Elsevier

Current Paediatrics

Volume 14, Issue 2, April 2004, Pages 104-109
Current Paediatrics

The role of probiotics in paediatrics

https://doi.org/10.1016/j.cupe.2003.11.002Get rights and content

Abstract

The recent demonstration that the gut microbiota, and by the same token probiotics, have a strong impact in priming major maturation processes in the intestine's mucosal barrier has opened up new angles to the science of nutrition. In modulating specific target functions in the gut and the immune system, probiotics in the diet may exert additional beneficial physiological effects beyond the nutritional impact of food. Probiotic bacteria are living microbial food ingredients which have a beneficial effect on human health. These effects are attributed to the normal restoration of increased intestinal permeability and unbalanced gut microbiota, improvement of the intestine's immunological barrier functions and alleviation of the intestinal inflammatory response. The application of probiotics in paediatric practice currently lies in enhancing these barrier functions in the gut and reducing the risk of diseases associated with their dysfunction. The most fully documented probiotic intervention is the treatment and prevention of acute infectious diarrhoea. Recent clinical and nutritional studies and characterisation of the immunomodulatory potential of specific probiotic strains have attracted active research interest also in allergic and inflammatory diseases.

Introduction

Probiotics are live microbial food ingredients which are beneficial to health.1 The prerequisites for probiotic action include survival in and adhesion to specific areas of the gastrointestinal tract and competitive exclusion of pathogens or harmful antigens. The current emphasis is on survival in the gut and temporary colonisation of the mucosal surfaces in the intestinal tract. The definition of probiotics requires that their efficacy and safety must be verified in clinical studies and thus, assessment of this constitutes an important part of their characterisation for human use. Currently, most probiotics have been selected from members of the normal healthy adult microbiota. The strains with beneficial properties, which are potential sources of probiotics, most frequently belong to the genera Bifidobacterium and Lactobacillus. Some of these exhibit powerful anti-inflammatory capabilities. Indeed, recent characterisation of the immunomodulatory potential of specific strains of the gut microbiota, beyond their effect on the composition of the microbiota, has led to new criteria for probiotic selection for novel applications in paediatric nutrition.

Section snippets

Modern nutrition for the modern child

The basic foundation of nutrition lies in a healthy, balanced diet to meet the needs for growth and development in children. In addition, a disease state may impose specific requirements for energy and nutrients, a deficiency of these may contribute to a deterioration of nutritional status and growth failure in children. Beyond this function in the prevention of direct diet-related deficiencies, the role of diet has changed as the science of nutrition has evolved.2 Research interest in

Rationale and targets for probiotic intervention

In addition to its principal physiological function, the digestion and absorption of nutrients, the gastrointestinal tract and the gut-associated immune system have evolved into an integrated barrier between the internal environment and antigens such as food and microorganisms from the external environment.5 The integrity of the intestine's mucosal defence depends on a number of factors in both intestinal lumen and mucosa. Nutrition via the gastrointestinal tract is important in maintaining

Probiotic intervention strategies in paediatric practice

The potential health effects of normal gut microbiota have to be demonstrated by well controlled clinical and nutritional studies in which lactobacilli or bifidobacteria are used as dietary supplements for the nutritional management of various gastrointestinal infectious and inflammatory diseases, or for reducing the risk of these diseases.

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