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Формирование микробиоты кишечника младенца в зависимости от способа родоразрешения: отдаленные последствия и варианты коррекции
Формирование микробиоты кишечника младенца в зависимости от способа родоразрешения: отдаленные последствия и варианты коррекции
Дедикова О.В., Захарова И.Н., Кучина А.Е., Бережная И.В., Сугян Н.Г. Формирование микробиоты кишечника младенца в зависимости от способа родоразрешения: отдаленные последствия и варианты коррекции. Педиатрия. Consilium Medicum. 2023;1:25–29. DOI: 10.26442/26586630.2023.1.202092
© ООО «КОНСИЛИУМ МЕДИКУМ», 2023 г.
© ООО «КОНСИЛИУМ МЕДИКУМ», 2023 г.
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Аннотация
Изучению микробиома человека посвящено большое количество исследований. Показано, что микробиом оказывает существенное влияние практически на всю жизнедеятельность организма хозяина. В статье рассматривается влияние различных факторов на формирование кишечной микробиоты новорожденных. Основное внимание уделяется способу родоразрешения, поскольку микробиота кишечника детей, рожденных естественным путем, отличается от таковой детей, извлеченных из чрева матери путем операции кесарева сечения. На формирование микробиома кишечника большое влияние оказывает микробиота кишечника и влагалища матери. Способ родоразрешения влияет не только на становление кишечной микробиты, но и опосредованно на развитие иммунной системы новорожденного. Нельзя исключить, что изменения кишечной микробиоты, связанные с оперативным родоразрешением, оказывают влияние на становление иммунной системы новорожденного младенца. Отсутствие колонизации материнской флорой в момент родов может способствовать большему риску развития различных инфекционных и неинфекционных заболеваний. Видится важным правильно и своевременно проводить коррекцию микробиоты детей, рожденных путем кесарева сечения, путем введения пробиотиков (моно- или мультиштаммовых пробиотиков). При назначении того или иного пробиотика важно, чтобы конкретный штамм являлся хорошо исследованным, обладал безопасностью, имел положительный опыт применения у новорожденных, являлся зарегистрированным именно для применения у детей с рождения.
Ключевые слова: новорожденный, микробиота, естественные роды, операция кесарева сечения, иммунитет, пробиотики, Lactobacillus, Bifidobacterium
Keywords: newborn microbiota, vaginal birth, cesarean section, immunity, probiotics, Lactobacillus, Bifidobacterium
Ключевые слова: новорожденный, микробиота, естественные роды, операция кесарева сечения, иммунитет, пробиотики, Lactobacillus, Bifidobacterium
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Keywords: newborn microbiota, vaginal birth, cesarean section, immunity, probiotics, Lactobacillus, Bifidobacterium
Полный текст
Список литературы
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35. Garcia Rodenas CL, Lepage M, Ngom-Bru C, et al. Effect of Formula Containing Lactobacillus reuteri DSM 17938 on Fecal Microbiota of Infants Born by Cesarean-Section Randomized Controlled Trial. J Pediatr Gastroenterol Nutr. 2016;63(6):681-7. DOI:10.1097/MPG.0000000000001198
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2. Mohr JL. Protozoa as indicators of pollution. The Scientific Monthly. 1952.
3. Romano-Keeler J, Weitkamp JH. Maternal influences on fetal microbial colonization and immune development. Pediatr Res. 2015;77(1-2):189-95.
4. Chiu CY, Chan YL, Tsai YS, et al. Airway microbial diversity is inversely associated with mite-sensitized rhinitis and asthma in early childhood. Sci Rep. 2017;7(1):1820.
5. Damgaard C, Magnussen K, Enevold C, et al. Viable bacteria associated with red blood cells and plasma in freshly drawn blood donations. PLoS One. 2015;10(3):e0120826.
