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Background: Probiotics and prebiotics have strain-specific effects on the host. Synbiotics, a mixture of probiotics and prebiotics, are proposed to have more beneficial effects on the host than either agent has alone.Purpose: We performed a randomized controlled trial to investigate the effect of Lactobacillus and Bifidobacterium together with oligosaccharides and lactoferrin on the development of necrotizing enterocolitis (NEC) or sepsis in very low birth weight neonates.Methods: Neonates with a gestational age ≤32 weeks and birth weight ≤1,500 g were enrolled. The study group received a combination of synbiotics and lactoferrin, whereas the control group received 1 mL of distilled water as placebo starting with the first feed until discharge. The outcome measures were the incidence of NEC stage ≥2 or late-onset cultureproven sepsis and NEC stage ≥2 or death.Results: Mean birth weight and gestational age of the study (n=104) and the control (n=104) groups were 1,197±235 g vs. 1,151±269 g and 29±1.9 vs. 28±2.2 weeks, respectively (P>0.05). Neither the incidence of NEC stage ≥2 or death, nor the incidence of NEC stage ≥2 or late-onset culture-proven sepsis differed between the study and control groups (5.8% vs. 5.9%, P=1; 26% vs. 21.2%, P=0.51). The only significant difference was the incidence of all stages of NEC (1.9% vs. 10.6%, P=0.019).Conclusion: The combination of synbiotics and lactoferrin did not reduce NEC severity, sepsis, or mortality.

The Gc2 variant was, after adjusting for confounders, associated with a decrease in the frequency of BPD. Our study adds Gc globulin to the list of candidate genes that potentially contribute to the etiology of the disease.

Smoking during pregnancy has several effects and risks on the neonates. The aim is to assess the effects of exposure to environmental tobacco smoke duringpregnancy on the antioxidant status of their neonates. Design: In cord blood samples of 116 healthy newborns which were classified into groups according to mothers smoking status (active, passive or non-smoker), the activities of paraoxanase 1 and aryl esterase, concentrations of free sulfhydryl groups and total antioxidant response were studied using appropriate methods. Results: Different parameters indicating antioxidant status had similar values in cord blood of term and preterm neonates of active or passive smoke or non-smoker mothers. Only, concentrations of total antioxidant response were statistically different between cord blood of neonates of active or passive smoker mothers and cord blood of term or preterm neonates of non-smoker mothers (1.12 ± 0.1, 1.10 ± 0.08 and 1.28 ± 0.12 mmol trolox equivalent/L, for term neonates, 0.95 ± 0.0, 1.07 ± 0.13 and 1.22 ± 0.02 mmol trolox equivalent/L, for preterm neonates, respectively). Conclusions: Neonates of active or passive smoker mothers have decreased antioxidant levels in cord blood and may be exposed to an oxidative stress greater.

Introduction. Probiotics and prebiotics, which are multifunctional agents, have potential benefits in chronic mucosal inflammation, including the prevention of necrotizing enterocolitis. However, the mechanisms and the results of these immunomodulatory effects are not clear. This study aimed to investigate the cytokine response to the combination of Lactobacillus and Bifidobacterium together with fructo-and galactooligosaccharides (symbiotic) and lactoferrin in very low birth weight neonates. Population and Methods. Infants ≤ 32 GWs and ≤ 1,500 g were randomly assigned to receive a symbiotic combination or 1 ml distilled water as placebo starting with the first feed until discharge. Blood samples were obtained at postnatal 0 ± 2, 14 ± 2, and 28 ± 2 days, and the serum levels of interferon-γ, interleukin (IL)-5, IL-10, and IL-17A were measured. Results. In the study group (n = 25), the IL-10 levels decreased throughout the study period (p = 0.011) but did not change in the control group. The IL-5 levels remained steady in the first 14 days and decreased significantly thereafter (p = 0.042) in the study group, whereas they increased in the first 14 days (p = 0.019), and then decreased in 28 days (p = 0.011) in the control group (n = 25). The levels of the other cytokines did not change throughout the study period. Conclusion. The combined use of probiotics with oligosaccharides and lactoferrin was associated with a decrease in IL-10 levels, but no change was observed in the other cytokines.