益生菌在婴幼儿消化道炎症性和功能性疾病中应用进展

doi:10.12372/jcp.2022.21e1701

摘要/Abstract

摘要：

微生态稳定失衡使儿童免疫功能的发育及成熟受阻，进而影响免疫力，其与多种消化系统疾病的发生、发展和转归密切相关。益生菌可通过调节肠道菌群平衡、提高免疫力、减轻炎性损害、减少有害物质吸收等多种机制，在婴幼儿腹泻、炎症性肠病、坏死性小肠结肠炎、功能性腹痛疾病等的治疗中发挥重要作用。文章综述最新文献，以探讨益生菌在婴幼儿消化道炎症性和功能性疾病中的疗效及安全性，为不同疾病有益菌株的选择提供参考。

关键词: 消化系统疾病, 益生菌, 疗效, 安全性, 婴幼儿

Abstract:

The imbalance of microecological stability hinders the development and maturity of immune function in children, which affects immunity and closely related to the occurrence, development and outcome of a variety of digestive diseases. Probiotics can play an important role in the treatment of infantile diarrhea, inflammatory bowel disease, necrotizing enterocolitis, functional abdominal pain by regulating the balance of intestinal flora, improving immunity, reducing inflammatory damage and reducing the absorption of harmful substances. This article intends to explore the efficacy and safety of probiotics in children's digestive system diseases through the latest literature research, so as to provide reference for the selection of beneficial strains fordifferent diseases.

Key words: digestive system diseases, probiotics, efficacy, safety, infant

陈钰波, 李宇宁. 益生菌在婴幼儿消化道炎症性和功能性疾病中应用进展[J]. 临床儿科杂志, 2022, 40(11): 869-874.

CHEN Yubo, LI Yuning. Progress on application of probiotics in inflammatory and functional diseases of digestive tract in infants and young children[J]. Journal of Clinical Pediatrics, 2022, 40(11): 869-874.

