Probiotics and Synbiotics in Necrotizing Enterocolitis: Where Are We?

Qasem, Wafaa; Alnaqi, Amar; Jorgensen, Sarah C J; Friel, James K.

doi:10.15406/jpnc.2014.01.00007

Cited by 3 publications

(11 citation statements)

References 50 publications

(58 reference statements)

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“…Recently, Sawh et al concluded that administration of probiotics may prevent severe NEC in infants with a birth weight < 2500 g but did not recommend for babies with a birth weight < 1000 g [107]. Reviewed literature suggested administration of probiotics in premature infants for prevention of NEC, however the current evidence are not conclusive due to the heterogeneity of probiotic formulations (single or multiple-strains of probiotics), diverse doses (10 5 to 10 10 cfu/ml) and duration of treatment [108]. Based upon reviewed literature routine use of probiotics in the preterm infant is not be recommended due to many uncertainties such as the mechanisms of action of probiotics, health effects of employed probiotics, forms of microbial adaptations and ecological consequences [109].…”

Section: Safety Of Probiotics For Preterm Infantsmentioning

confidence: 99%

Probiotic Therapy for Prevention of Necrotizing Enterocolitis in Preterm Infants – A Review

Sarkar¹

2018

jnhfs

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Purpose: Preterm infants are prone to systemic infections due to increased intestinal permeability to potentially pathogens resulting from immature intestinal function, frequent use of broad-spectrum antibiotics, delay in initiating enteral feeding, infection control procedures and sterilization of milk. Very Low Birth Weight infants, particularly Extremely Low Birth Weight infants are at higher risk due to abnormal pattern of colonization, which may contribute to the pathogenesis of neonatal Necrotizing Enterocolitis (NEC). Dietary intervention through probiotic supplementation is widely adopted for the prophylaxis of NEC and nosocomial infections throughout the world. Design/Methodology/Approach: This review paper is based upon systematic review of randomized controlled trials, metaanalyses, research papers and books related to the short and longterm administration of single or mixed probiotic cultures for the prevention of NEC only in preterm infants. Clinical trials and cohort studies concerning manipulation of the intestinal microbiota in premature infants are also included. Evidence based data published in the English language retrieved from three databases Pub Med, Science Direct and Cochrane Reviews, published in The Cochrane Library from 2000-2016, using a combination of key words like necrotizing enterocolitis, probiotics and preterm infants have been considered. Findings: All probiotic strains are not equally efficacious for preventing NEC and application of probiotic combinations may be advantageous. Due to heterogeneity of probiotic formulations exclusive administration of probiotics in premature infants is not recommended and should be introduced along with breast milk as routine clinical practice for neonatal health care. Originality/Value: Probiotic foods have been found effective in modulating gastrointestinal flora to prevent NEC but safety aspects must be evaluated prior to consideration of probiotic therapy for preterm infants and neonates.

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Section: Safety Of Probiotics For Preterm Infantsmentioning

confidence: 99%

Probiotic Therapy for Prevention of Necrotizing Enterocolitis in Preterm Infants – A Review

Sarkar¹

2018

jnhfs

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“…Subsequent enteral feeding and environmental factors affects colonization. The pattern changes according to the type of delivery (spontaneous vaginal delivery/ caesarean section), maturity of baby, feeding (human milk / formula), administration of antibiotics and drugs acting on gastrointestinal tract [8]. Newborns delivered vaginally have more Bifidobacterium and Lactobacillus species and colonization with these beneficial microorganisms [9].…”

Section: Introductionmentioning

confidence: 99%

“…Colonization with non-pathogenic diverse organisms such as Bifidobacteria and Lactobacillus is seen in healthy term babies [2]. The process of colonization in preterm and low birth weight is delayed, less diverse and with a pattern predominating pathogenic microbiome such as Staphylococci, coliforms, and bacteroids [8,9]. Bifidobacterium and Lactobacillus are the principal kinds of commensal bacteria found in breast fed babies [2,9].…”

Section: Introductionmentioning

confidence: 99%

“…In formula-fed infants potentially harmful bacterial colonization such as Coliforms, Enterococci, Clostrium and Bacteroids predominate [6,10]. The compromised gut microbiome of preterm due to broad-spectrum antibiotics and NICU environment become more pathogenic due to immature intestinal epithelial barrier and immunity [8].…”

Section: Introductionmentioning

confidence: 99%

“…Why preterm babies are more vulnerable to NEC-Gastrointestinal tract of preterm babies have immature peristaltic, digestive function along with deficient immunological and defence activities [8]. Secretory immunoglobulin A (Ig A) is also deficient in preterm babies.…”

