Probiotics to improve the gut microbiome in premature infants: are we there yet?

Abstract

Gut microbiome maturation in infants born prematurely is uniquely influenced by the physiological, clinical, and environmental factors surrounding preterm birth and early life, leading to altered patterns of microbial succession relative to term infants during the first months of life. These differences in microbiome composition are implicated in acute clinical conditions that disproportionately affect preterm infants, including necrotizing enterocolitis (NEC) and late-onset sepsis (LOS). Probiotic supplementation initiated early in life is an effective prophylactic measure for preventing NEC, LOS, and other clinical concerns relevant to preterm infants. In parallel, reported benefits of probiotics on the preterm gut microbiome, metabolome, and immune function are beginning to emerge. This review summarizes the current literature on the influence of probiotics on the gut microbiome of preterm infants, outlines potential mechanisms by which these effects are exerted, and highlights important clinical considerations for determining the best practices for probiotic use in premature infants.

Three Strains of Lactobacillus Derived from Piglets Alleviated Intestinal Oxidative Stress Induced by Diquat through Extracellular Vesicles

“…These bacteria play a role in competitive adhesion, disruption of the information transmission of harmful microorganisms, and maintenance of the intestinal microecology through their metabolites [27,28]. Furthermore, Lactobacillus can directly access the intestinal epithelium and participate in the cell surface factors recognition that modulates epithelial cell anti-inflammatory and anti-apoptotic functions and maintains intestinal epithelial cell viability [29][30][31]. Moreover, Lactobacillus can regulate intestinal microecology by controlling specific functions of the mucosal immune system through the mucosal immune system or epithelial cells [32,33].…”

The Interaction between Stress and Inflammatory Bowel Disease in Pediatric and Adult Patients

“…A recently published review highlights that infants treated with probiotics have bountiful Bifidobacterium spp. independent of the probiotic formulation and reduction in potentially pathogenic bacteria [ 94 ]. Probiotics containing both Bifidobacterium and Lactobacillaceae can influence the preterm gut microbiome configuration while promoting the development of a microbiome that is more typical of term newborns [ 95 ].…”

Bifidobacterium breve Protects the Intestinal Epithelium and Mitigates Inflammation in Colitis via Regulating the Gut Microbiota–Cholic Acid Pathway

“…Previous studies have revealed the association between Bifidobacterium deficiency and the higher incidence of intestinal disorders . A study showed that administration of Bifidobacterium reduced the risk of NEC in preterm infants . Thus, Bifidobacterium may have a positive influence on intestinal maturation in the early stages of life.…”

“…15 A study showed that administration of Bifidobacterium reduced the risk of NEC in preterm infants. 16 Thus, Bifidobacterium may have a positive influence on intestinal maturation in the early stages of life.…”