Garcia C, Duan R D, Brévaut-Malaty V, Gire C, Millet V, Simeoni U, Bernard M, Armand M
Aix—Marseille Université CNRS, CRMBM UMR 7339 Marseille France.
University of Lund Institution of Clinical Sciences, Gastroenterology and Nutrition Laboratory Lund Sweden.
Cell Mol Biol (Noisy-le-grand). 2013 Dec 30;59(1):108-31.
Premature births are increasing worldwide (about 15 millions per year) due to several reasons (an advanced maternal age, fertility treatments, stress, smoking, nutritional deficiencies) and lead to a high societal overall cost. Among neonatal care procedures, the clinical nutrition practices are essential to promote the development and to minimize the sequelae. Premature newborns are at major risk of death by infections due to the immaturity of their intestine. Human milk provides not only nutrients but also a plethora of biologically active components that are tailored to contribute to the development of the intestinal tract early in postnatal life. Among them, some bioactive molecules exhibit trophic effects (LC—PUFA, sphingomyelin, IGF—I and IGF—II, EGF, insulin, leptin, adiponectin, lactoferrin, lactadherin, probiotics, prebiotics, miRNA) or are part of the intestinal cell membranes (PUFA, LC—PUFA, phospholipids, sphingolipids, cholesterol), others educate the intestine for innate microbial recognition (sCD14, sTLR—2, miRNA), many of them display direct fighting against pathogens (some fatty acids and monoglycerides, some phospholipids and sphingolipids, BSSL, insulin, lactoferrin, sIgAs, MUC—1, lactadherin, probiotics, prebiotics), or contribute to establish the gut microbiota (LC—PUFA, lactoferrin, probiotics, prebiotics). A synergetic action exists between several bioactive molecules. All together these precious agents regulate the maturation of the intestinal mucosal barrier, and might program early in postnatal life the future adult intestinal health. This review lists the main bioactive compounds and addresses their plausible roles and mechanisms of action.
由于多种原因（产妇年龄增大、生育治疗、压力、吸烟、营养缺乏），全球早产率正在上升（每年约1500万例），并导致高昂的社会总成本。在新生儿护理程序中，临床营养实践对于促进发育和尽量减少后遗症至关重要。早产新生儿因其肠道不成熟而面临感染导致死亡的重大风险。母乳不仅提供营养，还含有大量生物活性成分，这些成分有助于在出生后早期促进肠道发育。其中，一些生物活性分子具有营养作用（长链多不饱和脂肪酸、鞘磷脂、胰岛素样生长因子-I和-II、表皮生长因子、胰岛素、瘦素、脂联素、乳铁蛋白、乳黏附素、益生菌、益生元、微小核糖核酸）或构成肠道细胞膜的一部分（多不饱和脂肪酸、长链多不饱和脂肪酸、磷脂、鞘脂、胆固醇），其他一些则帮助肠道进行先天性微生物识别（可溶性CD14、可溶性Toll样受体-2、微小核糖核酸），它们中的许多能直接对抗病原体（一些脂肪酸和甘油单酯、一些磷脂和鞘脂、牛小肠碱性丝氨酸蛋白酶抑制剂、胰岛素、乳铁蛋白、分泌型免疫球蛋白A、黏蛋白-1、乳黏附素、益生菌、益生元），或有助于建立肠道微生物群（长链多不饱和脂肪酸、乳铁蛋白、益生菌、益生元）。几种生物活性分子之间存在协同作用。所有这些珍贵的物质共同调节肠道黏膜屏障的成熟，并可能在出生后早期为未来成年人的肠道健康做好规划。本综述列出了主要的生物活性化合物，并阐述了它们可能的作用和作用机制。
