基于肠道菌群探讨婴幼儿湿疹的防治进展

目的 从肠道菌群角度探讨婴幼儿湿疹的防治进展,为其后续研究和临床防治提供重要依据。方法 分析近10年基础和临床研究,综述肠道菌群与湿疹的关系以及肠道微生态制剂补充对婴幼儿湿疹的防治作用。结果 婴幼儿湿疹与肠道微生态和黏膜免疫应答系统发育尚未健全,对致敏原易感有关。肠道微生态制剂补通过补充益生菌和/或益生元,调整肠道菌群结构和宿主免疫平衡,修复微生物屏障,是预防和治疗婴幼儿湿疹的重要途径。结论 婴幼儿湿疹与肠道微生态及黏膜免疫系统未发育成熟有关,补充微生态制剂是其防治重要途径。     

肠道微生态与疾病

作为人体微生态系统的重要组成部分之一,肠道微生态辅助人体进行营养物质的转化与吸收并与多个组织、器官存在密切的相互作用,是人体健康的重要保障。近年来利用宏基因组学和生物信息学技术对不同疾病人群的肠道微生态结构和特征进行分析表明,人体健康与肠道微生态存在密切而复杂的联系。在2型糖尿病、冠心病、肥胖、结肠癌、类风湿性关节炎等诸多疾病中开展的菌群研究为其复杂机制探索提供了新的思路,也为这些疾病的预防、预警、干预和治疗提供了新方法。同时,这些实践又进一步提升了我们对肠道微生态在人体健康中发挥作用的认知。     

急性胰腺炎肠道微生态的研究进展

肠道微生态与人体健康密切相关。越来越多研究证据表明,肠道菌群的变化在急性胰腺炎的发生、发展中起重要作用。探索肠道菌群在急性胰腺炎发病机制中的具体作用,可能有助于制定新的治疗策略,改善急性胰腺炎的预后。该文就肠道微生态对急性胰腺炎发病机制和治疗作用的最新研究进展进行综述。     

微生态制剂在小儿腹泻中的应用评价(综述)

目的:通过剖析微生态制剂类药物的分类、作用机制以及在儿科的临床应用现状,旨为临床提供一定的参考信息.方法:综述国内外近期医药学文献.结果:随着现代科技的发展,微生态制剂为小儿腹泻的临床治疗提供了美好的发展前景.结论:从微生态学角度看,腹泻的原因是肠道菌群失去平衡,而维持和调整肠道微生物平衡是防治小儿腹泻的根本.所以微生态制剂在小儿腹泻的治疗上具有广阔的应用前景.     

大肠癌患者肠道微生态变化的研究进展

正常人体肠道内定植着大量的微生物,它们在调节肠道生理功能方面具有重要的作用。饮食结构及环境变化导致的肠道菌群丰度及结构的改变,与大肠癌的发生发展密切相关。因此,探讨可能性致癌菌株与大肠癌发生的相关性,并通过添加微生态制剂调整肠道菌群结构,进而降低大肠癌发生率,具有重要的理论及临床意义。     

40例肠易激综合征患者肠道菌群分析与治疗观察

目的探讨肠易激综合征与肠道菌群之间的关系以及微生态制剂治疗的对照观察。方法对我院40例确诊的肠易激综合征患者及20例健康者进行粪便涂片染色及菌群检测。治疗过程中将IBS患者随机分为治疗组A及治疗组B(加用微生态制剂),并进行疗效分析。结果肠道菌群失调肠易激综合征患者达67.5%,对照组20%,两组差异有显著性(χ2=12.726,P<0.05)。药物治疗的有效率治疗组B为90%,治疗组A为70%,两组治疗效果比较有显著差异(χ2=6.48,P<0.05)。结论肠易激综合征与肠道菌群失调有一定相关性。IBS治疗中加用微生态制剂能有效改善IBS的临床症状与体征,效果明显优于单独使用胃肠解痉药或胃肠动力药,建议临床使用。     

