Advertisement

Can Postbiotics Represent a New Strategy for NEC?

Chapter
First Online:
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 1125)

Abstract

Increasing evidence indicates that many of the health beneficial effects associated with the establishment of a symbiotic gut microbiota are driven by bacterial metabolic by-products.

The term “postbiotics” indicates any soluble factor resulting from the metabolic activity of a live bacteria or any released molecule capable of providing health benefits through a direct or indirect mechanism.

Alterations in preterm gut colonization associated with the intestinal barrier immaturity and the increased reactivity of the intestinal mucosa to colonizing bacteria have been implicated in the pathogenesis of necrotizing enterocolitis. Recent advances in the comprehension of the postbiotic biological effects and related mechanisms, some of them reviewed here, indicate that postbiotics may be a promising effective preventive strategy against necrotizing enterocolitis while avoiding the risk of administering live microorganisms to preterm infants that could translocate and cause infection. However, data from trials investigating the efficacy of postbiotics for the prevention of necrotizing enterocolitis in preterm infants are needed, and issues regarding their optimal regimen and start and duration of treatment need to be addressed.

Keywords

Microbiota Necrotizing enterocolitis Postbiotics Preventive strategy Signaling 

Abbreviations

NEC

Necrotizing enterocolitis

TLRs

Toll-like receptors

This is a preview of subscription content, log in to check access.

