Human Milk Oligosaccharides to Prevent Gut Dysfunction and Necrotizing Enterocolitis in Preterm Neonates.
Human Milk Oligosaccharides to Prevent Gut Dysfunction and Necrotizing Enterocolitis in Preterm Neonates.
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DOI：
10.3390/nu10101461
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发表时间：
2018-10-08
期刊：
影响因子：
5.9
通讯作者：
Bering SB
中科院分区：
文献类型：
--
作者：
Bering SB
本文综述了母乳低聚糖（HMO）对早产儿健康益处的证据，以刺激肠道适应并降低早期坏死性小肠结肠炎（NEC）的发病率。母乳喂养对健康的好处部分是由于丰富的HMO作为益生元和免疫调节剂。早产儿的肠道不成熟导致难以耐受肠内喂养和细菌定植以及对NEC的高度敏感性，特别是当母乳不足时。由于早产儿的不成熟，他们对HMO的反应可能与足月儿不同。母乳中HMO的浓度变化很大，没有证据支持早产儿母乳中特定的高浓度。此外，早产后肠道微生物群不仅不同，而且高度可变。以猪作为早产儿模型的研究表明，在早产后的第一周内，配方奶粉中补充HMO不会使肠道成熟或预防NEC，其效果可能取决于肠道成熟的某个阶段。当肠道达到更成熟的阶段时，补充HMO对早产儿的肠道保护可能变得更加重要。
This review focuses on the evidence for health benefits of human milk oligosaccharides (HMOs) for preterm infants to stimulate gut adaptation and reduce the incidence of necrotizing enterocolitis (NEC) in early life. The health benefits of breastfeeding are partly explained by the abundant HMOs that serve as prebiotics and immunomodulators. Gut immaturity in preterm infants leads to difficulties in tolerating enteral feeding and bacterial colonization and a high sensitivity to NEC, particularly when breast milk is insufficient. Due to the immaturity of the preterm infants, their response to HMOs could be different from that in term infants. The concentration of HMOs in human milk is highly variable and there is no evidence to support a specifically adapted high concentration in preterm milk. Further, the gut microbiota is not only different but also highly variable after preterm birth. Studies in pigs as models for preterm infants indicate that HMO supplementation to formula does not mature the gut or prevent NEC during the first weeks after preterm birth and the effects may depend on a certain stage of gut maturity. Supplemented HMOs may become more important for gut protection in the preterm infants when the gut has reached a more mature phase.
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