替诺福韦酯联合微生态制剂治疗肝硬化的效果及对肠道屏障功能的影响

目的 探讨替诺福韦酯联合微生态制剂治疗肝硬化的效果及对肠道屏障功能的影响。方法 选取2019年9月至2021年9月我院收治的76例肝硬化患者,按照抽签法分为观察组与对照组。对照组采用替诺福韦酯治疗,观察组采用替诺福韦酯联合微生态制剂（地衣芽孢杆菌）治疗。比较两组的肠道菌群数量、肠道屏障功能、肝功能。结果 治疗后,观察组的双歧杆菌、乳酸菌、肠球菌、肠杆菌数量高于对照组（P <0.05）。治疗后,观察组的DAO、 ET、 PCT水平低于对照组（P <0.05）。治疗后,观察组的ALT、 AST、 TBIL水平低于对照组（P <0.05）。结论 替诺福韦酯联合微生态制剂可改善肝硬化患者的肝功能,调节肠道菌群平衡,提高肠道屏障功能。     

微生态制剂治疗小儿肺炎继发腹泻临床分析

目的探讨微生态制剂治疗小儿肺炎继发腹泻的临床效果。方法将60例小儿肺炎继发腹泻的患儿分为治疗组及对照组,治疗组在使用抗生素及对症治疗基础上应用微生态制剂,对照组使用抗生素及对症治疗。结果治疗组的总有效率为96．7％,对照组的70％,两组病例在显效率和总有效率经统计学分析,差异均具有统计学意义（p〈0.01）。结论微生态制剂治疗小儿肺炎继发腹泻简单易行,对缓解肠道症状和调整肠道菌群均有较好的疗效。     

肠道微生态与生殖障碍性疾病的相关研究进展

当前育龄人群的生殖健康面临前所未有的挑战, 不孕不育的患病率和不良妊娠结局的发生率逐年上升。肠道微生态作为人体的关键组成部分, 在一系列正常生命活动的进行中发挥着重要作用。肠道微生态的紊乱已被证明参与多种疾病的进程, 越来越多的研究表明, 肠道微生态的紊乱与生殖障碍性疾病的发生发展有关。因此, 本文将总结肠道微生态与女性生殖障碍性疾病的相关研究进展, 为其防治提供新的策略, 为提升育龄女性的生育力提供新的思路。     

调节肠道微生态

微生态是人体的有机组成部分,其中肠道微生态最为复杂而重要。肠道微生态与人体健康之间的关系,近年来已进入大众视野,肠道微生态制剂在老年人群中的使用,也逐渐受到重视。为此,笔者采访了浙江省医学会营养与代谢学分会主任委员、浙江大学医学院附属第一医院老年病科杨云梅主任。肠道微生态具有多样性、高密度、高代谢、多功能几大特点。人体中肠道菌群数量多达400~500种,活性与人生理互补,能力与肝相当,可促进肠上皮生长,维护肠道的屏障工作(生物屏障),抗感染,稳定代谢内环境,促进消化吸收等。     

Effects and Mechanisms of Probiotics,Prebiotics, Synbiotics,and Postbiotics on Metabolic Diseases Targeting Gut Microbiota: A Narrative Review

Metabolic diseases are serious threats to public health and related to gut microbiota. Probiotics, prebiotics, synbiotics, and postbiotics (PPSP) are powerful regulators of gut microbiota, thus possessing prospects for preventing metabolic diseases. Therefore, the effects and mechanisms of PPSP on metabolic diseases targeting gut microbiota are worth discussing and clarifying. Generally, PPSP benefit metabolic diseases management, especially obesity and type 2 diabetes mellitus. The underlying gut microbial-related mechanisms are mainly the modulation of gut microbiota composition, regulation of gut microbial metabolites, and improvement of intestinal barrier function. Moreover, clinical trials showed the benefits of PPSP on patients with metabolic diseases, while the clinical strategies for gestational diabetes mellitus, optimal formula of synbiotics and health benefits of postbiotics need further study. This review fully summarizes the relationship between probiotics, prebiotics, synbiotics, postbiotics, and metabolic diseases, presents promising results and the one in dispute, and especially attention is paid to illustrates potential mechanisms and clinical effects, which could contribute to the next research and development of PPSP.     

Probiotics,Prebiotics, and Synbiotics: Implications and Beneficial Effects against Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is still a common functional gastrointestinal disease that presents chronic abdominal symptoms but with a pathophysiology that is not yet fully elucidated. Moreover, the use of the synergistic combination of prebiotics and probiotics, known as synbiotics, for IBS therapy is still in the early stages. Advancements in technology led to determining the important role played by probiotics in IBS, whereas the present paper focuses on the detailed review of the various pathophysiologic mechanisms of action of probiotics, prebiotics, and synbiotics via multidisciplinary domains involving the gastroenterology (microbiota modulation, alteration of gut barrier function, visceral hypersensitivity, and gastrointestinal dysmotility) immunology (intestinal immunological modulation), and neurology (microbiota–gut–brain axis communication and co-morbidities) in mitigating the symptoms of IBS. In addition, this review synthesizes literature about the mechanisms involved in the beneficial effects of prebiotics and synbiotics for patients with IBS, discussing clinical studies testing the efficiency and outcomes of synbiotics used as therapy for IBS.     

