The importance of the development of the intestinal microbiota in infancy

Curr Opin Pediatr. 2009 Sep 16. [Epub ahead of print]

The importance of the development of the intestinal microbiota in infancy.

Vael C, Desager K. Department of Microbiology, Belgium bDepartment of Pediatrics, University of Antwerp, Antwerp, Belgium.

PURPOSE OF REVIEW: The development of the intestinal microbiota occurs primarily during infancy, and a distortion could potentially contribute to a wide range of diseases. This review summarizes the current understanding of the intestinal microbiota in infants. The potential consequences of different colonization patterns on child health and possible preventive interventions are discussed.

RECENT FINDINGS: Recent studies and the use of culture-independent techniques have shown that Bifidobacterium is only a minor component of the infant gut microbiota. These techniques have also introduced the concept of a core microbiome in which metabolic function is more important than the presence of a particular bacterial species. A less diverse gut microbiota with high counts of Bacteroides, Clostridium, Enterobacteriaceae and Staphylococcus early in life has been associated with an increased risk for atopic disease. Changes in infant gut colonization were also found in relation to childhood obesity. Probiotics have no proven preventive effect on the development of asthma and an unconfirmed effect on atopic dermatitis. A prebiotic trial could show a preventive effect on the development of both atopic diseases.

SUMMARY: Molecular techniques have improved our understanding of the infant gut ecosystem. The available probiotics for prevention of atopic disease are disappointing, and the results with prebiotics need further confirmation. New studies on the relation between gut microbiota and disease should consider asthma and atopic dermatitis separately. Future trials should focus on high-risk groups, determine their long-term effect and also investigate the effect on Bacteroides and Clostridium.

PMID: 19770768 [PubMed - as supplied by publisher]

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written by Maff, September 28, 2009

This review introduces an important new concept in understanding the relationship between the gut microflora and human health from infancy. While much work has focused on individual strains of probiotic bacteria such as Bifidobacteria sp, this paper highlights the fact that the overall metabolic activity of the gut microflora as a whole (the microbiome) is likely to be of greater importance and may explain why many probiotic trials have produced disappointing results. The review also highlights important new directions for future research into probiotics and prebiotics in atopic disease.