Пробиотики для профилактики гастроинтестинальных расстройств у детей: обзор научных данных


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Микробиом желудочно-кишечного тракта остается актуальной областью для клинических исследований. Данные о положительных эффектах отдельных пробиотиков в профилактике гастроинтестинальных расстройств ограничиваются исследованиями в отношении острого гастроэнтерита, антибиотикоассоциированной диареи, младенческих колик и некротизирующего энтероколита. Общий консенсус, рекомендующий использование пробиотиков при указанных состояниях, отсутствует, что обусловлено разным дизайном большинства работ, недостаточным объемом доказательств в отношении определенных штаммов, дозировок и показаний. Для формирования однозначных рекомендаций требуется большее количество хорошо спланированных исследований. На данном этапе доказательств, определяющих целесообразность рутинного использования пробиотиков для профилактики гастроинтестинальных расстройств у детей, недостаточно.

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Ц. Перцевал

Университетская клиника Брюсселя, Свободный университет Брюсселя

Брюссель, Бельгия

М. Плетинцх

Группа CHIREC, клиника Ste-Anne St-Remi

Брюссель, Бельгия

Иван Ванденплас

Университетская клиника Брюсселя, Свободный университет Брюсселя

Email: yvan.vandenplas@uzbrussel.be
д-р мед. наук, проф., зав. отд-нием педиатрии Брюссель, Бельгия

