Akut Gastroenteritlerin Tedavisinde Probiyotiklerin Rolü

ÖzAkut gastroenteritler çocukluk çağında önemli morbidite ve mortalite nedenidir. Mortaliteyi azaltmada koruyucu önlem olarak en önemli faktör anne sütü alımıdır. Bağırsak mikrobiyotası patojenlere karşı savunmada oldukça önemlidir. Bağırsak mukozasını örten sağlıklı bir mukus tabakası varlığı inflamatuvar ve enfeksiyöz hastalıkları önlemede önemli bir rol üstlenmektedir. Probiyotiklerin müsin ekspresyonunu düzenleyerek ve müsin tabakasını etkileyerek bağırsak immün sistemini dolaylı olarak etkiledikleri gösterilmiştir. Özellikle antibiyotik ilişkili ishallerde ve viral gastroenteritlerin seyrinde bağırsak mukozası üzerine yararlı etkileri olduğu gösterildikten sonra invazif gastroenterit, inflamatuvar bağırsak hastalığı ve nekrotizan enterokolit dahil birçok gastrointestinal durumla ilişkilendirilmektedirler. Probiyotiklerin enfeksiyon seyri sırasında intestinal hasarı önleyici ya da koruyucu potansiyel etkileri gösterilmiş olmasına rağmen özellikle immün yetersizlik hastalarında olası septisemi riski konusunda bazı çekinceler mevcuttur. Bu nedenle riskli gruplarda septisemi mekanizmasını araştıracak in vitro ve in vivo çalışmaların yapılması gereklidir.

Anahtar Kelimeler:

Probiyotik, enfeksiyöz, diyare, anne sütü

The Role of Probiotics in the Treatment of Acute Gastroenteritis

AbstractAcute gastroenteritis can cause significant morbidity and mortality in childhood. Breastfeeding is the most important factor as a preventive strategy in reducing mortality. Gut microbiota is very important to defense with the pathogens. A healthy mucus layer on the gut mucosa plays an important role in preventing inflammatory and infectious diseases. Probiotics have been demonstrated to regulate mucin expression and influencing the properties of the mucus layer and indirectly regulate the gut immune system. After having demonstrated the favorable effects of probiotics on the gut mucosa especially during viral gastroenteritis and antibiotic related gastroenteritis, they are associated with many gastrointestinal conditions including invasive gastroenteritis, inflammatory bowel diseases and necrotizing enterocolitis. Although the potential of probiotics to prevent or reverse intestinal damage during infection was demonstrated, there are some conflict about the possible septicemia risk especially in immunocompromise patients. Therefore, a combination of in vitro and in vivo models is essential to investigate the mechanisms of septicemia in risky groups.

Keywords:

Probiotic, infectious, diarr-hea, breast milk,

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