To start or not: Factors to consider when implementing routine probiotic use in the NICU

Barbian, Maria E.; Buckle, Rachel Louise; Denning, Patricia W.; Patel, Ravi

doi:10.1016/j.earlhumdev.2019.05.009

Cited by 18 publications

(13 citation statements)

References 48 publications

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“…An emergent trend of BB “prophylactic” consumption is presently widely scaled-up, not only as a food source but also as commercially available formulations of BB-derived functional foods and supplements whose regulatory oversight varies from country-to-country. In this context, uncertainties regarding their “real-life” efficacy and possible adverse effects subsist [ 67 , 68 , 69 ]. Accordingly, reliable and reproducible information from preclinical and human trials is still incongruent and requires a more in-depth elucidation to guide a healthier and safer consumption [ 29 , 30 , 34 , 36 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

Blueberry Consumption Challenges Hepatic Mitochondrial Bioenergetics and Elicits Transcriptomics Reprogramming in Healthy Wistar Rats

et al. 2020

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An emergent trend of blueberries’ (BB) “prophylactic” consumption, due to their phytochemicals’ richness and well-known health-promoting claims, is widely scaled-up. However, the benefits arising from BB indiscriminate intake remains puzzling based on incongruent preclinical and human data. To provide a more in-depth elucidation and support towards a healthier and safer consumption, we conducted a translation-minded experimental study in healthy Wistar rats that consumed BB in a juice form (25 g/kg body weight (BW)/day; 14 weeks’ protocol). Particular attention was paid to the physiological adaptations succeeding in the gut and liver tissues regarding the acknowledged BB-induced metabolic benefits. Systemically, BB boosted serum antioxidant activity and repressed the circulating levels of 3-hydroxybutyrate (3-HB) ketone bodies and 3-HB/acetoacetate ratio. Moreover, BB elicited increased fecal succinic acid levels without major changes on gut microbiota (GM) composition and gut ultra-structural organization. Remarkably, an accentuated hepatic mitochondrial bioenergetic challenge, ensuing metabolic transcriptomic reprogramming along with a concerted anti-inflammatory pre-conditioning, was clearly detected upon long-term consumption of BB phytochemicals. Altogether, the results disclosed herein portray a quiescent mitochondrial-related metabolomics and hint for a unified adaptive response to this nutritional challenge. The beneficial or noxious consequences arising from this dietary trend should be carefully interpreted and necessarily claims future research.

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Section: Discussionmentioning

confidence: 99%

Blueberry Consumption Challenges Hepatic Mitochondrial Bioenergetics and Elicits Transcriptomics Reprogramming in Healthy Wistar Rats

et al. 2020

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“…The study product was fed to preterm infants for a wide range of feedings, with the most premature infants receiving up to 100 feeds of the product. This assessment is particularly important as, despite evidence reporting infants supplemented with probiotics have better outcomes ( 48 ), safety concerns continue to be one major hurdle for the clinical use of probiotics in the NICU as part of standard feeding protocols ( 49 ).…”

Section: Discussionmentioning

confidence: 99%

B. infantis EVC001 Is Well-Tolerated and Improves Human Milk Oligosaccharide Utilization in Preterm Infants in the Neonatal Intensive Care Unit

et al. 2022

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Not all infants carry specialized gut microbes, meaning they cannot digest human milk oligosaccharides and therefore do not receive complete benefits from human milk. B. infantis EVC001 is equipped to convert the full array of complex oligosaccharides into compounds usable by the infant, making it an ideal candidate to stabilize gut function and improve nutrition in preterm infants. A prospective, open-label study design was used to evaluate the tolerability of B. infantis EVC001 and its effects on the fecal microbiota in preterm infants in a Neonatal Intensive Care Unit. Thirty preterm infants <1,500 g and/or <33 weeks gestation at birth were divided into two matched groups, and control infants were enrolled and discharged prior to enrolling EVC001 infants to prevent cross-colonization of B. infantis: (1) fifteen control infants received no EVC001, and (2) fifteen infants received once-daily feedings of B. infantis EVC001 (8.0 x 109 CFU) in MCT oil. Clinical information regarding medications, growth, nutrition, gastrointestinal events, diagnoses, and procedures was collected throughout admission. Infant stool samples were collected at baseline, Study Days 14 and 28, and 34-, 36-, and 38-weeks of gestation. Taxonomic composition of the fecal microbiota, functional microbiota analysis, B. infantis, and human milk oligosaccharides (HMOs) in the stool were determined or quantified using 16S rRNA gene sequencing, metagenomic sequencing, qPCR, and mass spectrometry, respectively. No adverse events or tolerability issues related to EVC001 were reported. Control infants had no detectable levels of B. infantis. EVC001 infants achieved high levels of B. infantis (mean = 9.7 Log10 CFU/μg fecal DNA) by Study Day 14, correlating with less fecal HMOs (ρ = −0.83, P < 0.0001), indicating better HMO utilization in the gut. In this study, B. infantis EVC001 was shown to be safe, well-tolerated, and efficient in colonizing the preterm infant gut and able to increase the abundance of bifidobacteria capable of metabolizing HMOs, resulting in significantly improved utilization of human milk.Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/NCT03939546, identifier: NCT03939546.

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“…The promotion of using mother's own milk or donor's milk has been strongly encouraged [41]. Despite the uncertainties regarding prophylactic probiotic intake, which this study aims to address, probiotics have been broadly implemented in many NICUs [42]. Probiotic alternatives, aiming to lower the risk of bacteremia, while retaining the positive eff ects on preterm infants' microbiome and infl ammatory system maturation are prebiotics and lactoferrin [43][44][45].…”

Section: Prophylaxis and Management Strategiesmentioning

confidence: 99%

Probiotic Use in Preterm Neonates: A Review and Bibliometric Analysis

Yordanov

2022

Acta Medica Bulgarica

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Background: Necrotizing enterocolitis (NEC) is a major health burden in peterm neonates with mortality rates between 21% and 50%. Prophylaxis is of primary importance as early diagnosis is hindered by the lack of specific signs and laboratory markers. Although probiotics have been routinely used for NEC prophylaxis in neonatal intensive care units around the world, clinical trials provide contradictory data, which fuels an ongoing debate about their efficacy and safety. Aims: To perform a review and bibliometric analysis on available clinical trials and case reports data on the safety and efficacy of probiotics in preterm neonates and identify relevant publication trends and patterns. Methods: A bibliometric search for publications on the topic was performed in the Web of Science Core Collection database and the resulting records analyzed in bibliometrix package in R. Results: Trends in publication activity, historical direct citation network relationships and keyword co-ocurrences were discussed in the context of the most recent therapeutic recommendations. Conclusion: We took a round view of the potential drawbacks to probiotic use in preterm infants and their possible solutions.

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To start or not: Factors to consider when implementing routine probiotic use in the NICU

Cited by 18 publications

References 48 publications

Blueberry Consumption Challenges Hepatic Mitochondrial Bioenergetics and Elicits Transcriptomics Reprogramming in Healthy Wistar Rats

Blueberry Consumption Challenges Hepatic Mitochondrial Bioenergetics and Elicits Transcriptomics Reprogramming in Healthy Wistar Rats

B. infantis EVC001 Is Well-Tolerated and Improves Human Milk Oligosaccharide Utilization in Preterm Infants in the Neonatal Intensive Care Unit

Probiotic Use in Preterm Neonates: A Review and Bibliometric Analysis

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