Список литературы

  1. Cani PD. Human gut microbiome: hopes, threats and promises. Gut. 2018; 67 (9): 1716-25.
  2. Dominguez-Bello MG. Delivery mode shapes the acquisition and structure of the initial microbiota across multiple body habitats in newborns. Proc Natl Acad Sci USA 2010; 107: 11971-5.
  3. Yasmin F. Cesarean section, formula feeding, and infant antibiotic exposure: separate and combined impacts on gut microbial changes in later infancy. Front Pediatr 2017; 5: 200.
  4. Odamaki T, Kato K, Sugahara H et al. Age-related changes in gut microbiota composition from newborn to centenarian: a cross-sectional study. BMC Microbiol 2016; 16: 90.
  5. Mitre E, Susi A, Kropp LE, Schwartz DJ et al. Association between use of acid-suppressive medications and antibiotics during infancy and allergic diseases in early childhood. JAMA Pediatr 2018; 172: e180315.
  6. Maier L, Pruteanu M, Kuhn M et al. Extensive impact of non-antibiotic drugs on human gut bacteria. Nature 2018; 555: 623-8.
  7. Vandeputte D, Falony G, Vieira-Silva S et al. Stool consistency is strongly associated with gut microbiota richness and composition, enterotypes and bacterial growth rates. Gut 2016; 65: 57-62.
  8. Lewis ZT, Totten SM, Smilowitz JT et al. Maternal fucosyltransferase 2 status affects the gut bifidobacterial communities of breastfed infants. Microbiome 2015; 3: 13.
  9. Reid G, Kumar H, Khan AI et al. The case in favour of probiotics before, during and after pregnancy: insights from the first 1,500 days. Benef Microbes 2016; 7: 353-62.
  10. Andersen SS, Michaelsen KF, Laursen RP et al. Why parents are skeptical about using probiotics preventively for small children: a Danish qualitative study. BMC Complement Altern Med 2018; 18: 336.
  11. Fernandez L, Langa S, Martin V et al. The human milk microbiota: origin and potential roles in health and disease. Pharmacol Res 2013; 69: 1-10.
  12. Panduru M, Panduru NM, S l v stru CM et al. Probiotics and primary prevention of atopic dermatitis: a meta-analysis of randomized controlled studies. J Eur Acad Dermatol Venereol 2015; 29: 232-42.
  13. Simpson MR, Dotterud CK, Storm O et al. Perinatal probiotic supplementation in the prevention of allergy related disease: 6 year follow up of a randomised controlled trial. BMC Dermatol 2015; 15: 13.
  14. Fiocchi A, Pawankar R, Cuello-Garcia C et al. World Allergy Organization-McMaster University guidelines for allergic disease prevention (GLAD-P): probiotics. World Allergy Organ J 2015; 8: 4.
  15. Rather IA, Bajpai VK, Kumar S et al. Probiotics and atopic dermatitis: an overview. Front Microbiol 2016; 7: 507.
  16. Li L, Han Z, Niu X et al. Probiotic supplementation for prevention of atopic dermatitis in infants and children: a systematic review and meta-analysis. Am J Clin Dermatol 2018 (in press).
  17. Forsberg A, West CE, Prescott SL et al. Pre-and probiotics for allergy prevention: time to revisit recommendations? Clin Exp Allergy 2016; 46; 1506-21.
  18. Grev J, Berg M, Soll R. Maternal probiotic supplementation for prevention of morbidity and mortality in preterm infants. Cochrane Database Syst Rev 2018; 12: CD012519.
  19. Lo Vecchio A, Vandenplas Y, Benninga M et al. An international consensus report on a new algorithm for the management of infant diarrhoea. Acta Paediatr 2016; 105: e384-9.
  20. Chouraqui JP, Van Egroo LD, Fichot MC. Acidified milk formula supplemented with bifidobacterium lactis: impact on infant diarrhea in residential care settings. J Pedi-atr Gastroenterol Nutr 2004; 38: 288-92.
  21. Hojsak I, Mo i Pavi A, Kos T et al. Bifidobacterium animalis subsp. lactis in prevention of common infections in healthy children attending day care centers - Randomized, double blind, placebo-controlled study. Clin Nutr 2016; 35: 587-91.
  22. Sazawal S, Dhingra U, Hiremath G et al. Prebiotic and probiotic fortified milk in prevention of morbidities among children: community-based, randomized, doubleblind, controlled trial. PLoS One 2010; 5: e12164.
  23. Laursen RP, Larnkj«r A, Ritz C et al. Probiotics and child care absence due to infections: a randomized controlled trial. Pediatrics 2017; 140: pii: e20170735.
