Очень трудно что-либо обсуждать, когда оппоненты раз за разом уходят в сторону от конкретного вопроса, поставленного в этой дискуссии: «имеют ли клиническое значение нарушения нормальной микрофлоры кишечника (дисбактериоз) на развитие тех или иных заболеваний» или это выдумки Российских врачей,
При этом в качестве основного аргумента, что дисбактериоз – высосанное из пальца безграмотными Российскими медиками патологическое состояние - приводят количество упоминаний этого термина в зарубежных медицинских источниках.
Привел ссылку, где приводятся куча зарубежных исследований, связанных с восстановлением нормальной микрофлоры. Похоже, оппонентам просто не досуг хотя бы взглянуть на них. Вместо этого, продолжают приводить пространные рассуждения общего плана, объясняют тебе именно то, за озвучивание чего г-н Зайцев в этом ДК получил кучу черных шаров: «что лечить надо не от микробов, пусть потенциально патогенных, обнаруженных ПЦР, а от заболеваний».
Учитывая дефицит времени у оппонентов, привожу аннотации только трех работ из вышеуказанной ссылки. И то, только потому, что они этого года и рандомизированные. Любопытно, что первая из них была проведена коллегами инициатора этой дискуссии из Израиля.
Pediatrics, 2005 Jan, 115(1), 5 - 9
Effect of a probiotic infant formula on infections in child care centers: comparison of two probiotic agents; Weizman Z et al.; OBJECTIVE: To investigate the effect of 2 different species of probiotics in preventing infections in infants attending child care centers . METHODS: A double-blind, placebo-controlled, randomized trial was conducted from December 1, 2000, to September 30, 2002, at 14 child care centers in the Beer-Sheva area of Israel in healthy term infants 4 to 10 months old . Infants were assigned randomly to formula supplemented with Bifidobacterium lactis (BB-12), Lactobacillus reuteri (American Type Culture Collection 55730), or no probiotics . Duration of feeding, including follow-up, for each participant was 12 weeks . All infants were fed only the assigned formula and were not breastfed due to parental decision before recruitment to the study . Probiotic or prebiotic food products or supplements were not allowed . Main outcome measures were number of days and number of episodes with fever (>38 degrees C) and number of days and number of episodes with diarrhea or respiratory illness . RESULTS: Participants (n = 201) were similar regarding gestational age, birth weight, gender, and previous breastfeeding . The controls (n = 60), compared with those fed B lactis (n = 73) or L reuteri (n = 68), had significantly more febrile episodes (mean {95% confidence interval}: 0.41 {0.28-0.54} vs 0.27 {0.17-0.37} vs 0.11 {0.04-0.18}, respectively) . The controls also had more diarrhea episodes (0.31 {0.22-0.40} vs 0.13 {0.05-0.21} vs 0.02 {0.01-0.05}, respectively) and episodes of longer duration (0.59 {0.34-0.84} vs 0.37 {0.08-0.66} vs 0.15 {0.12-0.18} days, respectively) . The L reuteri group, compared with BB-12 or controls, had a significant decrease of number of days with fever, clinic visits, child care absences, and antibiotic prescriptions . Rate and duration of respiratory illnesses did not differ significantly between groups . CONCLUSIONS: Child care infants fed a formula supplemented with L reuteri or B lactis had fewer and shorter episodes of diarrhea, with no effect on respiratory illnesses . These effects were more prominent with L reuteri, which was also the only supplement to improve additional morbidity parameters.
Pediatrics, 2005 Jan, 115(1), 1 - 4
Oral probiotics reduce the incidence and severity of necrotizing enterocolitis in very low birth weight infants; Lin HC et al.; OBJECTIVE: We evaluated the efficacy of probiotics in reducing the incidence and severity of necrotizing enterocolitis (NEC) in very low birth weight (VLBW) infants . PATIENTS AND METHODS: A prospective, masked, randomized control trial was conducted to evaluate the beneficial effects of probiotics in reducing the incidence and severity of NEC among VLBW (<1500 g) infants . VLBW infants who started to fed enterally and survived beyond the seventh day after birth were eligible for the trial . They were randomized into 2 groups after parental informed consents were obtained . The infants in the study group were fed with Infloran (Lactobacillus acidophilus and Bifidobacterium infantis) with breast milk twice daily until discharged . Infants in the control group were fed with breast milk alone . The clinicians caring for the infants were blinded to the group assignment . The primary outcome was death or NEC (>or= stage 2) . RESULTS: Three hundred sixty-seven infants were enrolled: 180 in the study group and 187 in the control group . The demographic and clinical variables were similar in both groups . The incidence of death or NEC (>or= stage 2) was significantly lower in the study group (9 of 180 vs 24 of 187) . The incidence of NEC (>or= stage 2) was also significantly lower in the study when compared with the control group (2 of 180 vs 10 of 187) . There were 6 cases of severe NEC (Bell stage 3) in the control group and none in the study group . None of the positive blood culture grew Lactobacillus or Bifidobacterium species . CONCLUSION: Infloran as probiotics fed enterally with breast milk reduces the incidence and severity of NEC in VLBW infants.
Gut, 2005 Feb, 54(2), 242 - 9
Synbiotic therapy (Bifidobacterium longum/Synergy 1) initiates resolution of inflammation in patients with active ulcerative colitis: a randomised controlled pilot trial; Furrie E et al.; BACKGROUND AND AIMS: Ulcerative colitis (UC) is an acute and chronic inflammatory disease of the large bowel with unknown aetiology . The immune response against normal commensal microorganisms is believed to drive inflammatory processes associated with UC . Therefore, modulation of bacterial communities on the gut mucosa, through the use of probiotics and prebiotics, may be used to modify the disease state . METHODS: A synbiotic was developed for use in UC patients combining a probiotic, Bifidobacterium longum, isolated from healthy rectal epithelium, and a prebiotic (Synergy 1), a preferential inulin-oligofructose growth substrate for the probiotic strain . Treatment was employed in a double blinded randomised controlled trial using 18 patients with active UC for a period of one month . Clinical status was scored and rectal biopsies were collected before and after treatment, and transcription levels of epithelium related immune markers were measured . RESULTS: Sigmoidoscopy scores (scale 0-6) were reduced in the test group (start 4.5 (1.4), end 3.1 (2.5)) compared with placebo (start 2.6 (2.1), end 3.2 (2.2)) (p = 0.06) . mRNA levels for human beta defensins 2, 3, and 4, which are strongly upregulated in active UC, were significantly reduced in the test group after treatment (p = 0.016, 0.038, and 0.008, respectively) . Tumour necrosis factor alpha and interleukin 1alpha, which are inflammatory cytokines that drive inflammation and induce defensin expression, were also significantly reduced after treatment (p = 0.018 and 0.023, respectively) . Biopsies in the test group had reduced inflammation and regeneration of epithelial tissue . CONCLUSIONS: Short term synbiotic treatment of active UC resulted in improvement of the full clinical appearance of chronic inflammation in patients receiving this therapy.