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Immune Modulation In Infancy

Abdulwahab Telmesani FRCPC, FAAP Associate prof. of Pediatrics College of Medicine and Medical science Umm Al-Qura University. Immune Modulation In Infancy. Cranberry Fruit. Cranberry Fruit التوت البرى.

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Immune Modulation In Infancy

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  1. Abdulwahab TelmesaniFRCPC, FAAPAssociate prof. of PediatricsCollege of Medicine and Medical scienceUmm Al-Qura University Immune Modulation In Infancy

  2. Cranberry Fruit

  3. Cranberry Fruit التوت البرى

  4. A randomized trial to evaluate effectiveness and cost effectiveness of naturopathic cranberry products as prophylaxis against urinary tract infection in women The Canadian journal of urology. 2002 EBM Reviews - Cochrane Central Register of Controlled Trials

  5. Cranberry prevents bacterial adhesion to the genitourinary system and acidify the bowel ecosystem which promotes probiotics growth

  6. What dose the literature say about probiotics and its role in health?

  7. Studies reviewed and quoted in this presentation, mostly published the year 2000 onward

  8. Probiotic

  9. Probiotic = For Life

  10. Probiotics are defined as “live microorganism which, when administered in adequate amounts confer a health benefits on the host”

  11. Probiotic e.g. Lactobacillus Bacteria Bifidobacteria spp

  12. Prebiotics defined as “Non digestible substances that provides a beneficial physiological growth or activity of a limited number of indigenous bacteria”

  13. Lactobacillus as a probiotic for preventing urogenital infections A. Andreu Reviews in Medical Microbiology2004

  14. The main indications for probiotic Lactobacillus use in urogenital tract infections would include recurrent urinary tract infection in healthy pre-menopausal and post-menopausal women, post-infection prophylaxis to re-establish the vaginal flora and prevent future episodes, bacterial vaginosis and recurrent vaginal candidiasis.

  15. Are probiotics useful in controlling gastric colonization by Helicobacter pylori? GOTTELAND Alimentary Pharmacology & Therapeutics. April 2006.

  16. Probiotics do not eradicate H. pylori but maintain lower levels of this pathogen in the stomach; in combination with antibiotics, probiotics may increase eradication rate and/or decrease adverse effects.

  17. Colonic Ecosystem In the Newborn Baby?

  18. Colonic Ecosystem The colon of the fetus is sterile

  19. Colonic Ecosystem • Maternal Vaginal flora • Personnel present at birth • Mothers breast milk, etc. • In 2 days colonic flora up to 10 to power 8 per gram stool

  20. Colonic Ecosystem In the following days selection among the colonic bacteria occurs

  21. Colonic Ecosystem In exclusively breast fed baby 90 – 95% of the colonic bacteria will be Bifidobacteria

  22. Why Bifidobacteria?

  23. Breast Milk Is Bifidogenic

  24. Bifidogenic Ingredients • Low protein • High whey protein • Low phosphorus content • Acidic intestinal environment • Growth of acid- tolerant Bifidobacteria

  25. Intestinal flora of breastfed and formula-fed infants Harmsen HJM et al. JPGN 2000

  26. Bifidobacteria counts in intestinal flora (Fish method) Palermo study 2002

  27. Bacteria-Epithelial Cross-Talk Refers to the communication or interaction process between bacteria and the epithelial cells Through this, bacteria can colonize the gut, maintain health or cause disease Possibly due to certain glycoconjugate receptors on the cells Walker WA, 2000

  28. Porbiotic or no probiotic ?

  29. Porbiotic Recent current research and publications are more pro probiotic

  30. A study of oral Bifidobacteria supplement to preterm and newborn babies showed a correlation between lacking Bifidobacteria predominance and sepsis. Z. Geburtsh Neonatology 1999

  31. Administration of Lactobacillus rhamnosus GG to preterm babies for 7 days can influence the incidence of NEC, sepsis and UTI Dani C, et al Biol Neonate 2002

  32. Regular intake of Lactobacillus rhamnosus GG significantly reduced the risk of nosocomial diarrhea among hospitalized infants and toddlers Szajewska H, et al J Pediatr 2001

  33. A placebo- controlled trial of Lactobacillus rhamnosus GG prevents diarrhea in undernourished children in underdeveloped countries Oberhelman RA J Pediatr 1999

  34. ORS enriched with Lactobacillus rhamnosus GG reduces the duration of diarrhea ameliorate the course and help early discharge from hospital Multicenter European Trial J Gastroenterol Nutr. 2000

  35. Guarino A. et al. JPGN 1997

  36. Rotavirus shedding Rotavirus excretion on day 6 in children receiving probiotic treatment and in control subjects. Guarino A. et al. JPGN 1997

  37. T Cell Imbalance Th1 ___ Th0 _______Th2

  38. T Cell Balance Th1 ________ Th0 _________ Th2

  39. The Th cell balance helps in reducing Atopic manifestations

  40. Early predictors of asthma Jennifer K. et al Allergy and Clinical Immunology 2002

  41. Early development of atopy is a strong predictor of later asthma Jennifer K. Allergy and Clinical Immunology 2002,

  42. Prenatal factors predicting asthma • Parental atopy and asthma • Early or threatened labour, • Restricted growth and • Malposition of the foetus

  43. Prenatal factors predicting asthma Cont. • Gestational age greater than 40 weeks • low levels of IgE at birth • greater than 40 weeks • Malaria parasites in cord blood were strong risk factors for later asthma ??

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