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The importance of intestinal microflora to health continues to be a hot and
intensely interesting subject as these recent articles reveal. Conditions
and factors such as stress during pregnancy can greatly affect the
intestinal bacterial colonization of infants. A reduction in the diversity
of microflora is associated with inflammatory bowel diseases. Research
needs to take a close look at the diversity of intestinal microflora in
celiac disease.
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J Pediatr Gastroenterol Nutr. 2004 Mar;38(3):293-7
Administration of oral probiotic bacteria to pregnant women causes
temporary infantile colonization.
Schultz M, Gottl C, Young RJ, Iwen P, Vanderhoof JA.
Department of Internal Medicine I, University of Regensburg, Regensburg,
Germany. [log in to unmask]
BACKGROUND: It is difficult to permanently change the composition of the
complex intestinal microflora of the adult. Orally administered probiotic
bacteria produce only temporary colonization of the intestine in patients
with a fully developed gut microflora. The gastrointestinal tract of a
healthy fetus is sterile. During the birth process and rapidly thereafter,
microbes from the mother and the surrounding environment colonize the
gastrointestinal tract until a dense, complex microflora develops.
Probiotic bacteria have been shown to beneficially influence the intestinal
and systemic immune system and mediate protection against nosocomial
infections affecting the neonate. OBJECTIVES: The purpose of this study was
to determine whether oral administration of the probiotic micro-organism
Lactobacillus rhamnosus strain GG (L. GG) to the pregnant woman leads to
colonization of the newborn infant. METHODS: The authors identified six
women who were taking L. GG during late pregnancy. None of the children
received L. GG after birth, and their mothers discontinued its consumption
at the time of delivery. L. GG concentration in fecal samples was
determined by colony morphology and molecular analysis. RESULTS: In all
four children delivered vaginally and in one of two children delivered by
cesarean section, L. GG was present in fecal samples at 1 and 6 months of
age. Three children remained colonized for at least 12 months, and in two
children L. GG was detected in fecal samples at 24 months of age. Three
mothers were tested 1 month post partum and no L. GG was present in fecal
samples. No L. GG was found in one of these women 24 months post partum.
There was no L. GG detectable in stools of the siblings of two children at
the 2-year and 3-years after birth of the index child. L. GG was not
isolated from the stools of children whose mothers were not taking L. GG.
CONCLUSIONS: Temporary colonization of an infant with L. GG may be possible
by colonizing the pregnant mother before delivery. Colonization is stable
for as long as 6 months, and in unexplained circumstances may persist for
as long as 24 months.
PMID: 15076629 [PubMed - in process]
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J Pediatr Gastroenterol Nutr. 2004 Apr;38(4):414-21
Prenatal stress alters bacterial colonization of the gut in infant monkeys.
Bailey MT, Lubach GR, Coe CL.
Harlow Primate Laboratory, University of Wisconsin, Madison, Wisconsin,
U.S.A.
OBJECTIVE:: The hypothesis that prenatal stress lowers the levels of
protective microflora and increases the risk for postpartum Gram-negative
pathogens was tested in infant monkeys. METHODS:: Female monkeys were left
undisturbed or were stressed during pregnancy using an acoustical startle
paradigm for 6 weeks either early or late in their 24-week gestation.
Several types of intestinal microflora were repeatedly enumerated by fecal
culture while infants were reared normally by their mothers. RESULTS::
Significant changes in microflora concentrations occurred during the first
6 months of life. The profile of total aerobes and facultative anaerobes
was biphasic, with peak concentrations occurring between 2 and 16 weeks of
age. The numbers of bifidobacteria and lactobacilli were low at 2 days
after birth but rapidly increased to a peak between 8 and 16 weeks of age.
Although similar temporal patterns were evident in all infants, prenatal
stress reduced the overall numbers of bifidobacteria and lactobacilli.
CONCLUSIONS:: Moderate disturbance during pregnancy was sufficient to alter
the intestinal microflora in the newborn infant. These alterations could
result in enhanced susceptibility to infection and suggest a mechanism for
some effects of maternal pregnancy conditions on infant health.
PMID: 15085020 [PubMed - in process]
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Postgrad Med J. 2004 Apr;80(942):206-13
Management of inflammatory bowel disease.
Nayar M, Rhodes JM.
Department of Medicine, University of Liverpool, Liverpool, UK.
Ulcerative colitis and Crohn's disease result from an interaction between
genetic and environmental factors. Only one gene, NOD2/CARD15, has been
clearly identified; a minority of people with alteration of this gene
develop Crohn's disease. The NOD2/CARD15 protein is thought to be involved
in defence against intracellular bacteria. This supports the idea that
Crohn's disease and ulcerative colitis result from altered immunological
responses to the normal intestinal flora. Life expectancy is normal in
ulcerative colitis and nearly so in Crohn's disease, but both conditions
cause considerable morbidity. Approximately 80% of patients with Crohn's
disease eventually require surgery, and about 25% of patients with
ulcerative colitis require colectomy. Treatment of ulcerative colitis is
generally by corticosteroids for acute disease and mesalazine for
maintenance, but the range of therapies for Crohn's disease is expanding.
Alternative therapies include immunosuppressives, enteral nutrition,
antibiotics, anti-TNF antibody (infliximab), corticosteroids, and surgery.
High dosages of corticosteroids may provide symptomatic relief in Crohn's
disease but do not affect the long term natural history of the disease, and
management strategies should avoid using steroids whenever possible.
PMID: 15082841 [PubMed - in process]
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Gut. 2004 May;53(5):685-93
Reduction in diversity of the colonic mucosa associated bacterial
microflora in patients with active inflammatory bowel disease.
Ott SJ, Musfeldt M, Wenderoth DF, Hampe J, Brant O, Folsch UR, Timmis KN,
Schreiber S.
Department of General Internal Medicine, University Hospital Schleswig-
Holstein, Campus Kiel, Germany. German Research Center for Biotechnology
(GBF), Department of Microbiology, Braunschweig, Germany.
BACKGROUND: and aims: The intestinal bacterial microflora plays an
important role in the aetiology of inflammatory bowel disease (IBD). As
most of the colonic bacteria cannot be identified by culture techniques,
genomic technology can be used for analysis of the composition of the
microflora. PATIENTS AND METHODS: The mucosa associated colonic microflora
of 57 patients with active inflammatory bowel disease and 46 controls was
investigated using 16S rDNA based single strand conformation polymorphism
(SSCP) fingerprint, cloning experiments, and real time polymerase chain
reaction (PCR). RESULTS: Full length sequencing of 1019 clones from 16S
rDNA libraries (n = 3) revealed an overall bacterial diversity of 83 non-
redundant sequences-among them, only 49 known bacterial species. Molecular
epidemiology of the composition of the colonic microflora was investigated
by SSCP. Diversity of the microflora in Crohn's disease was reduced to 50%
compared with controls (21.7 v 50.4; p<0.0001) and to 30% in ulcerative
colitis (17.2 v 50.4; p<0.0001). The reduction in diversity in inflammatory
bowel disease was due to loss of normal anaerobic bacteria such as
Bacteroides species, Eubacterium species, and Lactobacillus species, as
revealed by direct sequencing of variable bands and confirmed by real time
PCR. Bacterial diversity in the Crohn's group showed no association with
CARD15/NOD2 status. CONCLUSIONS: Mucosal inflammation in inflammatory bowel
disease is associated with loss of normal anaerobic bacteria. This effect
is independent of NOD2/CARD15 status of patients.
PMID: 15082587 [PubMed - in process]
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