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Gut Health Immunity - Synbiotic Lombok 2024 EB - MK

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20 views25 pages

Gut Health Immunity - Synbiotic Lombok 2024 EB - MK

Uploaded by

rsmitrahuada
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Advancing Gut Health and Immunity

through Synbiotic Interventions


in 6-12 Month Period

dr. Ezy Barnita, Sp.A(K)


RSUP Persahabatan
PEDIATRIC SUMMIT ALLERGY AND IMMUNITY SERIES
LOMBOK 2024
CURRICULUM VITAE
EDUCATION
• Elementary to senior high school at Bukittinggi
• Medical doctor at Padjadjaran University, OCCUPATION
Bandung 1993-1999 • PTT at Tebing Tinggi and Deli Serdang; North
Sumatera (2000-2003)
• General Pediatrician at Indonesia University, • Puskesmas Kecamatan Cempaka Putih; Jakarta
Jakarta 2007-2011 (2006-2007)
• Sahid Sahirman hospital; Jakarta (2011-2013)
• Gastroenterology and Hepatology Consultant at
Indonesia University, Jakarta 2020-2023 • Persahabatan hospital; Jakarta (2013- now)

ORGANIZATION
• IDI
• IDAI
• PGHNAI
• Perdalin
dr. Ezy Barnita, Sp.A(K)
Objectives
Gut function
Gut health
Gut immunity
Microbiota diversity
Breastmilk as source of synbiotic
Synbiotics interventions impact on gut
Gut Function
Fun facts

• Digestion begins in the mouth

• The intestine is 7 m long

• The colon is 1,5 m long

• Intestine’s absorption surface


est. 250m2 (~tennis court)

Walton KD. Generation of intestinal surface: an absorbing tale. Development. 2016.


Differences between small and large intestine. UPMC Children’s Hospital of Pittsburgh.
The fascinating world of digestion: fun facts and insights.
https://geniebook.com/tuition/primary-3/science/fascinating-world-digestion-fun-facts-and-
Accessory organs

Guyton, A. and Hall, J. Textbook of Medical Physiology, 9th


Gut Health
Microbial’s
• Gut microbiome  bacteria, cells >10x human cells
fungi, archaea,
protozoa, viruses Microbial’s genes >100 x human genes
• Bacteria: phyla, Bacteroidetes, Firmicutes.
• Fungi: Candida, Saccharomyces, Penicillium.
Host’s metabolism
• Archaea: Methanogenic, Verrucomicrobia,
Lentisphaerae. Synthesis of vitamins and non-essential AA
Enable digestion of undigested carbohydrates
• Protozoa: Blastocystis spp, Entamoeba spp,
Dientamoeba, Enteromonas. Host defenses
Participate in the gut-mucosal immune system
• Virus: Enterovirus, Rotavirus, Norovirus.
Communication system called gut-brain axis

Krishnamurthy, HK et all. Gut commensals and their metabolites in health and


Gut Immunity

• 70-80% immunity system embedded in


gut
• GALT (gut-associated lymphoid tissues)
 lymphoid tissues, including Peyer’s
patches
• PP  contain various immune cells
(macrophages, dentritic cells, T cells, B
cells, M cells, ect.
• GALT  the largest reservoir of immune
cells in the entire body
Andersen L., et. al. Nature Exposure and Its Effects on Immune System Functioning: A Systematic
Review. Int J Environ Res Public Health. 2021
Gut microbiota’s specific characteristics

Saeed, NK., et all. Gut microbiota in various childhood disorders: implicatio


• The early-life microbiome plays an important role
in the infant’s health.
• Environmental exposure from birth to childhood 
gut microbiota and the development of the immune
Gut in Early Life system
• Microbiome’s composition affected  mode of
delivery, smoke exposure, feeding options etc.
• Human milk contain prebiotics and probiotics 
stability of microflora

Yagi, K et all. Early life lung and gut microbiota development ans syncitial
respiratory virus. Front Immunol. 2022.
Enterobacteriaceae /
Early in utero (2nd Bifidobacteriaceae/
trimester) Clostridiaceae
Mode of delivery infant = 25/ 15/ 8 (%)
Fecal microbiome 18 months = 1/3/2,5 (%)
Skin to skin contact Early school age children
Breasfeeding  dominated by
commencement bifidobacterium, pre-
Cessation of breastfeeding aadolescent gut
Solid food dominated by Firmicutes
and Bacteroidetes.

Parkin K., et al. Risk factors for gut dysbiosis in early life.
Prebioti
cs
Probioti
cs
Synbioti
cs
Postbiot
ics

Lou, X., et all. Postbiotics as potential new therapeutics agent for


Breastmilk : source of synbiotics

Lyons, K., et all. Breastmilk, a source og beneficial microbes and associated benefits
Synbiotic
interventions
impact
Before 2010

Not enough evidence


that prebiotics,
probiotics or
synbiotics have any
significant clinical
impact.

Mugambi, MN., Synbiotic, probiotics or prebiotics in infant formula for full term
infants: a systematic review. NutritionJ. 2012.
Cohort study, randomized control trial, 129 subjects,
age 1-3 yr.

Synbiotics supplementation in formula significantly support increasing


Bifidobacterium proportion, modify a more acidic intestinal milieu and softer
stools.
Kosuwon, P., et al. A synbiotic mixture of scGOS/lcFOS and Bifidobacterium breve M-16V increases faecal
Bifidobacterium in healthy young children. Beneficial microbes. 2018
Clinical study, 290 healthy infants aged 6-19 weeks
Interventions: infant formula with synbiotics for 6 weeks (2 different doses)
Intention to treat group and all subjects treated group

Phavichitr, N., et al. Impact of synbiotics on gut microbiota during early life: a randomized,
Double-blind randomized controlled trial compare the effects on
toddler’s body composition between ones that consumed milk to
other having unfortified standard cow's milk .
Conducted in healthy children between 1 and 2 years of age

Healthy children that consume synbiotics fortified formula 


improved iron availability and absorption in the gut and increased
Bifidobacterium in gut.

Chew, C., et all. Young child formula supplemented with a synbiotic mixture of
scGOS/lcFOS and Bifidobacterium breve M-16V improves the gut microbiota and iron
status in healthy toddlers. Front Pediatr. 2024
Conclusions
• Gut has complex and dynamic interaction network between host
and its microbiome, established gut homestasis
• GALT is 70-80% immunity system
• Human gut microbiota is change dynamically until 3 yo, and
become stable up to adult life
• Synbiotic supplementation age 6-12 months will enhance gut
health and its immunity function

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