The Significance of the Enteric Microbiome on the Development of Childhood Disease: A Review of Prebiotic and Probiotic Therapies in Disorders of Childhood

Abstract

Recent studies have highlighted the fact that the enteric microbiome, the trillions of microbes that inhabit the human digestive tract, has a significant effect on health and disease. Methods for manipulating the enteric microbiome, particularly through probiotics and microbial ecosystem transplantation, have undergone some study in clinical trials. We review some of the evidence for microbiome alteration in relation to childhood disease and discuss the clinical trials that have examined the manipulation of the microbiome in an effort to prevent or treat childhood disease with a primary focus on probiotics, prebiotics, and/or synbiotics (ie, probiotics + prebiotics). Studies show that alterations in the microbiome may be a consequence of events occurring during infancy and/or childhood such as prematurity, C-sections, and nosocomial infections. In addition, certain childhood diseases have been associated with microbiome alterations, namely necrotizing enterocolitis, infantile colic, asthma, atopic disease, gastrointestinal disease, diabetes, malnutrition, mood/anxiety disorders, and autism spectrum disorders. Treatment studies suggest that probiotics are potentially protective against the development of some of these diseases. Timing and duration of treatment, the optimal probiotic strain(s), and factors that may alter the composition and function of the microbiome are still in need of further research. Other treatments such as prebiotics, fecal microbial transplantation, and antibiotics have limited evidence. Future translational work, in vitro models, long-term and follow-up studies, and guidelines for the composition and viability of probiotic and microbial therapies need to be developed. Overall, there is promising evidence that manipulating the microbiome with probiotics early in life can help prevent or reduce the severity of some childhood diseases, but further research is needed to elucidate biological mechanisms and determine optimal treatments.

Folate Metabolism Abnormalities in Autism: Potential Biomarkers

“…Deficiencies in these enteric bacteria could be linked to ASD through environmental factors. Of note, Bifidobacteria is primarily obtained through breastfeeding and reduced breastfeeding has been linked to ASD, and western diets, which have been linked to ASD, are low in Prevotella [18]. A recent small open-label clinical trial showed that microbiota transfer therapy significantly improved gastrointestinal and ASD symptoms in children and adolescents with ASD [16].…”

“…Folate is synthesized by enteric bacterial species, particularly Bifidobacteria, Prevotella and certain Lactobacilli species [13][14][15][16][17]. Children with ASD lack microbial diversity and have a decreased abundance in both Prevotella and Bifidobacteria, potentially leading to reduced folate production by microbiota in individuals with ASD [18]. Deficiencies in these enteric bacteria could be linked to ASD through environmental factors.…”

Fermented Food Guidelines for Children

“…These bacteria include Clostridia and other species producing propionic acid and related fatty acids by antibiotic-resistant gut bacteria that can increase the risk of autism or worsen its symptoms. They tend to overgrow in the gut following a course of antibiotics that wipes out other intestinal bacteria causing intestinal inflammation 11,12 .…”

More Than a Gut Feeling: The Implications of the Gut Microbiota in Psychiatry

“…In contrast, probiotics are microorganisms that are administered to directly colonize an organ system. The number of microbes living in the gastrointestinal (GI) tract is ten times the number of human cells in the body, and the total microbial genetic material is 100 times that of the entire human genome (2). In fact, the gut micro-biome has been referred to as the “second genome” of the human body.…”