参考文献 49

[1]	Levy M, Kolodziejczyk AA, Thaiss CA, et al. Dysbiosis and the immune system[J]. Nat Rev Immunol, 2017, 17(4): 219-232. doi: 10.1038/nri.2017.7 pmid: 28260787
[2]	Cristofori F, Dargenio VN, Dargenio C, et al. Anti-inflammatory and immunomodulatory effects of probiotics in gut inflammation: a door to the body[J]. Front Immunol, 2021, 12: 578386. doi: 10.3389/fimmu.2021.578386
[3]	Cruz N, Abernathy GA, Dichosa AEK, et al. The age of next-generation therapeutic-microbe discovery: exploiting microbe-microbe and host-microbe interactions for disease prevention[J]. Infect Immun, 2022, 90(5): e0058921. doi: 10.1128/iai.00589-21
[4]	张旭东, 庄伟清, 陈代杰, 等. 双歧杆菌与消化系统疾病的关系[J]. 中国微生态学杂志, 2021, 33(1): 104-111.
[5]	钟慧, 杨蓉. 益生菌与儿童功能性胃肠病的研究进展[J]. 淮海医药, 2021, 39(2): 213-216.
[6]	Ma X, Shin YJ, Jang HM, et al. Lactobacillus rhamnosus and Bifidobacterium longum alleviate colitis and cognitive impairment in mice by regulating IFN-γ to IL-10 and TNF-α to IL-10 expression ratios[J]. Sci Rep, 2021, 11(1): 20659. doi: 10.1038/s41598-021-00096-x
[7]	Smecuol E, Hwang HJ, Sugai E, et al. Exploratory, randomized, double-blind, placebo-controlled study on the effects of Bifidobacterium infantis natren life start strain super strain in active celiac disease[J]. J Clin Gastroenterol, 2013, 47(2): 139-147. doi: 10.1097/MCG.0b013e31827759ac
[8]	Javanshir N, Hosseini GNG, Sadeghi M, et al. Evaluation of the function of probiotics, emphasizing the role of their binding to the intestinal epithelium in the stability and their effects on the immune system[J]. Biol Proced Online, 2021, 23(1): 23. doi: 10.1186/s12575-021-00160-w pmid: 34847891
[9]	Nemati M, Omrani GR, Ebrahimi B, et al. The beneficial effects of probiotics via autophagy: a systematic review[J]. Biomed Res Int, 2021, 2021: 2931580.
[10]	Dinleyici EC, PROBAGE Study Group, Vandenplas Y. Lactobacillus reuteri DSM 17938 effectively reduces the duration of acute diarrhoea in hospitalised children[J]. Acta Paediatr, 2014, 103(7): e300-e305.
[11]	Markovinović L, Knezović I, Kniewald T, et al. Entero-adsorbent polymethylsiloxane polyhydrate vs. probiotic Lactobacillus reuteri DSM 17938 in the treatment of rotaviral gastroenteritis in infants and toddlers, a randomized controlled trial[J]. Front Pediatr, 2020, 8: 553960. doi: 10.3389/fped.2020.553960
[12]	Di JB, Gai ZT. Protective efficacy of probiotics on the treatment of acute rotavirus diarrhea in children: an updated meta-analysis[J]. Eur Rev Med Pharmacol Sci, 2020, 24(18): 9675-9683.
[13]	Ganji-Arjenaki M, Rafieian-Kopaei M. Probiotics are a good choice in remission of inflammatory bowel diseases: a meta analysis and systematic review[J]. J Cell Physiol, 2018, 233(3): 2091-2103. doi: 10.1002/jcp.25911 pmid: 28294322
[14]	Gomes DOVS, Morais MB. Gut microbiota and the use of probiotics in constipation in children and adolescents: systematic review[J]. Rev Paul Pediatr, 2019, 38: e2018123. doi: 10.1590/1984-0462/2020/38/2018123
[15]	GBD 2016 Diarrhoeal Disease Collaborators. Estimates of the global, regional, and national morbidity, mortality, and aetiologies of diarrhoea in 195 countries: a systematic analysis for the Global Burden of Disease Study 2016[J]. Lancet Infect Dis, 2018, 18(11): 1211-1228. doi: 10.1016/S1473-3099(18)30362-1
[16]	Kusumo PD, Bela B, Wibowo H, et al. Lactobacillus plantarum IS-10506 supplementation increases faecal sIgA and immune response in children younger than two years[J]. Benef Microbes, 2019, 10(3): 245-252. doi: 10.3920/BM2017.0178 pmid: 30694099