6. Aagaard K, Ma J, Antony KM, et al. The Placenta Harbors a Unique Microbiome. Sci Transl Med. 2014;6(237):237ra65.
7. Dominguez-Bello MG, Godoy-Vitorino F, Knight R, Blaser MJ. Role of the microbiome in human development. Gut. 2019;68(6):1108-14. DOI:10.1136/gutjnl-2018-317503
8. Gomez de Agüero M, Ganal-Vonarburg SC, Fuhrer T, et al. The maternal microbiota drives early postnatal innate immune development. Science. 2016;351(6279):1296-302.
9. Yao Y, Cai X, Ye Y, et al. The Role of Microbiota in Infant Health: From Early Life to Adulthood. Front Immunol. 2021;12:708472. DOI:10.3389/fimmu.2021.708472
10. Koh A, De Vadder F, Kovatcheva-Datchary P, Backhed F. From dietary fiber to host physiology: Short-chain fatty acids as key bacterial metabolites. Cell. 2016;165(6):1332-45. DOI:10.1016/j.cell.2016.05.041
11. Tan J, McKenzie C, Potamitis M, et al. The role of short-chain fatty acids in health and disease. Adv Immunol. 2014;121:91-119. DOI:10.1016/B978-0-12-800100-4.00003-9
12. Keski-Nisula L, Kyynarainen HR, Karkkainen U, et al. Maternal intrapartum antibiotics and decreased vertical transmission of Lactobacillus to neonates during birth. Acta Paediatr. 2013;102(5):480-5. DOI:10.1111/apa.12186
13. Stokholm J, Schjorring S, Eskildsen CE, et al. Antibiotic use during pregnancy alters the commensal vaginal microbiota. Clin Microbiol Infect. 2014;20(7):629‑35.
DOI:10.1111/1469-0691.12411
14. Zhou P, Zhou Y, Liu B, et al. Perinatal Antibiotic Exposure Affects the Transmission Between Maternal and Neonatal Microbiota and Is Associated With Early-Onset Sepsis. mSphere. 2020;5(1):e00984-19. DOI:10.1128/mSphere.00984-19
15. Qin S, Liu Y, Wang S, et al. Distribution Characteristics of intestinal Microbiota During Pregnancy and Postpartum in Healthy Women. J Matern Fetal Neonatal Med. 2022;35(15):2915-22. DOI:10.1080/14767058.2020.1812571
16. Dunn AB, Jordan S, Baker BJ, Carlson NS. The Maternal Infant Microbiome: Considerations for Labor and Birth. MCN Am J Matern Child Nurs. 2017;42(6):318‑25. DOI:10.1097/NMC.0000000000000373
17. Korpela K, de Vos WM. Early life colonization of the human gut: microbes matter everywhere. Curr Opin Microbiol. 2018;44:70-8.
18. Reddel S, Pascucci GR, Foligno S, et al. A Parallel Tracking of Salivary and Gut Microbiota Profiles Can Reveal Maturation and Interplay of Early Life Microbial Communities in Healthy Infants. Microorganisms. 2022;10(2):468. DOI:10.3390/microorganisms10020468
19. Korpela K. Impact of Delivery Mode on Infant Gut Microbiota. Ann Nutr Metab. 2021;1-9. DOI:10.1159/000518498
20. Stewart CJ, Ajami NJ, O’Brien JL, et al. Temporal development of the gut microbiome in early childhood from the TEDDY study. Nature. 2018;562(7728):583‑8.
DOI:10.1038/s41586-018-0617-x
21. Arboleya S, Suárez M, Fernández N, et al. C-section and the Neonatal Gut Microbiome Acquisition: Consequences for Future Health. Ann Nutr Metab. 2018;73(Suppl. 3):17-23.
22. Vargas S, Rego S, Clode N. Cesarean Section Rate Analysis in a Tertiary Hospital in Portugal According to Robson Ten Group Classification System. Rev Bras Ginecol Obstet. 2020;42(6):310-5. DOI:10.1055/s-0040-1712127
23. Gensollen T, Iyer SS, Kasper DL, Blumberg RS. How colonization by microbiota in early life shapes the immune system. Science. 2016;352(6285):539-44.