References

  1. Agostoni C, Kim KS (2015) Nutrition and the microbiome. Pediatr Res 77:113–114PubMedGoogle Scholar
  2. Aguilar-Toaláa JE, García-Varelab R, Garcíac HS et al (2018) Postbiotics: an evolving term within the functional foods field. Trends Food Sci Technol 75:105–114Google Scholar
  3. Aijaz MS, Sreeja V (2017) Metabiotics and their health benefits. Intl J Food Ferment 6:11–23Google Scholar
  4. Ammoscato F, Scirocco A, Altomare A et al (2013) Lactobacillus rhamnosus protects human colonic muscle from pathogen lipopolysaccharide-induced damage. Neurogastroenterol Motil 25:984–e777PubMedGoogle Scholar
  5. Canani RB, Costanzo MD, Leone L et al (2011) Potential beneficial effects of butyrate in intestinal and extraintestinal diseases. World J Gastroenterol 17:1519–1528PubMedPubMedCentralGoogle Scholar
  6. Chong CYL, Bloomfield FH, O’Sullivan JM (2018) Factors affecting gastrointestinal microbiome development in neonates. Nutrients 10:pii: E274Google Scholar
  7. Cicenia A, Scirocco A, Carabotti M et al (2014) Postbiotic activities of lactobacilli-derived factors. J Clin Gastroenterol 48(Suppl 1):S18–S22PubMedGoogle Scholar
  8. Corsello G, Carta M, Marinello R et al (2017) Preventive effect of cow’s milk fermented with lactobacillus paracasei CBA L74 on common infectious diseases in children: a multicenter randomized controlled trial. Nutrients 9(7):pii: E669Google Scholar
  9. Fanning S, Hall LJ, Cronin M et al (2012) Bifidobacterial surface-exopolysaccharide facilitates commensal-host interaction through immune modulation and pathogen protection. Proc Natl Acad Sci U S A 109:2108–2113PubMedPubMedCentralGoogle Scholar
  10. Frick JS, Schenk K, Quitadamo M et al (2007) Lactobacillus fermentum attenuates the proinflammatory effect of Yersinia enterocolitica on human epithelial cells. Inflamm Bowel Dis 13:83–90PubMedGoogle Scholar
  11. Giorgetti G, Brandimarte G, Fabiocchi F et al (2015) Interactions between innate immunity, microbiota, and probiotics. J Immunol Res 2015:501361PubMedPubMedCentralGoogle Scholar
  12. Hackam D, Caplan M (2018) Necrotizing enterocolitis: pathophysiology from a historical context. Semin Pediatr Surg 27:11–18PubMedGoogle Scholar
  13. Haileselassie Y, Navis M, Vu N et al (2016) Postbiotic modulation of retinoic acid imprinted mucosal-like dendritic cells by probiotic lactobacillus reuteri 17938 in vitro. Front Immunol 7:96PubMedPubMedCentralGoogle Scholar
  14. Hill C, Guarner F, Reid G et al (2014) 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 11:506–514PubMedGoogle Scholar
  15. Hodzic Z, Bolock AM, Good M (2017) The role of mucosal immunity in the pathogenesis of necrotizing enterocolitis. Front Pediatr 3(5):40Google Scholar
  16. Hollister EB, Riehle K, Luna RA et al (2015) Structure and function of the healthy pre-adolescent pediatric gut microbiome. Microbiome 3:36PubMedPubMedCentralGoogle Scholar
  17. Isani MA, Delaplain PT, Grishin A et al (2018) Evolving understanding of neonatal necrotizing enterocolitis. Curr Opin Pediatr 30:417–423PubMedGoogle Scholar
  18. Klaenhammer TR, Kleerebezem M, Kopp MV et al (2012) The impact of probiotics and prebiotics on the immune system. Nat Rev Immunol 12:728–734PubMedGoogle Scholar
  19. Konstantinov SR, Smidt H, de Vos WM et al (2008) S layer protein A of Lactobacillus acidophilus NCFM regulates immature dendritic cell and T cell functions. Proc Natl Acad Sci U S A 105:19474–19479PubMedPubMedCentralGoogle Scholar
  20. La Rosa PS, Warner BB, Zhou Y et al (2014) Patterned progression of bacterial populations in the premature infant gut. Proc Natl Acad Sci U S A 111:12522–12527PubMedPubMedCentralGoogle Scholar
  21. Lotz M, Gütle D, Walther S et al (2006) Postnatal acquisition of endotoxin tolerance in intestinal epithelial cells. J Exp Med 203:973–984PubMedPubMedCentralGoogle Scholar
  22. Lu L, Claud EC (2018) Intrauterine inflammation, epigenetics, and microbiome influences on preterm infant health. Curr Pathobiol Rep 6:15–21PubMedPubMedCentralGoogle Scholar
  23. Maffei D, Schanler RJ (2017) Human milk is the feeding strategy to prevent necrotizing enterocolitis. Semin Perinatol 41:36–40PubMedGoogle Scholar
  24. Mileti E, Matteoli G, Iliev ID et al (2009) Comparison of the immunomodulatory properties of three probiotic strains of Lactobacilli using complex culture systems: prediction for in vivo efficacy. PLoS One 4:e7056PubMedPubMedCentralGoogle Scholar
  25. Neu J, Walker WA (2011) Necrotizing enterocolitis. N Engl J Med 364:255–264PubMedPubMedCentralGoogle Scholar
  26. Nocerino R, Paparo L, Terrin G et al (2017) Cow’s milk and rice fermented with Lactobacillus paracasei CBA L74 prevent infectious diseases in children: a randomized controlled trial. Clin Nutr 36:118–125PubMedGoogle Scholar
  27. Pammi M, Cope J, Tarr PI et al (2017) Intestinal dysbiosis in preterm infants preceding necrotizing enterocolitis: a systematic review and meta-analysis. Microbiome 5:31PubMedPubMedCentralGoogle Scholar
  28. Paparo L, Aitoro R, Nocerino R et al (2018) Direct effects of fermented cow’s milk product with Lactobacillus paracasei CBA L74 on human enterocytes. Benefic Microbes 9:165–172Google Scholar
  29. Patel AL, Kim JH (2018) Human milk and necrotizing enterocolitis. Semin Pediatr Surg 27:34–38PubMedGoogle Scholar
  30. Patel RM, Underwood MA (2018) Probiotics and necrotizing enterocolitis. Semin Pediatr Surg 27:39–46PubMedGoogle Scholar
  31. Patel RM, Kandefer S, Walsh MC et al (2015) Causes and timing of death in extremely premature infants from 2000 through 2011. N Engl J Med 372:331–340PubMedPubMedCentralGoogle Scholar
  32. Quigley MA, Henderson G, Anthony MY et al (2007) Formula milk versus donor breast milk for feeding preterm or low birth weight infants. Cochrane Database Syst Rev 4:CD002971Google Scholar
  33. Schaefer L, Auchtung TA, Hermans KE et al (2010) The antimicrobial compound reuterin (3-hydroxypropionaldehyde) induces oxidative stress via interaction with thiol groups. Microbiology 156(Pt 6):1589–1599PubMedGoogle Scholar
  34. Schiavi E, Gleinser M, Molloy E et al (2016) The surface-associated exopolysaccharide of Bifidobacterium longum 35624 plays an essential role in dampening host Proinflammatory responses and repressing local TH17 responses. Appl Environ Microbiol 82:7185–7196PubMedPubMedCentralGoogle Scholar
  35. Sokol H, Pigneur B, Watterlot L et al (2008) Faecalibacterium prausnitzii is an anti-inflammatory commensal bacterium identified by gut microbiota analysis of Crohn disease patients. Proc Natl Acad Sci U S A 105:16731–16736PubMedPubMedCentralGoogle Scholar
  36. Tsilingiri K, Rescigno M (2013) Postbiotics: what else? Benefic Microbes 4:101–107Google Scholar
  37. Tsilingiri K, Barbosa T, Penna G et al (2012) Probiotic and postbiotic activity in health and disease: comparison on a novel polarised ex-vivo organ culture model. Gut 61:1007–1015PubMedGoogle Scholar
  38. Vancamelbeke M, Vermeire S (2017) The intestinal barrier: a fundamental role in health and disease. Expert Rev Gastroenterol Hepatol 11:821–834PubMedPubMedCentralGoogle Scholar
  39. von Schillde MA, Hörmannsperger G, Weiher M et al (2012) Lactocepin secreted by lactobacillus exerts anti-inflammatory effects by selectively degrading proinflammatory chemokines. Cell Host Microbe 11:387–396Google Scholar
  40. Wang Y, Liu Y, Sidhu A et al (2012) Lactobacillus rhamnosus GG culture supernatant ameliorates acute alcohol-induced intestinal permeability and liver injury. Am J Physiol Gastrointest Liver Physiol 303:G32–G41PubMedPubMedCentralGoogle Scholar
  41. Warner BB, Deych E, Zhou Y et al (2016) Gut bacteria dysbiosis and necrotising enterocolitis in very low birthweight infants: a prospective case-control study. Lancet 387:1928–1936PubMedPubMedCentralGoogle Scholar
  42. Zagato E, Mileti E, Massimiliano L et al (2014) Lactobacillus paracasei CBA L74 metabolic products and fermented milk for infant formula have anti-inflammatory activity on dendritic cells in vitro and protective effects against colitis and an enteric pathogen in vivo. PLoS One 9:e87615PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Fondazione I.R.C.C.S. Ca’ Granda Ospedale Maggiore Policlinico, Neonatal Intensive Care Unit, Department of Clinical Science and Community HealthUniversity of MilanMilanItaly
  2. 2.Humanitas University, Pieve EmanueleMilanItaly

Personalised recommendations

Cite chapter

Buy options