Review
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Clin Pediatr. Nov 8, 2013; 2(4): 46-53
Published online Nov 8, 2013. doi: 10.5409/wjcp.v2.i4.46
Bacterial colonization and intestinal mucosal barrier development
Xiao-Zhong Huang, Li-Bin Zhu, Zhong-Rong Li, Jing Lin
Xiao-Zhong Huang, Li-Bin Zhu, Zhong-Rong Li, Jing Lin, Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang Province, China
Jing Lin, Division of Newborn Medicine, Department of Pediatrics, Kravis Children’s Hospital of the Icahn School of Medicine at Mount Sinai, New York, NY 10029-6574, United States
Author contributions: Huang XZ wrote the first draft; Zhu LB and Li ZR contributed some sections of the first draft; Lin J initiated the project and finalized the manuscript.
Supported by In part by Zhejiang Provincial Natural Science Foundation, No. LY12H04005 and LY13H040011
Correspondence to: Jing Lin, MD, Division of Newborn Medicine, Department of Pediatrics, Kravis Children’s Hospital of the Icahn School of Medicine at Mount Sinai, Box 1508, One Gustave L. Levy Place, New York, NY 10029-6574, United States. jing.lin@mssm.edu
Telephone: +1-212-2416186 Fax: +1-212-5345207
Received: July 3, 2013
Revised: August 7, 2013
Accepted: September 18, 2013
Published online: November 8, 2013
Processing time: 127 Days and 18.8 Hours
Abstract

The intestinal tract is colonized soon after birth with a variety of ingested environmental and maternal microflora. This process is influenced by many factors including mode of delivery, diet, environment, and the use of antibiotics. Normal intestinal microflora provides protection against infection, ensures tolerance to foods, and contributes to nutrient digestion and energy harvest. In addition, enteral feeding and colonization with the normal commensal flora are necessary for the maintenance of intestinal barrier function and play a vital role in the regulation of intestinal barrier function. Intestinal commensal microorganisms also provide signals that foster normal immune system development and influence the ensuing immune responses. There is increasingly recognition that alterations of the microbial gut flora and associated changes in intestinal barrier function may be related to certain diseases of the gastrointestinal tract. This review summarizes recent advances in understanding the complex ecosystem of intestinal microbiota and its role in regulating intestinal barrier function and a few common pediatric diseases. Disruption in the establishment of a stable normal gut microflora may contribute to the pathogenesis of diseases including inflammatory bowel disease, nosocomial infection, and neonatal necrotizing enterocolitis.

Keywords: Bacterial colonization; Intestinal barrier; Intestinal microflora; Microbiota; Neonatal necrotizing enterocolitis; Nosocomial infection; Premature infants; Short chain fatty acids

Core tip: This review summarizes recent advances in understanding the complex ecosystem of intestinal microbiota and its role in regulating intestinal barrier function and a few common pediatric diseases. There is increasingly recognition that the stimulation of initial intestinal microbial colonization is important for proper maturation of the innate immune system and continued regulation and maintenance of intestinal barrier function. Disruption of the establishment of a stable normal gut microflora may contribute to the pathogenesis of diseases including inflammatory bowel disease, nosocomial infection, and neonatal necrotizing enterocolitis in premature infants.