24. Korpela K, Zijlmans M, Kuitunen M, et al. Childhood BMI in relation to microbiota in infancy and lifetime antibiotic use. Microbiome. 2017;5(1):26.
25. Francino MP. Birth mode-related differences in gut microbiota colonization and immune system development. Ann Nutr Metab. 2018;73(Suppl. 3):12-6. DOI:10.1159/000490842
26. Ratajczak W, Rył A, Mizerski A, et al. Immunomodulatory potential of gut microbiome-derived short-chain fatty acids (SCFAs). Acta Biochimica Polonica. 2019;66(1):1-12. DOI:10.18388/abp.2018_2648
27. Hemarajata P, Versalovic J. Effects of probiotics on gutmicrobiota: mechanisms of intestinal immunomodulation and neuromodulation. Therap Adv Gastroenterol. 2013;6(1):39-51.
28. La Fata G, Weber P, Mohajeri MH. Probiotics and the gut immune system: indirect regulation. Probiotics Antimicrob Proteins. 2018;10(1):11-21.
29. Zhang C, Li L, Jin B, et al. The Effects of Delivery Mode on the Gut Microbiota and Health: State of Art. Front Microbiol. 2021;12:724449. DOI:10.3389/fmicb.2021.724449
30. Palladino E, Van Mieghem T, Connor KL. Diet Rooks MG, Garrett WS. Gut Microbiota, Metabolites and Host Immunity. Nat Rev Immunol. 2016;16(6):341-52. DOI:10.1038/nri.2016.42
31. Yao Y, Cai X, Fei W, et al. The Role of Short-Chain Fatty Acids in Immunity, Inflammation and Metabolism. Crit Rev Food Sci Nutr. 2022;62(1):1-12. DOI:10.1080/10408398.2020.1854675
32. Olszak T, An D, Zeissig S, et al. Microbial Exposure During Early Life has Persistent Effects on Natural Killer T Cell Function. Science. 2012;336(6080):489‑93. DOI:10.1126/science.1219328
33. Słabuszewska-Jóźwiak A, Szymański JK, Ciebiera M, et al. Pediatrics Consequences of Caesarean Section–A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. 2020;17(21):8031. DOI:10.3390/ijerph17218031
34. Hill C, Guarner F, Reid G, et al. Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol. 2014;11(8):506-14. DOI:10.1038/nrgastro.2014.66
35. Garcia Rodenas CL, Lepage M, Ngom-Bru C, et al. Effect of Formula Containing Lactobacillus reuteri DSM 17938 on Fecal Microbiota of Infants Born by Cesarean-Section Randomized Controlled Trial. J Pediatr Gastroenterol Nutr. 2016;63(6):681-7. DOI:10.1097/MPG.0000000000001198
36. Hurkala J, Lauterbach R, Radziszewska R, et al. Effect of a Short-Time Probiotic Supplementation on the Abundance of the Main Constituents of the Gut Microbiota of Term Newborns Delivered by Cesarean Section – A Randomized, Prospective, Controlled Clinical Trial. Nutrients. 2020;12(10):3128. DOI:10.3390/nu12103128
37. Yang W, Tian L, Luo J, Yu J. Ongoing Supplementation of Probiotics to Cesarean-Born Neonates during the First Month of Life may Impact the Gut Microbial. Am J Perinatol. 2021;38(11):1181-91. DOI:10.1055/s-0040-1710559
38. Martín-Peláez S, Cano-Ibáñez N, Pinto-Gallardo M, Amezcua-Prieto C. The Impact of Probiotics, Prebiotics, and Synbiotics during Pregnancy or Lactation on the Intestinal Microbiota of Children Born by Cesarean Section: A Systematic Review. Nutrients. 2022;14(2):341. DOI:10.3390/nu14020341
2. Mohr JL. Protozoa as indicators of pollution. The Scientific Monthly. 1952.
3. Romano-Keeler J, Weitkamp JH. Maternal influences on fetal microbial colonization and immune development. Pediatr Res. 2015;77(1-2):189-95.
