Content area
Full text
Introduction
Human viability, which refers to the gestational age at which the chance of survival is 50%, is currently estimated at 23–24 weeks in developed countries. Despite significant technological advancements and the efforts of child health experts, extremely preterm infants (those with less than 28 weeks of gestation) and extremely low birth weight infants (those whose weight is less than 1000 g) continue to face high risks of mortality and disability1, 2–3. Moreover, these infants are vulnerable to life-threatening surgical intestinal disorders such as necrotizing enterocolitis (NEC) and meconium-related ileus (MRI)2,4,5. Despite numerous studies investigating the blood, urine, and tissues of these infants5,6, the underlying mechanisms of these intestinal disorders remain unclear, and diagnostic biomarkers are not yet available.
Proteome analysis enables the comprehensive analysis of protein composition in various body fluids and tissues7, 8, 9–10 and has been widely applied in numerous clinical studies in newborn babies11, 12, 13, 14–15. In recent years, mass spectrometry has undergone significant advancements, enabling the detection of over 10,000 proteins within a single run in cellular or tissue samples16, 17–18. Utilizing this method, we previously identified over 2000 proteins in stool proteome analysis19. Additionally, the amniotic fluid proteome has been used to elucidate the intrauterine environment associated with sex, gestational age, and specific diseases, such as gastrointestinal diseases (GID), congenital heart diseases (CHD), chromosomal abnormalities (CA), and congenital infection diseases (CID)20, 21, 22, 23, 24–25.
Meconium is a viscid, odourless, greenish-black material present in the foetal intestine from approximately the 12th week of gestation. In full-term neonates, the initial meconium is typically passed within 48 h after birth. Thus, it can be collected noninvasively after birth, making it an ideal clinical sample for investigating the gastrointestinal pathophysiological condition of newborn babies26, 27, 28, 29–30.
Because meconium is minimally excreted by the foetus during gestation but is defaecated after birth, its components accumulate exclusively during intrauterine life31. The composition of the meconium may vary depending on the time of its formation in the foetal intestine. Therefore, it is believed that the composition of the initial meconium differs from that of the subsequent stool passed during the postnatal period32,33. In addition,...