[17]	Freedman SB, Horne R, Johnson-Henry K, et al. Probiotic stool secretory immunoglobulin A modulation in children with gastroenteritis: a randomized clinical trial[J]. Am J Clin Nutr, 2021, 113(4): 905-914. doi: 10.1093/ajcn/nqaa369 pmid: 34269370
[18]	Schnadower D, O'connell KJ, Vanburen JM, et al. Association between diarrhea duration and severity and probiotic efficacy in children with acute gastroenteritis[J]. Am J Gastroenterol, 2021, 116(7): 1523-1532. doi: 10.14309/ajg.0000000000001295 pmid: 34183579
[19]	Wu X, Qian L, Liu K, et al. Gastrointestinal microbiome and gluten in celiac disease[J]. Ann Med, 2021, 53(1): 1797-1805. doi: 10.1080/07853890.2021.1990392 pmid: 34647492
[20]	Xu HB, Jiang RH, Sheng HB. Meta-analysis of the effects of Bifidobacterium preparations for the prevention and treatment of pediatric antibiotic-associated diarrhea in China[J]. Complement Ther Med, 2017, 33: 105-113. doi: 10.1016/j.ctim.2017.07.001
[21]	Brüssow H. Probiotics and prebiotics in clinical tests: an update[J]. F1000Res, 2019, 8: F1000 Faculty Rev-1157.
[22]	Maity C, Gupta AK. Therapeutic efficacy of probiotic Alkalihalobacillus clausii 088AE in antibiotic-associated diarrhea: a randomized controlled trial[J]. Heliyon, 2021, 7(9): e07993. doi: 10.1016/j.heliyon.2021.e07993
[23]	王玉环. 粪菌移植在儿童消化系统疾病中的应用[J]. 中华实用儿科临床杂志, 2016, 31(7): 481-483.
[24]	Saez-Lara MJ, Gomez-Llorente C, Plaza-Diaz J, et al. The role of probiotic lactic acid bacteria and bifidobacteria in the prevention and treatment of inflammatory bowel disease and other related diseases: a systematic review of randomized human clinical trials[J]. Biomed Res Inter, 2015, 2015: 505878.
[25]	罗燕, 陈志涛, 徐崇明, 等. VSL#3通过PI3K/Akt信号通路调节溃疡性结肠炎大鼠调节性T细胞表达[J]. 华中科技大学学报(医学版), 2019, 48(4): 411-416.
[26]	Hagen PC, Skelley JW. Efficacy of Bifidobacterium species in prevention of necrotizing enterocolitis in very-low birth weight infants. A systematic review[J]. J Pediatr Pharmacol Ther, 2019, 24(1): 10-15.
[28]	Morgan RL, Preidis GA, Kashyap PC, et al. Probiotics reduce mortality and morbidity in preterm, low-birth-weight infants: a systematic review and network meta-analysis of randomized trials[J]. Gastroenterology, 2020, 159(2): 467-480. doi: S0016-5085(20)34849-6 pmid: 32592699
[29]	van den Akker CHP, van Goudoever JB, Shamir R, et al. Probiotics and preterm infants: a position paper by the European Society for Paediatric Gastroenterology Hepatology and Nutrition Committee on Nutrition and the European Society for Paediatric Gastroenterology Hepatology and Nutrition Working Group for Probiotics and Prebiotics[J]. J Pediatr Gastroenterol Nutr, 2020, 70(5): 664-680. doi: 10.1097/MPG.0000000000002655
[30]	Wang X, Li Z, Xu Z, et al. Probiotics prevent Hirschsprung's disease-associated enterocolitis: a pros-pective multicenter randomized controlled trial[J]. Int J Colorectal Dis, 2015, 30(1): 105-110. doi: 10.1007/s00384-014-2054-0
[31]	Huang Y, Tan SY, Parikh P, et al. Prevalence of functional gastrointestinal disorders in infants and young children in China[J]. BMC Pediatr, 2021, 21(1): 131. doi: 10.1186/s12887-021-02610-6 pmid: 33731059
[32]	Francavilla R, Cristofori F, Indrio F. Indications and recommendations by societies and institutions for the use of probiotics and prebiotics in paediatric functional intestinal disorders[J]. J Pediatr Gastroenterol Nutr, 2016, 63(Suppl 1): S36-S37.
[33]	Koppen IJ, Benninga MA, Tabbers MM. Is there a role for pre-, pro- and synbiotics in the treatment of functional constipation in children? A systematic review[J]. J Pediatr Gastroenterol Nutr, 2016, 63(Suppl 1): S27-S35.
