Necrotizing Enterocolitis: Probiotics, Prebiotics and Synbiotics for Prevention in Preterm Infants
Journal Title: Pediatric Review: International Journal of Pediatric Research - Year 2016, Vol 3, Issue 11
Abstract
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.
Authors and Affiliations
Prasanta Kumar Tripathy, Rachita Nanda
Keywords
Related Articles
- EP ID EP227385
- DOI 10.17511
- Views 131
- Downloads 0
Patent ductus arteriosus – clinical profile and outcome after treatment in a tertiary care hospital
Background: Patent ductus arteriosus (PDA) is the commonest congenital heart disease seen in neonatal ICU. Methods: A prospective observational study was conducted in the neonatal intensive care unit of Vydehi institute...
Anthropometric profiles of children with congenital heart disease
Background: Congenital heart disease (CHD) is often associated with malnutrition and failure to thrive in children. Children with congenital heart diseases are frequently undernourished irrespective of cardiac defect and...
Television viewing and aggressive behavior during adolescence
1. StrasburgerVC,Wilson BT, Jordem AB. Children adolescents and the media-2nd ed Thousand oaks,CA:Sage :2009. 2. Zimmerman FJ, Glew GM, Christakis DA, Katon W. Early cognitive stimulation, emotional support, and televis...
Outcome analysis of intussusception in fifty children at a tertiary centre in Mumbai
Background: Intussusception is a common cause of obstruction in Paediatric patients. Recognizing and treating this condition rapidly is important to prevent potentially fatal complications. Methods: Fifty consecutive pat...
A comparative study of serum electrolytes in newborns with birth asphyxia and non-asphyxiated newborns
Background: Birth asphyxia is a common neonatal problem and contributes significantly to neonatal morbidity and mortality. HIE is the foremost concern in asphyxiated neonate because contrary to other system derangements...