Pancreatic Cancer and Gut Microbiome-Related Aspects: A Comprehensive Review and Dietary Recommendations

Gut microbiota plays a significant role in the human body providing many beneficial effects on the host. However, its dysbiotic alterations may affect the tumorigenic pathway and then trigger the development of pancreatic cancer. This dysbiosis can also modulate the aggressiveness of the tumor, influencing the microenvironment. Because pancreatic cancer is still one of the most lethal cancers worldwide with surgery as the only method that influences prognosis and has curative potential, there is a need to search for other strategies which will enhance the efficiency of standard therapy and improve patients’ quality of life. The administration of prebiotics, probiotics, next-generation probiotics (Faecalibacterium prausnitzii, Akkermansia muciniphila), synbiotics, postbiotics, and fecal microbiota transplantation through multiple mechanisms affects the composition of the gut microbiota and may restore its balance. Despite limited data, some studies indicate that the aforementioned methods may allow to achieve better effect of pancreatic cancer treatment and improve therapeutic strategies for pancreatic cancer patients.     

The role of prebiotics and synbiotics in critically ill patients

PURPOSE OF REVIEW: To examine current knowledge regarding the role of prebiotics in critical illness when administered singly or in combinations with probiotics (synbiotics). RECENT FINDINGS: Recent experimental and clinical studies support the fact that bioecological intestinal control with early enteral nutrition enriched with synbiotics may reduce systemic inflammation, improve the immunological status of the intestinal mucosa and help prevent infections in critically ill patients. Three prebiotics, oligofructose, galactooligosaccharides and lactulose are able to modify the balance of intestinal microbiota. It appears that treatment with synbiotics during critical illness should restore the balance of microbial communities in a beneficial way with positive effects on intestinal permeability and bacterial translocation. Only data from small trials are currently available to support use of prebiotics and synbiotics in the treatment of different clinical scenarios. However, in some critical conditions, this supplementation has so far not been effective. SUMMARY: Numerous questions about the molecular mechanisms of action or clinical indications of prebiotics remain unanswered. Large, randomized, multicentre trials are necessary to precisely define the role of prebiotics as therapeutic agents in critical illness. These trials must identify clinically significant improvements in relevant clinical endpoints before any large-scale usage is advocated for critical illness.     

The inflammatory status of old age can be nurtured from the intestinal environment

PURPOSE OF REVIEW: Recent studies suggest an association between inflammation status and the presence of chronic disease in the elderly. The review examines publications that address the low level of chronic inflammation and emphasizes how an altered host-microbiota interaction at the gut level could contribute to maintaining a low systemic inflammatory status in the elderly. RECENT FINDINGS: The first population cross-sectional studies with relevant numbers of healthy elderlies show age-related global changes in gut microbiota with a consistent increase in nonpathogenic Gram-negative mainly Enterobacteria and country-specific changes in bifidobacteria. Noninvasive methods have permitted us to detect subclinical intestinal inflammation in the elderly population. Furthermore, few studies report on immune and/or inflammatory response; however, prebiotics, probiotics or synbiotics might improve the inflammatory condition of the elderly. SUMMARY: A better understanding of the mechanisms of host-gut microbiota cross-talk would significantly help in the design of novel nutritional strategies targeting immune reactivity at the mucosal level.     

Potential Role of Probiotics for Inflammaging: A Narrative Review

Background and aims: Inflammaging, a chronic, low-grade inflammation (LGI), is one of the mechanisms of adaptation of an organism to aging. Alterations in the composition of gut microbiota and gut permeability are among the main sources of LGI. They may be modulated by supplementation with live microorganisms, i.e. probiotics. This narrative review was performed with the aim to critically examine the current evidence from randomized clinical trials (RCTs) on the effects of probiotics on pro-inflammatory and anti-inflammatory cytokines and C-reactive protein (CRP) in healthy older subjects. Methodology: RCTs on the effects of probiotics on inflammatory parameters in subjects older than 65 years published in English and Italian from 1990 to October 2020 were searched in PubMed. Studies that were not RCTs, those using probiotics together with prebiotics (synbiotics), and studies performed in subjects with acute or chronic diseases were excluded. The findings of RCTs were reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results: A total of nine RCTs met the eligibility criteria and were included in this narrative review. Four articles reported that probiotic supplementation significantly affected inflammatory parameters, respectively, by reducing TGF-β1 concentrations, IL-8, increasing IL-5 and Il-10, and IFN-γ and IL-12. Conclusions: Based on this narrative review, probiotic supplementation showed a limited effect on inflammatory markers in healthy individuals older than 65 years. Besides being few, the studies analyzed have methodological limitations, are heterogeneous, and provide results which are incomparable.     