[34]	Wegner A, Banaszkiewicz A, Kierkus J, et al. The effectiveness of Lactobacillus reuteri DSM 17938 as an adjunct to macrogol in the treatment of functional constipation in children. A randomized, double-blind, placebo-controlled, multicentre trial[J]. Clin Res Hepatol Gastroenterol, 2018, 42(5): 494-500. doi: 10.1016/j.clinre.2018.03.008
[35]	Korterink JJ, Diederen K, Benninga MA, et al. Epidemiology of pediatric functional abdominal pain disorders: a meta-analysis[J]. PLoS One, 2015, 10(5): e0126982. doi: 10.1371/journal.pone.0126982
[3]	Koppen I, Nurko S, Saps M, et al. The pediatric Rome IV criteria: what's new?[J]. Expert Rev Gastroenterol Hepatol, 2017, 11(3): 193-201.
[37]	Shirazinia R, Golabchifar AA, Fazeli MR. Efficacy of probiotics for managing infantile colic due to their anti-inflammatory properties: a meta-analysis and systematic review[J]. Clin Exp Pediatr, 2021, 64(12): 642-651. doi: 10.3345/cep.2020.01676 pmid: 33848417
[38]	Simonson J, Haglund K, Weber E, et al. Probiotics for the management of infantile colic: a systematic review[J]. MCN Am J Matern Child Nurs, 2021, 46(2): 88-96. doi: 10.1097/NMC.0000000000000691 pmid: 33315632
[39]	Giannetti E, Staiano A. Probiotics for irritable bowel syndrome: clinical data in children[J]. J Pediatr Gastroenterol Nutr, 2016, 63(Suppl 1): S25-S26.
[40]	Sudha M, Jayanthi N, Aasin M, et al. Efficacy of Bacillus coagulans Unique IS2 in treatment of irritable bowel syndrome in children: a double blind, randomised placebo controlled study[J]. Benef Microbes, 2018, 9(4): 563-572. doi: 10.3920/BM2017.0129
[41]	Xu HL, Zou LL, Chen MB, et al. Efficacy of probiotic adjuvant therapy for irritable bowel syndrome in children: a systematic review and meta-analysis[J], PLoS One, 2021, 16(8): e0255160. doi: 10.1371/journal.pone.0255160
[42]	Fatahi S, Hosseini A, Sohouli MH, et al. Effects of probiotic supplementation on abdominal pain severity in pediatric patients with irritable bowel syndrome: a systematic review and meta-analysis of randomized clinical trials[J]. World J Pediatr, 2022, 18(5): 320-332. doi: 10.1007/s12519-022-00516-6 pmid: 35106700
[43]	Rahmani P, Ghouran-Orimi A, Motamed F, et al. Evaluating the effects of probiotics in pediatrics with recurrent abdominal pain[J]. Clin Exp Pediatr, 2020, 63(12):485-490. doi: 10.3345/cep.2019.01613
[44]	Jadrešin O, Hojsak I, Mišak Z, et al. Lactobacillus reuteri DSM 17938 in the treatment of functional abdominal pain in children: RCT study[J]. J Pediatr Gastroenterol Nutr, 2017, 64(6): 925-929. doi: 10.1097/MPG.0000000000001478
[45]	Nouri Gharajalar S, Kazemi-Darabadi S, Valinezhad Lajimi H, et al. The roles of Lactobacillus Acidophilus and pectin in preventing postoperative sepsis and intestinal adaptation in a rat model of short bowel syndrome[J]. Probiotics Antimicrob Proteins, 2021, 13(5): 1355-1362. doi: 10.1007/s12602-021-09764-w pmid: 33719025
[46]	王海燕, 孙一丹, 隋坤鹏, 等. 益生菌在腹型过敏性紫癜中临床应用的研究进展[J]. 中国微生态学杂志, 2020, 32(7): 866-869.
[47]	Chen Z, Zhang L, Zeng L, et al. Probiotics supplementation therapy for pathological neonatal jaundice: a systematic review and meta-analysis[J]. Front Pharmacol, 2017, 8: 432. doi: 10.3389/fphar.2017.00432 pmid: 28713275
[48]	Coffey MJ, Garg M, Homaira N, et al. Probiotics for people with cystic fibrosis[J]. Cochrane Database Syst Rev, 2020, 1(1): CD012949.
[49]	刘菲, 郝萱语, 李东阳. 益生菌在临床应用中的毒副作用研究进展[J]. 山东医药, 2016, 56(20): 106-108.