Rational Probiotic Strain Selection to Prevent Necrotizing Enterocolitis.
Rational Probiotic Strain Selection to Prevent Necrotizing Enterocolitis.
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合理选择益生菌菌株预防坏死性小肠结肠炎。
DOI：
10.1097/mpg.0000000000003571
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发表时间：
2022-10-01
影响因子：
2.9
通讯作者：
Preidis, Geoffrey A.
中科院分区：
文献类型：
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作者：
Preidis, Geoffrey A.
死亡率很高，长期神经发育迟缓很常见。尽管有几十年的研究，NEC的病理生理学仍然知之甚少。目前的理论包括遗传易感性，不成熟的肠道功能（如运动，屏障功能，免疫反应，微血管张力），以及新生儿肠道的不适当的初始微生物定植（1）。异常肠道微生物定植（通常在早期抗生素之后）促进炎症和NEC的可能性为益生菌靶向新生儿肠道微生物组提供了理论基础。益生菌在这方面已经研究了四十年，并且证据的总量是巨大的。最近更新的科克伦综述（2）确定了56项试验，包括10,812名极早产或极低出生体重婴儿。总体而言，益生菌可将NEC的风险降低约50%。然而，证据的确定性很低，因为人们担心许多试验规模较小，使用的方法不可靠，并且测试了一系列不同的益生菌干预措施（2）。
Mortality rates are high and long-term neurodevelopmental delays are common. Despite decades of research, the pathophysiology of NEC remains poorly understood. Current theories include genetic predisposition, immature intestinal function (eg motility, barrier function, immune response, microvascular tone), and inappropriate initial microbial colonization of the newborn intestine (1).The possibility that aberrant gut microbial colonization (often following early-life antibiotics) promotes inflammation and NEC provides a theoretical basis for targeting the neonatal gut microbiome with probiotics. Probiotics have been studied in this context for four decades, and the total body of evidence is substantial. A recently updated Cochrane review (2) identified 56 trials including 10,812 very preterm or very low-birth weight infants. Overall, probiotics reduce the risk of NEC by around 50%. However, the certainty of the evidence was low based on concerns that many trials were small, used unreliable methods, and tested a heterogeneous array of probiotic interventions (2).