Para-probiotics for Preterm Neonates-The Next Frontier

被引:114
作者
Deshpande, Girish [1 ,2 ]
Athalye-Jape, Gayatri [3 ]
Patole, Sanjay [3 ]
机构
[1] Nepean Hosp, Dept Neonatol, Kingswood, NSW 2747, Australia
[2] Univ Sydney, Sydney Med Sch Nepean, Kingswood, NSW 2747, Australia
[3] King Edward Mem Hosp Women, Dept Neonatol, Perth, WA 6008, Australia
关键词
infant; newborn; probiotics; review; sepsis; LACTOBACILLUS-RHAMNOSUS GG; INDUCED INTERLEUKIN-8 PRODUCTION; BLOOD MONONUCLEAR-CELLS; BIRTH-WEIGHT INFANTS; LATE-ONSET SEPSIS; NECROTIZING ENTEROCOLITIS; INTENSIVE-CARE; BIFIDOBACTERIUM SEPTICEMIA; IMMUNE-RESPONSE; BACTERIA;
D O I
10.3390/nu10070871
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Current evidence supports the use of probiotics in preterm neonates for prevention of necrotizing enterocolitis, mortality and late onset sepsis. Despite the strong evidence, the uptake of this intervention has not been universal due to concerns including probiotic sepsis, pro-inflammatory response and transmission of antibiotic resistance. Critically ill extremely preterm neonates with potentially compromised gut integrity are at higher risk of probiotic sepsis due to translocation. In most countries, probiotics are sold as food supplements with poor quality control. The traditional definition of probiotics as live microorganisms has been challenged as many experts have questioned the importance of viability in the context of the beneficial effects of probiotics. Paraprobiotics (ghost probiotics), are defined as non-viable microbial cells (intact or broken) or crude cell extracts (i.e., with complex chemical composition), which, when administered (orally or topically) in adequate amounts, confer a benefit on the human or animal consumer. Current evidence indicates that paraprobiotics could be safe alternatives to probiotics in preterm neonates. High-quality pre-clinical and clinical studies including adequately powered randomised controlled trials (RCTs) are warranted in preterm neonates to explore this new frontier.
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页数:9
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