  24. Bocquet A, Lachambre E, Kempf C et al. Effect of infant and follow-on formulas containing B lactis and galacto- and fructo-oligosaccharides on infection in healthy term infants. J Pediatr Gastroenterol Nutr 2013; 57: 180-7.
  25. Oberhelman RA, Gilman RH, Sheen P et al. A placebo-controlled trial of Lactobacillus GG to prevent diarrhea in undernourished Peruvian children. J Pediatr 1999; 134: 15-20.
  26. Schneider C, Illi M, Lotscher M et al. Isolation of Antibodies from Human Plasma, Saliva, Breast Milk, and Gastrointestinal Fluid. Methods Mol Biol 2017; 1643: 23-31.
  27. Freedman SB, Williamson-Urquhart S, Farion KJ et al. Multicenter trial of a combination probiotic for children with gastroenteritis. N Engl J Med 2018; 379: 2015-26.
  28. Schnadower D, Tarr PI, Casper TC et al. Lactobacillus rhamnosus GG versus placebo for acute gastroenteritis in children. N Engl J Med 2018; 379: 2002-14.
  29. Pedone CA, Arnaud CC, Postaire ER et al. Multicentric study of the effect of milk fermented by Lactobacillus casei on the incidence of diarrhoea. Int J Clin Pract 2000; 54: 568-71.
  30. Weizman Z, Asli G, Alsheikh A. Effect of a probiotic infant formula on infections in child care centers: comparison of two probiotic agents. Pediatrics 2005; 115: 5-9.
  31. Gutierrez-Castrellon P, Lopez-Velazquez G, Diaz-Garcia L et al. Diarrhea in preschool children and Lactobacillus reuteri: a randomized controlled trial. Pediatrics 2014; 133: e904-9.
  32. Urbanska M, Szajewska H. The efficacy of Lactobacillus reuteri DSM 17938 in infants and children: a review of the current evidence. Eur J Pediatr 2014; 173: 1327-37.
  33. Saavedra JM, Bauman NA, Oung I et al. Feeding of Bifidobacterium bifidum and Streptococcus thermophilus to infants in hospital for prevention of diarrhoea and shedding of rotavirus. Lancet 1994; 344: 1046-9.
  34. Hojsak I, Toki Pivac V, Mocic Pavi A et al. Bifidobacterium animalis subsp. lactis fails to prevent common infections in hospitalized children: a randomized, doubleblind, placebo-controlled study. Am J Clin Nutr 2015; 101: 680-4.
  35. Szajewska H, Kotowska M, Mrukowicz JZ et al. Efficacy of Lactobacillus GG in prevention of nosocomial diarrhea in infants. J Pediatr 2001; 138: 361-5.
  36. Mastretta E, Longo P, Laccisaglia A et al. Effect of Lactobacillus GG and breast-feeding in the prevention of rotavirus nosocomial infection. J Pediatr Gastroenterol Nutr 2002; 35: 527-31.
  37. Bruzzese E, Fedele MC, Bruzzese D et al. Randomised clinical trial: a Lactobacillus GG and micronutrient-containing mixture is effective in reducing nosocomial infections in children, vs. placebo. Aliment Pharmacol Ther 2016; 44: 568-75.
  38. Wanke M, Szajeweska H. Probiotics for preventing healthcare-associated diarrhea in children: A meta-analysis of randomized controlled trials. Pediatr Pol 2014; 89: 8-16.
  39. Trivi I, Hojsak I. Use of probiotics in the prevention of nosocomial infections. J Clin Gastroenterol 2018; 52 (Suppl. 1): S62-5.
  40. Urbanska M, Gieruszczak-Bialek D, Szymanski H et al. Effectiveness of Lactobacillus reuteri DSM 17938 for the prevention of nosocomial diarrhea in children: A randomized, double-blind, placebo-controlled trial. Pediatr Infect Dis J 2016; 35: 142-5.
  41. Wanke M, Szajewska H. Lack of an effect of Lactobacillus reuteri DSM 17938 in preventing nosocomial diarrhea in children: a randomized, double-blind, placebo-controlled trial. J Pediatr 2012; 161: 40-3.
  42. Hojsak I, Szajewska H, Canani RB et al. Probiotics for the Prevention of nosocomial diarrhea in children. J Pediatr Gastroenterol Nutr 2018; 66: 3-9.
  43. Cameron D, Hock QS, Kadim M et al. Probiotics for gastrointestinal disorders: Proposed recommendations for children of the Asia-Pacific region. World J Gastroenterol 2017; 23: 7952-64.
  44. Guandalini S. Probiotics for prevention and treatment of diarrhea. J Clin Gastroenterol 2011; 45: S149-53.
  45. Fox MJ, Ahuja KD, Robertson IK et al. Can probiotic yogurt prevent diarrhoea in children on antibiotics? A double-blind, randomised, placebo-controlled study. BMJ Open 2015; 5: e006474.
  46. Olek A, Woynarowski M, Ahren IL et al. Efficacy and safety of Lactobacillus plantarum DSM 9843 (LP299V) in the prevention of antibiotic-associated gastrointestinal symptoms in children-randomized, double-blind, placebo-controlled study. J Pedi-atr 2017; 186: 82-6.
