maturation in infants is important, but the understanding of the gut microbiota-metabolite-brain axis in preterm infants is limited. This review summarizes the mechanisms by which intestinal microbiota contribute to neurodevelopment and brain injury in preterm infants, emphasizing the influence of microorganisms and metabolites on neurocognitive development and neurodevelopmental risks associated with preterm birth, infection, and NEC. The review supports the development and application of therapeutic strategies such as probiotics, prebiotics, synbiotics, and fecal bacteria transplantation for brain injury in preterm infants.