Could parabiotics safely enhance immune maturation and mitigate NEC/sepsis in preterm neonates?
Medical Hypotheses, cilt.199, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 199
- Basım Tarihi: 2025
- Doi Numarası: 10.1016/j.mehy.2025.111635
- Dergi Adı: Medical Hypotheses
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CINAHL, EMBASE
- Anahtar Kelimeler: Neonatal Prematurity, Paraprobiotics, Necrotizing Enterocolitis, Late-Onset Sepsis, Immunomodulation, Gut Barrier
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Necrotizing enterocolitis (NEC) and late-onset sepsis (LOS) remain among the most serious complications in preterm neonates, contributing significantly to morbidity and mortality in neonatal intensive care units. Although probiotics have demonstrated potential in reducing these risks, concerns regarding microbial translocation and variability in product quality have limited their routine use in clinical settings. Paraprobiotics, defined as non-viable microbial cells or fragments, offer a promising and potentially safer alternative. These inactivated forms may help enhance gut barrier integrity and modulate immune responses without introducing the risks associated with live microorganisms. We hypothesize that paraprobiotic supplementation can reduce the incidence of NEC and LOS by strengthening mucosal defenses and supporting balanced immune maturation. This paper reviews current preclinical and clinical evidence, discusses underlying mechanisms, and outlines a framework for future research to evaluate their therapeutic potential. If confirmed, paraprobiotics could become an important microbial-based strategy in neonatal care.