  47. Kolodziej M, Szajewska H. Lactobacillus reuteri DSM 17938 in the prevention of antibiotic-associated diarrhoea in children: a randomized clinical trial. Clin Microbiol Infect 2018; pii: S1198-743X (18)30591-3
  48. Shan LS, Hou P, Wang ZJ et al. Prevention and treatment of diarrhoea with Saccha-romyces boulardii in children with acute lower respiratory tract infections. Benef Microbes 2013; 4: 329-34.
  49. Johnston BC, Goldenberg JZ, Parkin PC. Probiotics and the Prevention of Antibiotic-Associated Diarrhea in Infants and Children. JAMA 2016; 316: 1484-5.
  50. Goldenberg JZ, Lytvyn L, Steurich J et al. Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Cochrane Database Syst Rev 2015; 12: CD004827.
  51. Goldenberg JZ, Yap C, Lytvyn L et al. Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children. Cochrane Database Syst Rev 2017; 12: CD006095.
  52. Szajewska H, Kolodziej M. Systematic review with meta-analysis: Lactobacillus rhamnosus GG in the prevention of antibiotic-associated diarrhoea in children and adults. Aliment Pharmacol Ther 2015; 42: 1149-57.
  53. Goldenberg JZ, Mertz D, Johnston BC. Probiotics to prevent Clostridium difficile infection in patients receiving antibiotics. JAMA 2018; 320: 499-500.
  54. Szajewska H, Canani RB, Guarino A et al. ESPGHAN Working Group for Probiotics and Prebiotics. Probiotics for the prevention of antibiotic-associated diarrhea in children. J Pediatr Gastroenterol Nutr 2016; 62: 495-506.
  55. Mantegazza C, Molinari P, D'Auria E et al. Probiotics and antibiotic-associated diarrhea in children: A review and new evidence on Lactobacillus rhamnosus GG during and after antibiotic treatment. Pharmacol Res 2018; 128: 63-72.
  56. Dinleyici M, Vandenplas Y. Clostridium difficile colitis prevention and treatment In: Adv Exp Med Biol. New York, Springer, 2019.
  57. Vermeersch SJ, Vandenplas Y, Tanghe A et al. Economic evaluation of 6. boulardii CNCM I-745 for prevention of antibioticassociated diarrhoea in hospitalized patients. Acta Gastroenterol Belg 2018; 81: 269-76.
  58. Sung V. Infantile colic. Aust Prescr 2018; 41 (4): 105-10.
  59. Johnson JD, Cocker K, Chang E. Infantile colic: recognition and treatment. Am Fam Physician 2015; 92: 577-82.
  60. Sung V, D'Amico F, Cabana MD et al. Lactobacillus reuteri to treat infant colic: a meta-analysis. Pediatrics 2018; 141: e20171811.
  61. Harb T, Matsuyama M, David M et al. Infant colic-what works: a systematic review of interventions for breast-fed infants. J Pediatr Gastroenterol Nutr 2016; 62: 668-86.
  62. Indrio F, Di Mauro A, Riezzo G et al. Prophylactic use of a probiotic in the prevention of colic, regurgitation and functional constipation: a randomized clinical trial. JAMA Pediatr 2014; 168: 228-33.
  63. Savino F, Ceratto S, Poggi E et al. Preventive effects of oral probiotic on infantile colic: a prospective, randomised, blinded, controlled trial using Lactobacillus reuteri DSM 17938. Benef Microbes 2015; 6: 245-51.
  64. Indrio F, Di Mauro A, Di Mauro A et al. Prevention of functional gastrointestinal disorders in neonates: clinical and socioeconomic impact Benef Microbes 2015; 6: 195-8.
  65. Cabana MD, McKean M, Beck AL et al. Pilot analysis of early LGG for infant colic prevention. JPGN 2019; 68: 17-9.
  66. Giglione E, Prodam F, Bellone S et al. The association of bifidobacterium breve br03 and b632 is effective to prevent colics in bottle-fed infants: a pilot, controlled, randomized, and double-blind study. J Clin Gastroenterol 2016; 50 (Suppl. 2): S164-S167.
  67. Grave GD, Nelson SA, Walker WA et al. New therapies and preventive approaches for necrotizing enterocolitis: report of a research planning workshop. Pediatr Res 2007; 62: 510-4.
  68. Neu J, Walker WA. Necrotizing Enterocolitis. N Engl J Med 2011; 20: 255-64.
  69. Claud EC, Walker WA Hypothesis: inappropriate colonization of the premature intestine can cause neonatal necrotizing enterocolitis. FASEB J 2001; 15: 1398-403.
  70. Morowitz MJ, Poroyko V, Caplan M et al. Redefining the role of intestinal microbes in the pathogenesis of necrotizing enterocolitis. Pediatrics 2010; 125: 777-85.