4. Chiu CY, Chan YL, Tsai YS, et al. Airway microbial diversity is inversely associated with mite-sensitized rhinitis and asthma in early childhood. Sci Rep. 2017;7(1):1820.
5. Damgaard C, Magnussen K, Enevold C, et al. Viable bacteria associated with red blood cells and plasma in freshly drawn blood donations. PLoS One. 2015;10(3):e0120826.
6. Aagaard K, Ma J, Antony KM, et al. The Placenta Harbors a Unique Microbiome. Sci Transl Med. 2014;6(237):237ra65.
7. Dominguez-Bello MG, Godoy-Vitorino F, Knight R, Blaser MJ. Role of the microbiome in human development. Gut. 2019;68(6):1108-14. DOI:10.1136/gutjnl-2018-317503
8. Gomez de Agüero M, Ganal-Vonarburg SC, Fuhrer T, et al. The maternal microbiota drives early postnatal innate immune development. Science. 2016;351(6279):1296-302.
9. Yao Y, Cai X, Ye Y, et al. The Role of Microbiota in Infant Health: From Early Life to Adulthood. Front Immunol. 2021;12:708472. DOI:10.3389/fimmu.2021.708472
10. Koh A, De Vadder F, Kovatcheva-Datchary P, Backhed F. From dietary fiber to host physiology: Short-chain fatty acids as key bacterial metabolites. Cell. 2016;165(6):1332-45. DOI:10.1016/j.cell.2016.05.041
11. Tan J, McKenzie C, Potamitis M, et al. The role of short-chain fatty acids in health and disease. Adv Immunol. 2014;121:91-119. DOI:10.1016/B978-0-12-800100-4.00003-9
12. Keski-Nisula L, Kyynarainen HR, Karkkainen U, et al. Maternal intrapartum antibiotics and decreased vertical transmission of Lactobacillus to neonates during birth. Acta Paediatr. 2013;102(5):480-5. DOI:10.1111/apa.12186
13. Stokholm J, Schjorring S, Eskildsen CE, et al. Antibiotic use during pregnancy alters the commensal vaginal microbiota. Clin Microbiol Infect. 2014;20(7):629‑35.
DOI:10.1111/1469-0691.12411
14. Zhou P, Zhou Y, Liu B, et al. Perinatal Antibiotic Exposure Affects the Transmission Between Maternal and Neonatal Microbiota and Is Associated With Early-Onset Sepsis. mSphere. 2020;5(1):e00984-19. DOI:10.1128/mSphere.00984-19
15. Qin S, Liu Y, Wang S, et al. Distribution Characteristics of intestinal Microbiota During Pregnancy and Postpartum in Healthy Women. J Matern Fetal Neonatal Med. 2022;35(15):2915-22. DOI:10.1080/14767058.2020.1812571
16. Dunn AB, Jordan S, Baker BJ, Carlson NS. The Maternal Infant Microbiome: Considerations for Labor and Birth. MCN Am J Matern Child Nurs. 2017;42(6):318‑25. DOI:10.1097/NMC.0000000000000373
17. Korpela K, de Vos WM. Early life colonization of the human gut: microbes matter everywhere. Curr Opin Microbiol. 2018;44:70-8.
18. Reddel S, Pascucci GR, Foligno S, et al. A Parallel Tracking of Salivary and Gut Microbiota Profiles Can Reveal Maturation and Interplay of Early Life Microbial Communities in Healthy Infants. Microorganisms. 2022;10(2):468. DOI:10.3390/microorganisms10020468
19. Korpela K. Impact of Delivery Mode on Infant Gut Microbiota. Ann Nutr Metab. 2021;1-9. DOI:10.1159/000518498
20. Stewart CJ, Ajami NJ, O’Brien JL, et al. Temporal development of the gut microbiome in early childhood from the TEDDY study. Nature. 2018;562(7728):583‑8.
