Пробиотики для профилактики гастроинтестинальных расстройств у детей: обзор научных данных
Пробиотики для профилактики гастроинтестинальных расстройств у детей: обзор научных данных
Перцевал Ц., Плетинцх М., Ванденплас И. Пробиотики для профилактики гастроинтестинальных расстройств у детей: обзор научных данных. Педиатрия. Consilium Medicum. 2020; 3: 12–19. DOI: 10.26442/26586630.2020.3.200239
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Perceval C., Pletincx M., Vandenplas Y. Probiotics as prevention for gastro-intestinal disorders in pediatrics. Pediatrics. Consilium Medicum. 2020; 3: 12–19. DOI: 10.26442/26586630.2020.3.200239
Пробиотики для профилактики гастроинтестинальных расстройств у детей: обзор научных данных
Перцевал Ц., Плетинцх М., Ванденплас И. Пробиотики для профилактики гастроинтестинальных расстройств у детей: обзор научных данных. Педиатрия. Consilium Medicum. 2020; 3: 12–19. DOI: 10.26442/26586630.2020.3.200239
________________________________________________
Perceval C., Pletincx M., Vandenplas Y. Probiotics as prevention for gastro-intestinal disorders in pediatrics. Pediatrics. Consilium Medicum. 2020; 3: 12–19. DOI: 10.26442/26586630.2020.3.200239
Микробиом желудочно-кишечного тракта остается актуальной областью для клинических исследований. Данные о положительных эффектах отдельных пробиотиков в профилактике гастроинтестинальных расстройств ограничиваются исследованиями в отношении острого гастроэнтерита, антибиотикоассоциированной диареи, младенческих колик и некротизирующего энтероколита. Общий консенсус, рекомендующий использование пробиотиков при указанных состояниях, отсутствует, что обусловлено разным дизайном большинства работ, недостаточным объемом доказательств в отношении определенных штаммов, дозировок и показаний. Для формирования однозначных рекомендаций требуется большее количество хорошо спланированных исследований. На данном этапе доказательств, определяющих целесообразность рутинного использования пробиотиков для профилактики гастроинтестинальных расстройств у детей, недостаточно.
The gastro-intestinal microbiome is a hot topic in clinical research. Beneficial effects of selected probiotics in the prevention of gastrointestinal disorders are mainly limited to acute gastroenteritis, antibiotic-associated diarrhea, infantile colic and necrotizing enterocolitis. However, there is no broad consensus to recommend the use of probiotics in the prevention of these conditions, mainly because of the different design of the multiple studies, resulting in a limited evidence for specific strains and dosages and indications. More well-designed studies are needed before recommendations can be proposed. At this stage, there is insufficient evidence to recommend the routine use of probiotics in infants and children for the prevention of gastro-intestinal disorders.
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1. Cani PD. Human gut microbiome: hopes, threats and promises. Gut. 2018; 67 (9): 1716–25.
2. Dominguez-Bello MG. Delivery mode shapes the acquisition and structure of the initial microbiota across multiple body habitats in newborns. Proc Natl Acad Sci USA 2010; 107: 11971–5.
3. Yasmin F. Cesarean section, formula feeding, and infant antibiotic exposure: separate and combined impacts on gut microbial changes in later infancy. Front Pediatr 2017; 5: 200.
4. Odamaki T, Kato K, Sugahara H et al. Age-related changes in gut microbiota composition from newborn to centenarian: a cross-sectional study. BMC Microbiol 2016; 16: 90.
5. Mitre E, Susi A, Kropp LE, Schwartz DJ et al. Association between use of acid-suppressive medications and antibiotics during infancy and allergic diseases in early childhood. JAMA Pediatr 2018; 172: e180315.
6. Maier L, Pruteanu M, Kuhn M et al. Extensive impact of non-antibiotic drugs on human gut bacteria. Nature 2018; 555: 623–8.
7. Vandeputte D, Falony G, Vieira-Silva S et al. Stool consistency is strongly associated with gut microbiota richness and composition, enterotypes and bacterial growth rates. Gut 2016; 65: 57–62.
8. Lewis ZT, Totten SM, Smilowitz JT et al. Maternal fucosyltransferase 2 status affects the gut bifidobacterial communities of breastfed infants. Microbiome 2015; 3: 13.
9. Reid G, Kumar H, Khan AI et al. The case in favour of probiotics before, during and after pregnancy: insights from the first 1,500 days. Benef Microbes 2016; 7: 353–62.
10. Andersen SS, Michaelsen KF, Laursen RP et al. Why parents are skeptical about using probiotics preventively for small children: a Danish qualitative study. BMC Complement Altern Med 2018; 18: 336.
11. Fernández L, Langa S, Martín V et al. The human milk microbiota: origin and potential roles in health and disease. Pharmacol Res 2013; 69: 1–10.
12. Panduru M, Panduru NM, Sălăvăstru CM et al. Probiotics and primary prevention of atopic dermatitis: a meta-analysis of randomized controlled studies. J Eur Acad Dermatol Venereol 2015; 29: 232-42.
13. Simpson MR, Dotterud CK, Storrø O et al. Perinatal probiotic supplementation in the prevention of allergy related disease: 6 year follow up of a randomised controlled trial. BMC Dermatol 2015; 15: 13.
14. Fiocchi A, Pawankar R, Cuello-Garcia C et al. World Allergy Organization-McMaster University guidelines for allergic disease prevention (GLAD-P): probiotics. World Allergy Organ J 2015; 8: 4.
