Probiotiques et pathologies digestives de l'enfant

The intestinal mucosa is continuously exposed to a magnitude of foreign antigenic structures of alimentary but also microbial origin. Interactions between the intestinal epithelium and the gut immune system is critical to develop and maintain (normal) intestinal (absorptive and immunological) functions. Commensal intestinal microflora is a major player in the homeostasis of the intestinal tract. The process of intestinal colonization and interaction of the microflora with the intestinal epithelium and (mucosal) immune system (is especially crucial and) starts during the first days of life. Any dysregulation of this symbiotic interaction between microflora and intestinal mucosa might impede tolerance acquisition towards food or bacterial antigens and cause a pathological state, resulting in clinical disorders. Based on the concept of beneficial and symbiotic interaction between the host and its endogenous microflora, it is logical to develop strategies to directly modulate the intestinal microflora in the prevention or treatment of certain pathological states. One such strategy is in the form of administering viable probiotic bacteria. Here, we review the clinical evidence for beneficial use of probiotics in infants and children of different ages, to prevent or treat, (infectious and antibiotic-associated) acute diarrhoea, allergic diseases and necrotizing enterocolitis.