Новые взгляды на понятие «пребиотики» и их влияние на организм ребенка
Аннотация
Обнаружение большого количества олигосахаридов в грудном молоке предопределило их использование в составе детских молочных смесей. Наиболее изученным пребиотиком, имитирующим уникальные свойства олигосахаридов грудного молока, является комплекс scGOS/lcFOS. Его эффективность подтверждена в клинических исследованиях. В 2017 г. эксперты Международной научной ассоциации пробиотиков и пребиотиков (ISAPP) приняли новое определение понятия «пребиотики», что значительно расширило концепцию их использования. Всемирная организация по аллергии рекомендует использовать пребиотики у детей с повышенным риском развития аллергии. Рекомендации основаны на результатах исследований влияния пребиотиков на микробиом кишечника, нарушение состава и функций которого предрасполагает к развитию аллергии. В настоящее время продолжается поиск более перспективных технологий по производству пребиотиков.
Ключевые слова
Об авторах
О. Л. ЛукояноваРоссия
доктор медицинских наук, ведущий научный сотрудник отделения питания здорового и больного ребенка НМИЦ здоровья детей
Адрес: 119991, Москва, Ломоносовский пр-т, д. 2/62, тел.: +7 (495) 132-26-00
Раскрытие интересов:
проведение научно-исследовательских работ при поддержке компаний Nestle, Heinz, Хироу Рус, Philips
Т. Э. Боровик
Россия
Раскрытие интересов:
проведение научно-исследовательских работ при поддержке компаний Nestle, Heinz, Хироу Рус, Philips
А. В. Суржик
Россия
Раскрытие интересов:
проведение научно-исследовательских работ при поддержке компании Nutricia
Список литературы
1. Prescott SL, Logan AC, Millstein RA, Katszman MA. Biodiversity, the human microbiome and mental health: moving toward a new clinical ecology for the 21st Century? International Journal of Biodiversity. 2016;2016:2718275. doi: 10.1155/2016/2718275.
2. David LA, Maurice CF, Carmody RN, et al. Diet rapidly and reproducibly alters the human gut microbiome. Nature. 2014; 505(7484):559–563. doi: 10.1038/nature12820.
3. Gibson GR, Roberfroid MB. Dietary modulation of the human colonic microbiota: introducing the concept of prebiotics. J Nutr. 1995;125(6):1401–1412.
4. Dosage-related bifidogenic effects of galacto- and fructooligosaccharides in formula-fed term infants. J Pediatr Gastroenterol Nutr. 2002;34(3):291–295. doi: 10.1097/00005176-200203000-00014.
5. Knol J, Scholtens P, Kafka C, et al. Colon microflora in infants fed formula with galacto- and fructo-oligosaccharides: more like breastfed infants. J Pediatr Gastroenterol Nutr. 2005;40(1):36–42.
6. Scholtens PA, Alliet P, Raes M, et al. Fecal secretory immunoglobulin A is increased in healthy infants who receive a formula with short-chain galacto-oligosaccharides and long- chain fructooligosaccharides. J Nutr. 2008;138(6):1141–1147.
7. van Hoffen E1, Ruiter B, Faber J, et al. A specific mixture of shortchain galacto- oligosaccharides and long-chain fructo-oligosaccharides induces a beneficial immunoglobulin profile in infants at high risk for allergy. Allergy. 2009;64(3):484–487. doi: 10.1111/j.1398-9995.2008.01765.x.
8. Bode L. Human milk oligosaccharides: every baby needs a sugar mama. Glycobiology. 2012;22(9):1147–1162. doi: 10.1093/glycob/cws074.
9. Bode L, Jantscher-Krenn E. Structure-function relationship of human milk oligosaccharides. Adv Nutr. 2012;3(3):383S–391S. doi: 10.3945/an.111.001404.
10. Bao Y, Chen C, Newburg DS. Quantification of neutral human milk oligosaccharides by graphitic carbon high-performance liquid chromatography with tandem mass spectrometry. Anal Biochem. 2013;433(1):28–35. doi: 10.1016/j.ab.2012.10.003.
11. Thurl S, Henker J, Siegel M, et al. Detection of four human milk groups with respect to Lewis blood group dependent oligosaccharides. Glycoconj J. 1997;14(7):795–799.