15. Rather IA, Bajpai VK, Kumar S et al. Probiotics and atopic dermatitis: an overview. Front Microbiol 2016; 7: 507.
16. Li L, Han Z, Niu X et al. Probiotic supplementation for prevention of atopic dermatitis in infants and children: a systematic review and meta-analysis. Am J Clin Dermatol 2018 (in press).
17. Forsberg A, West CE, Prescott SL et al. Pre-and probiotics for allergy prevention: time to revisit recommendations? Clin Exp Allergy 2016; 46; 1506–21.
18. Grev J, Berg M, Soll R. Maternal probiotic supplementation for prevention of morbidity and mortality in preterm infants. Cochrane Database Syst Rev 2018; 12: CD012519.
19. Lo Vecchio A, Vandenplas Y, Benninga M et al. An international consensus report on a new algorithm for the management of infant diarrhoea. Acta Paediatr 2016; 105: e384–9.
20. Chouraqui JP, Van Egroo LD, Fichot MC. Acidified milk formula supplemented with bifidobacterium lactis: impact on infant diarrhea in residential care settings. J Pediatr Gastroenterol Nutr 2004; 38: 288–92.
21. Hojsak I, Močić Pavić A, Kos T et al. Bifidobacterium animalis subsp. lactis in prevention of common infections in healthy children attending day care centers – Randomized, double blind, placebo-controlled study. Clin Nutr 2016; 35: 587–91.
22. Sazawal S, Dhingra U, Hiremath G et al. Prebiotic and probiotic fortified milk in prevention of morbidities among children: community-based, randomized, double-blind, controlled trial. PLoS One 2010; 5: e12164.
23. Laursen RP, Larnkjær A, Ritz C et al. Probiotics and child care absence due to infections: a randomized controlled trial. Pediatrics 2017; 140: pii: e20170735.
24. Bocquet A, Lachambre E, Kempf C et al. Effect of infant and follow-on formulas containing B lactis and galacto- and fructo-oligosaccharides on infection in healthy term infants. J Pediatr Gastroenterol Nutr 2013; 57: 180–7.
25. Oberhelman RA, Gilman RH, Sheen P et al. A placebo-controlled trial of Lactobacillus GG to prevent diarrhea in undernourished Peruvian children. J Pediatr 1999; 134: 15–20.
26. Schneider C, Illi M, Lötscher M et al. Isolation of Antibodies from Human Plasma, Saliva, Breast Milk, and Gastrointestinal Fluid. Methods Mol Biol 2017; 1643: 23–31.
27. Freedman SB, Williamson-Urquhart S, Farion KJ et al. Multicenter trial of a combination probiotic for children with gastroenteritis. N Engl J Med 2018; 379: 2015–26.
28. Schnadower D, Tarr PI, Casper TC et al. Lactobacillus rhamnosus GG versus placebo for acute gastroenteritis in children. N Engl J Med 2018; 379: 2002–14.
29. Pedone CA, Arnaud CC, Postaire ER et al. Multicentric study of the effect of milk fermented by Lactobacillus casei on the incidence of diarrhoea. Int J Clin Pract 2000; 54: 568–71.
30. Weizman Z, Asli G, Alsheikh A. Effect of a probiotic infant formula on infections in child care centers: comparison of two probiotic agents. Pediatrics 2005; 115: 5–9.
31. Gutierrez-Castrellon P, Lopez-Velazquez G, Diaz-Garcia L et al. Diarrhea in preschool children and Lactobacillus reuteri: a randomized controlled trial. Pediatrics 2014; 133: e904–9.
32. Urbańska M, Szajewska H. The efficacy of Lactobacillus reuteri DSM 17938 in infants and children: a review of the current evidence. Eur J Pediatr 2014; 173: 1327–37.
33. Saavedra JM, Bauman NA, Oung I et al. Feeding of Bifidobacterium bifidum and Streptococcus thermophilus to infants in hospital for prevention of diarrhoea and shedding of rotavirus. Lancet 1994; 344: 1046–9.
34. Hojsak I, Tokić Pivac V, Močić Pavić A et al. Bifidobacterium animalis subsp. lactis fails to prevent common infections in hospitalized children: a randomized, double-blind, placebo-controlled study. Am J Clin Nutr 2015; 101: 680–4.
35. Szajewska H, Kotowska M, Mrukowicz JZ et al. Efficacy of Lactobacillus GG in prevention of nosocomial diarrhea in infants. J Pediatr 2001; 138: 361–5.
36. Mastretta E, Longo P, Laccisaglia A et al. Effect of Lactobacillus GG and breast-feeding in the prevention of rotavirus nosocomial infection. J Pediatr Gastroenterol Nutr 2002; 35: 527–31.
37. Bruzzese E, Fedele MC, Bruzzese D et al. Randomised clinical trial: a Lactobacillus GG and micronutrient-containing mixture is effective in reducing nosocomial infections in children, vs. placebo. Aliment Pharmacol Ther 2016; 44: 568–75.
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Авторы
Ц. Перцевал1, М. Плетинцх2, И. Ванденплас*1
1 Университетская клиника Брюсселя, Свободный университет Брюсселя, Бельгия;
2 Группа CHIREC, клиника Ste-Anne St-Remi, Брюссель, Бельгия
*yvan.vandenplas@uzbrussel.be
________________________________________________
Celine Perceval1, Michel Pletincx2, Yvan Vandenplas*1
1 KidZ Health Castle, UZ Brussel, Vrije Universiteit Brussel, Brussels, Belgium;
2 CHIREC, St-Anne St-Remi, Brussels, Belgium
*yvan.vandenplas@uzbrussel.be