Section: Introductionmentioning

confidence: 99%

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Necrotizing Enterocolitis: Probiotics, Prebiotics and Synbiotics for Prevention in Preterm Infants

Tripathy¹,

Nanda

Aiims³

2016

Int J Pediatr Res

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Necrotizing enterocolitis is a devastating disease of newborns associated with intestinal inflammation and necrosis. In spite of advances in neonatal care, intensive care units and refinement of surgical practices, the high mortality and long term morbidity due to NEC remains a challenge. The pathogenesis of the disease is complicated and not completely understood. Gradual development in the field of NEC revealed innate immune system, comprised of 'Toll-like receptors' (TLR) in the pathogenesis of the disease. TLR4 is an important member of TLR and is the receptor for bacterial lipopolysaccharide. Activation of TLR4 causes intestinal mucosal injury and decreased epithelial repair in premature neonates. Probiotics are live microorganisms and are rich in bacterial DNA. CpG motifs of DNA can inhibit TLR4 signaling and reduce NEC severity. Probiotics also modulate enterocyte genes that regulate innate immune-mediated inflammation, thereby preventing NEC. The above molecular basis is supported by multiple individual studies using probiotics especially Lactobacillus and Bifidobacteria for preventing NEC in preterm infants. Their encouraging results prompted us to carry out an analysis of major trials on probiotics along with considering pathophysiological and immunological aspects of the disease. Prebiotics have a protective effect in NEC by stimulating colonization of beneficial bacteria in intestine. Products containing both probiotics and prebiotics (synbiotics) were also tried and they are found to be more beneficial than either probiotics or prebiotics. This review will highlight recent concepts and evidences on probiotics and prebiotics in preventing NEC in preterm, low birth weight infants.

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Effects of Taro (Colocasia esculenta) Water-Soluble Non-Starch Polysaccharide, Lactobacillus acidophilus, Bifidobacterium breve, Bifidobacterium infantis, and Their Synbiotic Mixtures on Pro-Inflammatory Cytokine Interleukin-8 Production

et al. 2022

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In the past decades, the regulation of pro-inflammatory cytokine production, including interleukin-8 (IL-8), has been the goal of many targeted therapeutic interventions for Necrotising enterocolitis (NEC), a gastrointestinal disease commonly associated with a very low birth weight in preterm infants. In this study, the ability to regulate the production of IL-8 of the water-soluble non-starch polysaccharide (WS-NSP) from taro corm (Tc-WS-NSP) extracted using a conventional (CE) or improved conventional (ICE) extraction method, of the probiotics Lactobacillus acidophilus, Bifidobacterium breve, and Bifidobacterium infantis, and their synbiotic mixtures were evaluated. The TNF-α stimulated HT-29 cells were incubated with undigested or digested Tc-WS-NSPs (CE or ICE), probiotics, and their synbiotic mixtures with Klebsiella oxytoca, an NEC-positive-associated pathogen. Overall, the synbiotic mixtures of digested Tc-WS-NSP-ICE and high bacterial concentrations of L. acidophilus (5.57 × 109), B. breve (2.7 × 108 CFU/mL), and B. infantis (1.53 × 108) demonstrated higher (42.0%, 45.0%, 43.1%, respectively) ability to downregulate IL-8 compared to the sole use of Tc-WS-NSPs (24.5%), or the probiotics L. acidophilus (32.3%), B. breve (37.8%), or B. infantis (33.1%). The ability demonstrated by the Tc-WS-NSPs, the probiotics, and their synbiotics mixtures to downregulate IL-8 production in the presence of an NEC-positive-associated pathogen may be useful in the development of novel prophylactic agents against NEC.

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Probiotics and Synbiotics in Necrotizing Enterocolitis: Where Are We?

Cited by 3 publications

References 50 publications

Probiotic Therapy for Prevention of Necrotizing Enterocolitis in Preterm Infants – A Review

Probiotic Therapy for Prevention of Necrotizing Enterocolitis in Preterm Infants – A Review

Necrotizing Enterocolitis: Probiotics, Prebiotics and Synbiotics for Prevention in Preterm Infants

Effects of Taro (Colocasia esculenta) Water-Soluble Non-Starch Polysaccharide, Lactobacillus acidophilus, Bifidobacterium breve, Bifidobacterium infantis, and Their Synbiotic Mixtures on Pro-Inflammatory Cytokine Interleukin-8 Production

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