Probiotics,gut microbiota and health

The human gut is a huge complex ecosystem where microbiota, nutrients, and host cells interact extensively, a process crucial for the gut homeostasis and host development with a real partnership. The various bacterial communities that make up the gut microbiota have many functions including metabolic, barrier effect, and trophic functions. Hence, any dysbiosis could have negative consequences in terms of health and many diseases have been associated to impairment of the gut microbiota. These close relationships between gut microbiota, health, and disease, have led to great interest in using probiotics (i.e. live micro-organisms), or prebiotics (i.e. non-digestible substrates) to positively modulate the gut microbiota to prevent or treat some diseases. This review focuses on probiotics, their mechanisms of action, safety, and major health benefits. Health benefits remain to be proven in some indications, and further studies on the best strain(s), dose, and algorithm of administration to be used are needed. Nevertheless, probiotic administration seems to have a great potential in terms of health that justifies more research.     

Potential Benefits of Probiotics and Prebiotics for Coronary Heart Disease and Stroke

Among cardiovascular diseases (CVDs), a major cause of morbidity and mortality worldwide, coronary heart disease and stroke are the most well-known and extensively studied. The onset and progression of CVD is associated with multiple risk factors, among which, gut microbiota has received much attention in the past two decades. Gut microbiota, the microbial community colonizing in the gut, plays a prominent role in human health. In particular, gut dysbiosis is directly related to many acute or chronic dysfunctions of the cardiovascular system (CVS) in the host. Earlier studies have demonstrated that the pathogenesis of CVD is strongly linked to intestinal microbiota imbalance and inflammatory responses. Probiotics and prebiotics conferring various health benefits on the host are emerging as promising therapeutic interventions for many diseases. These two types of food supplements have the potential to alleviate the risks of CVD through improving the levels of several cardiovascular markers, such as total and low-density lipoprotein (LDL) cholesterol, high sensitivity C-reactive protein (hs-CRP), and certain cytokines involved in the inflammatory response. In this review, we focus mainly on the preventive effects of probiotics and prebiotics on CVD via rebalancing the structural and functional changes in gut microbiota and maintaining immune homeostasis.     

Probiotics, prebiotics, and synbiotics: approaches for modulating the microbial ecology of the gut

The microbiota of the human large intestine influences health and well-being. Whereas it has long been accepted that gut bacteria play a role in host pathogenesis, current opinion is that certain microflora components can have beneficial effects on gastroenteritis resistance, blood lipids, antitumor properties, lactose tolerance, and gastrointestinal immunity. It is postulated that in the infant gut an elevated bifidobacterial count may be associated with health advantages that breast-fed infants may have over formula-fed infants. Whereas beneficial aspects of the human gut flora still need definitive confirmation and mechanistic explanations, there is now interest in modulating the composition of gut flora such that a potentially more remedial community exists. This may be achieved through the targeted use of dietary supplementation. This article provides an overview of how probiotics, prebiotics, and synbiotics may contribute toward nutritional modulation of the gut microecology, with emphasis on the neonatal intestine where appropriate. The use of modern molecular methods, as an essential step forward for assessing the validity and accuracy of the modulatory approach, is also discussed.     

Targeting the intestinal microbiota in the pediatric population: a clinical perspective

The intestinal microbiota is a functional organ with a variety of important metabolic, trophic, immunologic, and digestive activities. Current data suggest that alterations in the intestinal microbiota may be related to disease conditions. Manipulation of the intestinal microbiota such as with probiotics, prebiotics, and synbiotics may be beneficial in preventing and treating certain disease conditions. This article provides an overview of the evidence gathered through randomized clinical trials, reviews, and meta-analyses on probiotics and prebiotics in commonly studied conditions in the pediatric population. It concludes with current recommendations for their use, noting safety and gaps in clinical evidence.