DOI:10.1038/s41586-018-0617-x
21. Arboleya S, Suárez M, Fernández N, et al. C-section and the Neonatal Gut Microbiome Acquisition: Consequences for Future Health. Ann Nutr Metab. 2018;73(Suppl. 3):17-23.
22. Vargas S, Rego S, Clode N. Cesarean Section Rate Analysis in a Tertiary Hospital in Portugal According to Robson Ten Group Classification System. Rev Bras Ginecol Obstet. 2020;42(6):310-5. DOI:10.1055/s-0040-1712127
23. Gensollen T, Iyer SS, Kasper DL, Blumberg RS. How colonization by microbiota in early life shapes the immune system. Science. 2016;352(6285):539-44.
24. Korpela K, Zijlmans M, Kuitunen M, et al. Childhood BMI in relation to microbiota in infancy and lifetime antibiotic use. Microbiome. 2017;5(1):26.
25. Francino MP. Birth mode-related differences in gut microbiota colonization and immune system development. Ann Nutr Metab. 2018;73(Suppl. 3):12-6. DOI:10.1159/000490842
26. Ratajczak W, Rył A, Mizerski A, et al. Immunomodulatory potential of gut microbiome-derived short-chain fatty acids (SCFAs). Acta Biochimica Polonica. 2019;66(1):1-12. DOI:10.18388/abp.2018_2648
27. Hemarajata P, Versalovic J. Effects of probiotics on gutmicrobiota: mechanisms of intestinal immunomodulation and neuromodulation. Therap Adv Gastroenterol. 2013;6(1):39-51.
28. La Fata G, Weber P, Mohajeri MH. Probiotics and the gut immune system: indirect regulation. Probiotics Antimicrob Proteins. 2018;10(1):11-21.
29. Zhang C, Li L, Jin B, et al. The Effects of Delivery Mode on the Gut Microbiota and Health: State of Art. Front Microbiol. 2021;12:724449. DOI:10.3389/fmicb.2021.724449
30. Palladino E, Van Mieghem T, Connor KL. Diet Rooks MG, Garrett WS. Gut Microbiota, Metabolites and Host Immunity. Nat Rev Immunol. 2016;16(6):341-52. DOI:10.1038/nri.2016.42
31. Yao Y, Cai X, Fei W, et al. The Role of Short-Chain Fatty Acids in Immunity, Inflammation and Metabolism. Crit Rev Food Sci Nutr. 2022;62(1):1-12. DOI:10.1080/10408398.2020.1854675
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36. Hurkala J, Lauterbach R, Radziszewska R, et al. Effect of a Short-Time Probiotic Supplementation on the Abundance of the Main Constituents of the Gut Microbiota of Term Newborns Delivered by Cesarean Section – A Randomized, Prospective, Controlled Clinical Trial. Nutrients. 2020;12(10):3128. DOI:10.3390/nu12103128
37. Yang W, Tian L, Luo J, Yu J. Ongoing Supplementation of Probiotics to Cesarean-Born Neonates during the First Month of Life may Impact the Gut Microbial. Am J Perinatol. 2021;38(11):1181-91. DOI:10.1055/s-0040-1710559
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Авторы
О.В. Дедикова*, И.Н. Захарова, А.Е. Кучина, И.В. Бережная, Н.Г. Сугян
ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, Москва, Россия
*olga.dedikova74@yandex.ru
Russian Medical Academy of Continuous Professional Education, Moscow, Russia
*olga.dedikova74@yandex.ru
ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, Москва, Россия
*olga.dedikova74@yandex.ru
________________________________________________
Russian Medical Academy of Continuous Professional Education, Moscow, Russia
*olga.dedikova74@yandex.ru
Цель портала OmniDoctor – предоставление профессиональной информации врачам, провизорам и фармацевтам.