  71. Schwiertz A, Gruhl B, Lbbnitz M et al. Development of the intestinal bacterial composition in hospitalized preterm infants in comparison with breast-fed, full-term infants. Pediatr Res 2003; 54: 393-9.
  72. Collado MC, Rautava S, Aakko J et al. Human gut colonisation may be initiated in utero by distinct microbial communities in the placenta and amniotic fluid. Sci Rep 2016; 6: 23129.
  73. Heida FH, van Zoonen AG, Hulscher JB et al. A necrotizing enterocolitis-associated gut microbiota is present in the meconium: results of a prospective study. Clin Infect Dis 2016; 62: 863-70.
  74. Zhu XL, Tang XG, Qu F et al. Bifidobacterium may benefit the prevention of necrotizing enterocolitis in preterm infants: A systematic review and meta-analysis. Int J Surg 2019; 61: 17-25.
  75. Kane AF, Bhatia AD, Denning PW et al. Routine supplementation of Lactobacillus rhamnosus GG and risk of necrotizing enterocolitis in very low birth weight infants. J Pediatr 2018; 195: 73-9.
  76. Patel S, Chaudhari M, Kadam S et al. Standardized feeding and probiotic supplementation for reducing necrotizing enterocolitis in preterm infants in a resource limited set up. Eur J Clin Nutr 2018; 72: 281-7.
  77. Van den Akker CHP, van Goudoever JB, Szajewska H et al. Probiotics for preterm infants: a strain-specific systematic review and network meta-analysis. J Pediatr Gastroenterol Nutr 2018; 67: 103-22.
  78. Pell LG, Loutet MG, Roth DE et al. Arguments against routine administration of probiotics for NEC prevention. Curr Opin Pediatr 2019.
  79. Sanders ME, Benson A, Lebeer S et al. Shared mechanisms among probiotic taxa: implications for general probiotic claims. Curr Opin Biotechnol 2018; 49: 207-16.
  80. Athalye-Jape G, Patole S. Probiotics for preterm infants - time to end all controversies. Microb Biotechnol 2019; 12: 249-53.
  81. Escribano E, Zozaya C, Madero R et al. Increased incidence of necrotizing enterocolitis associated with routine administration of Infloran™ in extremely preterm infants. Benef Microbes 2018; 9: 683-90.
  82. Garofoli F, Civardi E, Indrio F et al. The early administration of Lactobacillus reuteri DSM 17938 controls regurgitation episodes in full-term breastfed infants. Int J Food Sci Nutr 2014; 65: 646-8.
  83. Indrio F, Riezzo G, Raimondi F et al. Lactobacillus reuteri accelerates gastric emptying and improves regurgitation in infants. Eur J Clin Invest 2011; 41: 417-22.
  84. Vandenplas Y, Analitis A, Tziouvara C et al. Safety of a new synbiotic starter formula. Pediatr Gastroenterol Hepatol Nutr 2017; 20: 167-77.
  85. Belei O, Olariu L, Dobrescu A et al. Is it useful to administer probiotics together with proton pump inhibitors in children with gastroesophageal reflux? J Neuroga-stroenterol Motil 2018; 24: 51-7.
  86. 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 Pedi-atr Gastroenterol Nutr 2016; 63 (Suppl. 1): S27-35.
  87. Huang R, Hu J. Positive effect of probiotics on constipation in children: a systematic review and meta-analysis of six randomized controlled trials. Front Cell Infect Microbiol 2017; 7: 153.
  88. Fang HR, Zhang GQ, Cheng JY, Li ZY. Efficacy of Lactobacillus-supplemented triple therapy for Helicobacter pylori infection in children: a meta-analysis of randomized controlled trials. Eur J Pediatr 2019; 178: 7-16.
  89. Szajewska H, Horvath A, Kolodziej M. Systematic review with meta-analysis: Sac-charomyces boulardii supplementation and eradication of Helicobacter pylori infection. Aliment Pharmacol Ther 2015; 41: 1237-45.
  90. Hegar B, Hutapea EI, Advani N et al. A double-blind placebo-controlled randomized trial on probiotics in small bowel bacterial overgrowth in children treated with omeprazole. J Pediatr (Rio J) 2013; 89: 381-7.
  91. Wegh CAM, Benninga MA, Tabbers MM. Effectiveness of probiotics in children with functional abdominal pain disorders and functional constipation: a systematic review. J Clin Gastroenterol 2018; 52 (Suppl. 1): S10-S26.
  92. Guandalini S, Magazzu G, Chiaro A et al. VSL#3 improves symptoms in children with irritable bowel syndrome: a multicenter, randomized, placebo-controlled, double-blind, crossover study J Pediatr Gastroenterol Nutr 2010; 51: 24-30.

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