vspВопросы современной педиатрииCurrent Pediatrics1682-55271682-5535Издательство «ПедиатрЪ»10.15690/vsp.v20i6.2354vsp-2775Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWТаргетное формирование микробиоты младенцев на искусственном вскармливании: современные возможностиTargeted Development of Infant Microbiota on Formula Feeding: Modern Optionshttps://orcid.org/0000-0002-8717-2539БеляеваИ. А.BelyaevaIrina A.

Беляева Ирина Анатольевна, доктор медицинских наук, профессор РАН, профессор кафедры факультетской педиатрии педиатрического факультета РНИМУ им. Н.И. Пирогова, главный научный сотрудник НИИ педиатрии и охраны здоровья детей ЦКБ РАН, врач-неонатолог высшей квалификационной категории Морозовской детской городской клинической больницы

119333, Москва, ул. Фотиевой, д. 10, к. 1

Moscow

irinaneo@mail.ruhttps://orcid.org/0000-0002-2209-7531Намазова-БарановаЛ. С.Namazova-BaranovaLeyla S.

Москва

Moscow

https://orcid.org/0000-0002-6677-2914БомбардироваЕ. П.BombardirovaElena P.

Москва

Moscow

https://orcid.org/0000-0002-4955-0121ТуртиТ. В.TurtiTatiana V.

Москва

Moscow

https://orcid.org/0000-0001-5915-6219СадчиковП. Е.SadchikovPavel E.

Москва

Moscow

НИИ педиатрии и охраны здоровья детей ЦКБ РАН; Российский национальный исследовательский медицинский университет им. Н.И. Пирогова; Морозовская детская городская клиническая больницаРоссияResearch Institute of Pediatrics and Children’s Health in “Central Clinical Hospital of the Russian Academy of Sciences”;Pirogov Russian National Research Medical University;Morozovskaya Children’s City HospitalRussian FederationНИИ педиатрии и охраны здоровья детей ЦКБ РАН; Российский национальный исследовательский медицинский университет им. Н.И. ПироговаРоссияResearch Institute of Pediatrics and Children’s Health in “Central Clinical Hospital of the Russian Academy of Sciences”; Pirogov Russian National Research Medical UniversityRussian FederationНИИ педиатрии и охраны здоровья детей ЦКБ РАНРоссияResearch Institute of Pediatrics and Children’s Health in “Central Clinical Hospital of the Russian Academy of Sciences”Russian FederationНИИ педиатрии и охраны здоровья детей ЦКБ РАН; Российский национальный исследовательский медицинский университет им. Н.И. Пирогова; НИИ организации здравоохранения и медицинского менеджментаРоссияResearch Institute of Pediatrics and Children’s Health in “Central Clinical Hospital of the Russian Academy of Sciences”; Pirogov Russian National Research Medical University; Research Institute for Healthcare Organization and Medical ManagementRussian Federation202116122021206484491Copyright © Беляева И.А., Намазова-Баранова Л.С., Бомбардирова Е.П., Турти Т.В., Садчиков П.Е., 20222022Беляева И.А., Намазова-Баранова Л.С., Бомбардирова Е.П., Турти Т.В., Садчиков П.Е.Belyaeva I.A., Namazova-Baranova L.S., Bombardirova E.P., Turti T.V., Sadchikov P.E.This work is licensed under a Creative Commons Attribution 4.0 License.https://vsp.spr-journal.ru/jour/article/view/2775

В обзоре приводится анализ последних публикаций, посвященных расшифровке с помощью современных исследовательских технологий биологической значимости микробиома младенца. Оценены связи количественных и качественных характеристик микробиоты кишечника с отсроченными нарушениями здоровья. Рассмотрены различные концепции происхождения микробиома новорожденного, сроков и этапов бактериальной колонизации желудочно-кишечного тракта. Представлены данные о роли способа родоразрешения в формировании микробиоты младенца, в том числе значимость контаминации материнской вагинальной флорой, в составе которой онтогенетическая приоритетность принадлежит представителям рода лактобацилл. Установлено, что Lactobacillus fermentum выполняет роль стартовой микрофлоры, обеспечивающей условия для последующей успешной колонизации кишечника ребенка облигатными симбионтами. Подтверждена значимость грудного вскармливания в адекватном становлении микро-биоты. При вынужденном искусственном вскармливании целесообразно обогащение детских молочных смесей компонентами, способствующими селекции симбиотической микрофлоры, в том числе длинноцепочечными полиненасыщенными жирными кислотами, пребиотиками — олигосахаридами и пробиотиками направленного действия. Инновационная смесь, созданная на основе концепции синбиотик/комбиотик, сможет частично компенсировать нарушение формирования микробиоты младенца при вынужденном искусственном вскармливании.

The review provides the analysis of recent publications covering the biological significance of infant microbiome and showing modern research technologies. Correlations of quantitative and qualitative characteristics of intestinal microbiota with delayed health issues were evaluated. Various concepts of newborn microbiome origin, timing, and stages of bacterial colonization of gastrointestinal tract were considered. Data on the role of delivery method on infant microbiota development is presented (including the significance of contamination with maternal vaginal flora where ontogenetic priority belongs to lactobacilli). It was revealed that Lactobacillus fermentum was the basis microflora providing the conditions for the subsequent successful colonization of the child’s intestines with obligate symbionts. The significance of breastfeeding in adequate microbiota development was confirmed. In case of mandatory formula feeding, it is necessary to enrich infant milk formulas with components that promote the selection of symbiotic microflora such as: long-chain polyunsaturated fatty acids, prebiotics, oligosaccharides, and probiotics of specific action. The innovative formula based on synbiotic/combiotic concept will be able to partially compensate impaired microbiota development in infant on mandatory formula feeding.

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The authors declare that there are no conflicts of interest present.