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Published on: January 27, 2019
Probiotics and Innate and Adaptive Immune Responses in Premature Infants
1Chief Division of Neonatology, School of Medicine, University of California at Davis, Sacramento, CA.
Insights
Probiotics reduce the risk of necrotizing enterocolitis (NEC) and death in premature infants. Their protective mechanisms involve modulating gut health and the immune response, though specific actions vary by strain.
Area of Science:
- Neonatal Medicine
- Microbiology
- Immunology
Background:
- Premature infants face high risks of necrotizing enterocolitis (NEC) and sepsis, leading to significant morbidity and mortality.
- Probiotics are known to reduce NEC and mortality in premature infants, but their precise mechanisms remain incompletely understood.
Purpose of the Study:
- To review the mechanisms by which probiotics confer protection against NEC and sepsis in premature infants.
- To explore the impact of various probiotic species and strains on the innate and adaptive immune responses.
Main Methods:
- Review of in vitro studies, animal models, and clinical trials evaluating probiotic efficacy in premature infants.
- Analysis of proposed protective mechanisms, including modulation of intestinal inflammation, apoptosis, dysmotility, and permeability.
- Examination of microbial competition via bacteriocin production and nutrient utilization.
Main Results:
- Probiotics demonstrate varied protective effects depending on species and strain.
- Common mechanisms include reducing intestinal inflammation, apoptosis, dysmotility, and permeability.
- Probiotics can displace pathogenic microbes and enhance nutrient absorption.
Conclusions:
- Probiotics offer a promising strategy for preventing NEC and sepsis in premature infants.
- Understanding probiotic mechanisms, particularly their influence on the immune system, is crucial for optimizing their use.
- Further research into specific strains and their immune interactions will refine therapeutic applications.
Abstract:
Premature infants are at increased risk for morbidity and mortality due to necrotizing enterocolitis (NEC) and sepsis. Probiotics decrease the risk of NEC and death in premature infants; however, mechanisms of action are unclear. A wide variety of probiotic species have been evaluated for potential beneficial properties in vitro, in animal models, and in clinical trials of premature infants. Although there is variation by species and even strain, common mechanisms of protection include attenuation of intestinal inflammation, apoptosis, dysmotility, permeability, supplanting other gut microbes through production of bacteriocins, and more effective use of available nutrients. Here, we review the most promising probiotics and what is known about their impact on the innate and adaptive immune response.
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