Bacterial colonization, probiotics, and necrotizing enterocolitis
Bacterial colonization, probiotics, and necrotizing enterocolitis
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DOI：
10.1097/mcg.0b013e31815a57a8
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发表时间：
2008-07-01
影响因子：
2.9
通讯作者：
Walker, W. Allan
中科院分区：
文献类型：
--
作者：
Claud, Erika C.;Walker, W. Allan
肠道菌群对肠道健康和肠道功能具有重要作用。新生儿群体的独特之处在于肠道定植尚未建立，并且已知受分娩方式、喂养、胎龄和医疗干预的影响。早产儿对定植模式特别敏感，因为固有的肠道防御机制是不成熟的，并且已知未成熟的肠上皮细胞对共生菌和致病菌都有夸大的炎症反应。这些反应有助于新生儿坏死性小肠结肠炎的发展。由于已知某些细菌会影响肠道成熟并下调肠道炎症，因此有人认为影响早产儿的肠道菌群可能是有益的。临床研究表明，益生菌治疗可降低坏死性小肠结肠炎的发病率，目前正在研究不同益生菌的作用机制。尽管仍存在担忧，需要进一步研究，但益生菌是优化肠道定植和影响这些易感婴儿结局的合理手段。
The intestinal microflora has a significant role in intestinal health and gut function. The neonatal population is unique in that intestinal colonization is not established and is known to be influenced by delivery method, feeding, gestational age, and medical interventions. The preterm infant is particularly sensitive to colonization patterns as inherent intestinal defense mechanisms are immature and immature intestinal epithelial cells are known to have exaggerated inflammatory responses to both commensal and pathogenic bacteria. These responses contribute to the development of neonatal necrotizing enterocolitis in this patient population. As certain bacteria are known to influence intestinal maturation and down-regulate intestinal inflammation, it has been suggested that influencing the intestinal flora of preterm infants may be beneficial. Clinical studies indicate that probiotic therapy may decrease the incidence of necrotizing enterocolitis and studies are ongoing to elucidate the mechanism of action of different probiotic organisms. Although concerns remain and further study is necessary, probiotics are a plausible means of optimizing intestinal colonization and influencing outcome of these vulnerable infants.