PDF(Pubmed)
Abstract：
The role of gut microbiome in health, a century-old concept, has been on the center stage of medical research recently. While different body sites, disease conditions, and populations have been targeted, neonatal and early infancy appear to be the most suitable period for such interventions. It is intriguing to note that, unlike traditional use in diarrhea and maintenance of gastrointestinal health, microbiome-mediating therapies have now addressed the most serious medical conditions in young infants such as necrotizing enterocolitis and neonatal sepsis. Unfortunately, almost all new endeavors in this space have been carried out in the Western world leaving behind millions of neonates that can benefit from such manipulations while serving as a large resource for further learning. In this review, an attempt has been made to quantify the global burden of neonatal morbidity and mortality, examples presented on interventions that have failed as a result of drawing from studies conducted in the West, and a case made for manipulating the neonatal gut microbiome to address the biggest killers in early life. A brief comparative analysis has been made to demonstrate the differences in the gut microbiota of North and South and a large clinical trial of synbiotics conducted by our group in a South Asian setting has been presented. Although challenging, the value of conducting such global health research is introduced with an intent to invite medical scientists to engage in well-planned, scientifically robust research endeavors. This can bring about innovation while saving and serving the most vulnerable citizens now and protecting them from the negative health consequences in the later part of their lives, ultimately shaping a resilient and equitable world as pledged by 193 United Nations member countries in 2015.
摘要：
肠道微生物在健康中的作用，一个有百年历史的概念，最近一直处于医学研究的中心舞台。虽然身体部位不同，疾病状况,人口已经成为目标，新生儿和早期婴儿期似乎是这种干预措施的最合适时期。有趣的是，注意到，与传统的腹泻和维持胃肠道健康不同，微生物组介导疗法现在已经解决了年轻婴儿中最严重的医学状况，例如坏死性小肠结肠炎和新生儿败血症。不幸的是,在这个领域几乎所有的新努力都是在西方世界进行的，留下了数百万的新生儿，他们可以从这种操纵中受益，同时作为进一步学习的大量资源。在这次审查中,已经尝试量化新生儿发病率和死亡率的全球负担，从西方进行的研究中得出的失败的干预措施的例子，以及操纵新生儿肠道微生物组以解决早期生命中最大的杀手的案例。进行了简短的比较分析，以证明南北肠道微生物群的差异，并提出了我们小组在南亚环境中进行的合生元的大型临床试验。虽然具有挑战性，进行这种全球健康研究的价值是为了邀请医学科学家参与有计划的，科学上强有力的研究努力。这可以带来创新，同时拯救和服务现在最脆弱的公民，并保护他们免受生活后期的负面健康后果。最终塑造一个弹性和公平的世界，正如193个联合国会员国在2015年所承诺的那样。
