Friday, March 27, 2009

Babies with bad guts

The first post of many, hopefully.

I'll try and focus upon research that may not otherwise get the press that it deserves, either because of the obscurity of the topic or the location of the researchers. Here's an interesting article performed by researchers in Kolkata, randomizing premature babies to prophylactic probiotics or placebo, and finding a fairly significant response rate with the outcomes of necrotizing enterocolitis, hospital stay, and time to full gut feeding. Not revolutionary stuff, since prior studies have backed this up, including a well-performed Cochrane analysis, which showed that by giving little babies probiotics, you reduce the incidence of this serious gut disease. This has been slow to disseminate into practice, however, since people seem to be still afraid of giving little babies, with their immature little immune systems, more microorganisms. None of the data says that this is a concern, with no significantly increased rates of new blood infections or other serious adverse events in the babies that received the probiotic.

What's more notable than just the direct clinical application of this study, however, is just how crucial our endogenous bacterial flora is in our physiology. Premature infants are premature in everything, including the establishment of an appropriate microbial environment, and by artificially inducing something akin to that, as the researchers have done through providing organisms that are commensal in breast milk, they have reduced the incidence of a disease. Bacteria have long gotten a bad rap, and only recently their multi-varied function in the developing infant has been realized: from digestion to vitamin production to immune regulation
to many more, emphasizing the complex host-microbial relationship. Some exciting stuff is being performed looking at the long-term incidence of disease and the neonatal gut flora, and most exciting is the human microbiome project, with the potential to seed the gut with specific disease-preventing/treating bacteria and add even more complexity to the gene-environment interactability discussions. Exciting times.

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