12. Rudloff S, Obermeier S, Borsch C, et al. Incorporation of orally applied C-galactose into milk lactose and oligosaccharides. Glycobiology. 2006;16(6):477–487. doi: 10.1093/glycob/cwj092.
13. Rudloff S, Pohlentz G, Borsch C, et al. Urinary excretion of in vivo 13C-labelled milk oligosaccharides in breastfed infants. Br J Nutr. 2011;107(7):957–963. doi: 10.1017/S0007114511004016.
14. Vos AP, M’Rabet L, Stahl B, et al. Immune-modulatory effects and potential working mechanisms of orally applied nondigestible carbohydrates. J Crit Rev Immunol. 2007;27(2):97–140.
15. Coppa GV, Zampini L, Galeazzi T. Prebiotics in human milk: a review. Dig Liver Dis. 2006;38 Suppl 2:S291–294. doi: 10.1016/S1590-8658(07)60013-9.
16. Jantscher-Krenn E, Zherebtsov M, Nissan C, et al. The human milk oligosaccharide disialyllacto-N-tetraose prevents necrotising enterocolitis in neonatal rats. Gut. 2013;61(10):1417–1425. doi: 10.1136/gutjnl-2011-301404.
17. Zivkovic AM, German JB, Lebrilla CB, Mills DA. Human milk glycobiome and its impact on the infant gastrointestinal microbiota. Proc Natl Acad Sci U S A. 2011;108 Suppl 1:4653– 4658. doi: 10.1073/pnas.1000083107.
18. Wang B, Brand-Miller J, McVeagh P, Petocz P. Concentration and distribution of sialic acid in human milk and infant formulas. Am J Clin Nutr. 2001;74(4):510–515.
19. Gibson G, Hutkins R, Sanders M, et al. Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nat Rev Gastroenterol Hepatol. 2017;14:491–502. doi: 10.1038/nrgastro.2017.75.
20. Cuello-Garcia CA, Fiocchi A, Pawankar R, et al. World Allergy Organization-McMaster University Guidelines for Allergic Disease Prevention (GLAD-P): prebiotics. World Allergy Organ J. 2016;9:10. doi: 10.1186/s40413-016-0102-7.
21. Huang YJ, Marsland BJ, Bunyavanich S, et al. The microbiome in allergic disease: current understanding and future opportunities- 2017 PRACTALL document of the American Academy of Allergy, Asthma & Immunology and the European Academy of Allergy and Clinical Immunology. J Allergy Clin Immunol. 2017;139(4): 1099–1110. doi: 10.1016/j.jaci.2017.02.007.
22. Trompette A, Gollwitzer ES, Yadava K, et al. Gut microbiota metabolism of dietary fiber influences allergic airway disease and hematopoiesis. Nat Med. 2014;20(2):159–166. doi: 10.1038/nm.3444.
23. Fransen CT, Van Laere KM, van Wijk AA, et al. alpha-D-Glcp-(1<->1)-beta-D-Galp- containing oligosaccharides, novel products from lactose by the action of beta- galactosidase. Carbohydr Res. 1998;314(1–2):101–114. doi: 10.1016/S0008-6215(98)00285-7.
24. Valdes-Varela L, Ruas-Madiedo P, Gueimonde M. In vitro fermentation of different fructo-oligosaccharides by Bifidobacterium strains for the selection of synbiotic combinations. Int J Food Microbiol. 2017;242:19–23. doi: 10.1016/j.ijfoodmicro.2016.11.011.
25. Vandenplas Y, Ludwig T, Bouritius H, et al. Randomised controlled trial demonstrates that fermented infant formula with shortchain galacto-oligosaccharides and long-chain fructo-oligosaccharides reduces the incidence of infantile colic. Acta Paediatr. 2017;106(7):1150–1158. doi: 10.1111/apa.13844.
26. ec.europa.eu [Internet]. Additional statement on the use of resistant short chain carbohydrates (oligofructosyl-saccharose and oligogalactosyl-lactose) in infant formulae and in follow-on formulae [cited 2017 Oct 19]. Available from: https://ec.europa.eu/food/sites/food/files/safety/docs/sci-com_scf_out109_en.pdf.
