The potential of probiotics in the fight against necrotizing enterocolitis

Eaton, Simon; Hall, Nigel

doi:10.1586/17474124.2013.827480

Cited by 3 publications

(2 citation statements)

References 19 publications

(21 reference statements)

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“…Modulation of initial gut colonization by anti-, pre- and probiotics may reduce NEC risk but the optimal efficacy, time and dose of such treatments are unclear. 20–25 Although antibiotics have been reported to decrease NEC incidence in several small studies, 25 there is a well-justified reluctance to use prophylactic antibiotics owing to insufficient mechanistic evidence for benefits and risk of antibiotic resistance. In addition, it is important that prolonged postnatal administration of systemic antibiotics is associated with altered gut bacterial colonization and increased risk of NEC in preterm infants.…”

Section: Introductionmentioning

confidence: 99%

Oral antibiotics increase blood neutrophil maturation and reduce bacteremia and necrotizing enterocolitis in the immediate postnatal period of preterm pigs

et al. 2015

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Immature immunity may predispose preterm neonates to infections and necrotizing enterocolitis (NEC). Intravenous antibiotics are frequently given to prevent and treat sepsis, while oral antibiotics are seldom used. We hypothesized that oral antibiotics promote maturation of systemic immunity and delay gut bacterial colonization and thereby protect preterm neonates against both NEC and bacteremia in the immediate postnatal period. Preterm pigs were given formula and administered saline (CON) or broad-spectrum antibiotics orally (ORA) or systemically (SYS) for 5 d after birth. Temporal changes in blood parameters and bacterial composition in the intestine, blood and immune organs were analyzed. Newborn preterm pigs had few blood neutrophils and a high frequency of progenitor cells. Neutrophils gradually matured after preterm birth with increasing CD14 and decreasing CD172a expressions. Preterm neutrophil and monocyte TLR2 expression and TLR2-mediated blood cytokine responses were low relative to adults. ORA pigs showed enhanced blood neutrophil maturation with reduced cell size and CD172a expression. Only ORA pigs, but not SYS pigs, were protected from a high density of gut Gram-positive bacteria, high gut permeability, Gram-positive bacteremia and NEC. Neonatal oral antibiotics may benefit mucosal and systemic immunity via delayed gut colonization and enhanced blood neutrophil maturation just after preterm birth.

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Section: Introductionmentioning

confidence: 99%

Oral antibiotics increase blood neutrophil maturation and reduce bacteremia and necrotizing enterocolitis in the immediate postnatal period of preterm pigs

et al. 2015

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“…Given the morbidity and mortality, there is an urgent need for development of strategies to prevent and treat the disease. Although there has been much recent interest in the use of prophylactic probiotic administration to premature infants to prevent NEC [8], this is unlikely to eradicate the disease [9]. Similarly, although randomized controlled trials of different surgical approaches may yield incremental improvements in outcomes, it is unlikely that any surgical intervention will be 'curative' or yield a massive reduction in morbidity or mortality [9].…”

Section: Introductionmentioning

confidence: 99%

Stem cells as a potential therapy for necrotizing enterocolitis

Eaton¹,

Zani

Pierro

et al. 2013

Expert Opinion on Biological Therapy

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The current data are promising and demonstrate that stem cells do have an effect in rodent models of NEC. However, the short timescale, limited ability for longitudinal evaluation and uncertain clinical relevance of these models means that there are considerable challenges to be overcome before attempting stem cell therapy in clinical trials. Nevertheless, these data open up novel areas of research into a prevention or therapy for this devastating disease.

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