Prebióticos en las fórmulas para lactantes. ¿Podemos modificar la respuesta inmune?

Abstract

The intestinal microflora of breast-fed infants is an important physiological factor in gut function and the development of the immune system. Human milk oligosaccharides have been shown to selectively stimulate the growth of Bifidobacteria and Lactobacilli in the intestine. In the last few years several attempts have been made to establish the presence of similar microbiota in formula-fed infants. One of the approaches to modify the balance of intestinal microflora is to supply the potentially helpful microbiota with selective nutrients (prebiotics).To review the current scientific evidence related to the addition of prebiotics to infant feeds and their possible role in the immune function.A bibliographic search with Mesh terms: Prebiotics OR oligosaccharides OR intestinal microflora AND infant formula AND results was performed. Special analysis was done on clinical studies.Prebiotics are substances that are not absorbed through the small intestine and are fermented by colonic bacteria. A prebiotic mixture from galacto-oligosaccharides and fructo-oligosaccharides has been used to mimic the effect of human milk oligosaccharides. It has been demonstrated that such a mixture significantly increases the number of bifidobacteria in a dose-related way (maximum effect at 0.8 g/dl) and reduces the number of pathogens in term as well as in preterm infants when compared with a group of infants fed a non-supplemented formula. The effect of oligosaccharides on bacterial metabolism was studied by measuring short chain fatty acid production and fecal pH. More recent studies have been able to show clinical benefits with the use of a prebiotic mixture in infant formulas. Firstly, it has been shown to decrease the risk of developing atopic dermatitis in high risk infants; secondly a reduced incidence of intestinal as well as upper airway infections in the first year of life. It can be hypothesized that prebiotics might play an important role as a new concept in allergy and infection prevention in infants.