27. fsvps.ru [интернет]. Директива комиссии (EC) № 2006/141/ ЕС от 22.12.06 о смесях для детского питания первой и второй ступеней, вносящая изменения в Директиву 1999/21/ЕС [доступ от 21.10.2017]. Доступ по ссылке https://www.fsvps.ru/fsvpsdocs/ru/laws/eu/2006-141.pdf.
28. EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA). Scientific Opinion on the essential composition of infant and follow-on formulae. EFSA Journal. 2014;12(7):3760. doi: 10.2903/j.efsa.2014.3760.
29. Bruzzese E, Volpicelli M, Squeglia V, et al. A formula containing galacto- and fructooligosaccahrides prevents intestinal and extra intestinal infections: аn observational study. Clin Nutr. 2009;28(2):156–161. doi: 10.1016/j.clnu.2009.01.008.
30. Gruber C, van Stuivenberg M, Mosca F, et al. Immunoactive prebiotics transiently prevent occurrence of early atopic dermatitis among low-atopy-risk infants. J Allergy Clin Immunol. 2015;136(6):1696–1698.e1. doi: 10.1016/j.jaci.2015.07.049.
31. Boyle RJ, Tang ML, Chiang WC, et al. Prebiotic-supplemented partially hydrolysed cow’s milk formula for the prevention of eczema in high-risk infants: a randomized controlled trial. Allergy. 2016;71(5):701–710. doi: 10.1111/all.12848.
32. Sprenger GA, Baumgartner F, Albermann C. Production of human milk oligosaccharides by enzymatic and whole-cell microbial biotransformations. J Biotechnol. 2017;258:79–91. doi: 10.1016/j.jbiotec.2017.07.030.
33. Huang D, Yang K, Liu J, et al. Metabolic engineering of Escherichia coli for the production of 2’-fucosyllactose and 3-fucosyllactose through modular pathway enhancement. Metab Eng. 2017;41: 23–38. doi: 10.1016/j.ymben.2017.03.001.
34. Moro G, Minoli I, Mosca M, et al. Dosage-related bifidogenic effects of galacto-and fructooligosaccharides in formula-fed term infants. J Pediatr Gastroenterol Nutr. 2002;34(3):291–295.
35. Coulet M, Phothirath P, Constable A, et al. Pre-clinical safety assessment of the synthetic human milk, nature-identical, oligosaccharide lacto-N-neotetraose (LNnT). Food Chem Toxicol. 2013; 62:528–537. doi: 10.1016/j.fct.2013.09.018.
36. Coulet M, Phothirath P, Allais L. Pre-clinical safety evaluation of the synthetic human milk, nature-identical, oligosaccharide 2’-O-Fucosyllactose (2’FL). Regul Toxicol Pharmacol. 2014; 68(1):59–69. doi: 10.1016/j.yrtph.2013.11.005.
37. Marriage BJ, Buck RH, Goehring KC, et al. Infants fed a lower calorie formula with 2’FL show growth and 2’FL uptake like breastfed infants. J Pediatr Gastroenterol Nutr. 2015;61(6):649–658. doi: 10.1097/MPG.0000000000000889.
38. Puccio G, Alliet P, Cajozzo C, et al. Effects of infant formula with human milk oligosaccharides on growth and morbidity: a randomized multicenter trial. J Pediatr Gastroenterol Nutr. 2017;64(4): 624–631. doi: 10.1097/MPG.0000000000001520.
39. Aly H, Said RN, Wali IE, et al. Medically-graded honey supplementation formula to preterm infants as a prebiotic: а randomized controlled trial. J Pediatr Gastroenterol Nutr. 2017;64(6):966–970. doi: 10.1097/MPG.0000000000001597.
Рецензия
Для цитирования:
Лукоянова О.Л., Боровик Т.Э., Суржик А.В. Новые взгляды на понятие «пребиотики» и их влияние на организм ребенка. Вопросы современной педиатрии. 2017;16(6):516-521. https://doi.org/10.15690/vsp.v16i6.1825
For citation:
Lukoyanova O.L., Borovik T.E., Surzhik A.V. Reconsidered Concept of «Prebiotics» and Their Impact on the Child’s Organism. Current Pediatrics. 2017;16(6):516-521. (In Russ.) https://doi.org/10.15690/vsp.v16i6.1825