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益生菌有益效果证据的确证指南:益生菌预防和控制感染。

Guidance for substantiating the evidence for beneficial effects of probiotics: prevention and management of infections by probiotics.

机构信息

Unilever Food and Health Research Institute, Vlaardingen, The Netherlands.

出版信息

J Nutr. 2010 Mar;140(3):698S-712S. doi: 10.3945/jn.109.113753. Epub 2010 Jan 27.


DOI:10.3945/jn.109.113753
PMID:20107143
Abstract

The rationale for the use of probiotics in the management of infectious diseases is supported by their potential to influence and stabilize the composition of gut microbiota, enhance colonization resistance, and modulate immune function parameters. A literature review was conducted to determine the efficacy of using probiotics in selected infections: 1) infectious diarrhea in infants and children, 2) traveler's diarrhea, 3) necrotizing enterocolitis in infants, 4) Helicobacter pylori infection, 5) respiratory tract infections in adults and children, 6) ear, nose, and throat infections, and 7) infectious complications in surgical and critically ill patients. The different types of infections that have been subject to clinical studies with different probiotics obviously prevent any generic conclusions. Furthermore, the lack of consistency among studies focusing on 1 specific infection, in study design, applied probiotic strains, outcome parameters, and study population, along with the still limited number of studies, preclude clear and definite conclusions on the efficacy of probiotics and illustrate the need for better-aligned study designs and methodology. Exceptions were the management of infectious diarrhea in infants and traveler's diarrhea, antibiotic-associated diarrhea, and necrotizing enterocolitis. Sufficient consistent data exist for these applications to conclude that certain probiotics, under certain conditions, and in certain target populations, are beneficial in reducing the risk of infection. In addition, some evidence exists, although conclusions are premature, for the management of Helicobacter pylori infection and possible reduction of treatment side effects. Certain probiotics may also reduce the risk of various symptoms of respiratory tract infections in adults and children, including ear, nose, and throat infections, although data are currently far too limited to distill any clinical recommendations in this area. Positive but also negative results have been obtained in prevention of infectious complications in surgical and critically ill patients. For future studies it is recommended that researchers provide adequate power, identify pathogens, and report both clinical outcomes and immune biomarkers relating to putative underlying mechanisms.

摘要

使用益生菌来管理传染病的基本原理是基于其影响和稳定肠道微生物群落组成、增强定植抗力以及调节免疫功能参数的潜力。进行了文献回顾,以确定在选定感染中使用益生菌的疗效:1)婴儿和儿童感染性腹泻,2)旅行者腹泻,3)婴儿坏死性小肠结肠炎,4)幽门螺杆菌感染,5)成人和儿童呼吸道感染,6)耳部、鼻部和喉部感染,以及 7)外科和重症患者的感染并发症。显然,不同类型的感染已经在不同的益生菌临床试验中得到了研究,这使得任何一般性结论都无法得出。此外,针对 1 种特定感染的研究在研究设计、应用的益生菌菌株、结果参数和研究人群方面缺乏一致性,以及研究数量仍然有限,这使得益生菌疗效的明确结论无法得出,并说明了需要更好的研究设计和方法。在婴儿感染性腹泻和旅行者腹泻、抗生素相关性腹泻和坏死性小肠结肠炎的管理方面,存在例外情况。这些应用存在足够的一致性数据,可以得出某些益生菌在某些条件下和特定目标人群中有助于降低感染风险的结论。此外,尽管结论还不成熟,但在幽门螺杆菌感染的管理和可能减少治疗副作用方面,也有一些证据存在。某些益生菌还可能降低成人和儿童呼吸道感染(包括耳部、鼻部和喉部感染)各种症状的风险,但目前的数据还远远不足以从中提炼出任何临床建议。在外科和重症患者感染并发症的预防方面,也得到了阳性和阴性结果。对于未来的研究,建议研究人员提供足够的效能、确定病原体,并报告与推测的潜在机制相关的临床结果和免疫生物标志物。

相似文献

[1]
Guidance for substantiating the evidence for beneficial effects of probiotics: prevention and management of infections by probiotics.

J Nutr. 2010-1-27

[2]
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Expert Rev Anti Infect Ther. 2015-10-23

[3]
A meta-analysis of probiotic efficacy for gastrointestinal diseases.

PLoS One. 2012-4-18

[4]
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Adv Clin Exp Med. 2013

[5]
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Curr Opin Clin Nutr Metab Care. 2020-9

[6]
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Am Fam Physician. 2017-8-1

[7]
Probiotics in the mechanism of protection against gut inflammation and therapy of gastrointestinal disorders.

Curr Pharm Des. 2014

[8]
Probiotics in the prevention and treatment of gastrointestinal infections.

Gastroenterol Clin North Am. 2006-6

[9]
Probiotics in intestinal and non-intestinal infectious diseases--clinical evidence.

Curr Pharm Des. 2008

[10]
Probiotics: their role in the treatment and prevention of disease.

Expert Rev Anti Infect Ther. 2006-4

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[4]
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[5]
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[6]
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[7]
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