RESUMO
Necrotizing enterocolitis (NEC) is a severe intestinal inflammatory disorder in newborns. Although the pathogenesis of NEC is not completely understood, we reviewed the literature and our previous studies to explore the mechanism of NEC and to evaluate the role for probiotics in this disease. NEC may be associated with an inappropriate innate immune and excessive inflammatory response of the immature intestine. Probiotics are widely used in promoting human health and adjunctive therapy of human disease. There are growing clinical trials and research studies that support a beneficial role for probiotics for NEC. We have reviewed the literature associated with the use of probiotics in NEC.
Assuntos
Enterocolite Necrosante/prevenção & controle , Doenças do Prematuro/prevenção & controle , Mucosa Intestinal/microbiologia , Probióticos/uso terapêutico , Translocação Bacteriana , Aleitamento Materno , Enterocolite Necrosante/imunologia , Enterocolite Necrosante/microbiologia , Humanos , Imunidade Inata , Fórmulas Infantis , Recém-Nascido , Recém-Nascido Prematuro , Doenças do Prematuro/imunologia , Doenças do Prematuro/microbiologia , Mucosa Intestinal/imunologia , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
The development of the intestinal immune system is a complex sequence of events that begins in utero under various genetic influences, but continues after birth, being modified by factors such as bacteria, hormones and feeds. This review discusses what is known about the ontogeny of each aspect of the mucosal immune system so as to provide a better understanding of how aberrations in the system might lead to systemic disease.
Assuntos
Imunidade nas Mucosas , Mucosa Intestinal/imunologia , Animais , Bactérias/imunologia , Humanos , Mucosa Intestinal/crescimento & desenvolvimento , Mucosa Intestinal/microbiologia , Tecido Linfoide/crescimento & desenvolvimento , Tecido Linfoide/imunologiaRESUMO
The role of polyunsaturated fatty acids (PUFAs) in inflammatory lesions of the intestines is the subject of increasing research. This review begins with a background discussion of the source, elongation, and desaturation of PUFAs, as well as the role they have played in the human diet through evolution. The available data and hypotheses as to how manipulation of PUFAs might effect the various components of the immune system are then provided. Possible mechanisms by which PUFAs result in immunomodulation include alterations in eicosanoid synthesis, membrane fluidity, signal transduction, intraluminal bacteria, and gene expression. Attention is then turned to the known effects that these polyunsaturated fatty acids have on the various individual components of the immune system including lymphocytes, neutrophils, and antigen presenting cells, as well as the immunoregulatory process of apoptosis. Finally, laboratory data on the role of PUFAs in necrotizing enterocolitis, and to a greater extent inflammatory bowel disease, first as demonstrated in animal models of the disease, and second in human studies are then summarized.
