1. PROTECTIVE GUT & NUTRITION STRATEGIES Scientific data prepared by Dr. Ragia Labieb Presented by: Perwin Aly Waly Neonatology resident N.I.C.U _ Ain Shams University June 2009
30. The intestine is the primary immune organ in the body because it contains 60% of the total immunoglobulins and more than 10 6 lymphocytes/gm tissue. Role of the gut in immune functions Kelly D Trends in immunology 2005
31. Immature Conditions of the Neonate’s Immune System Immune system is shifted towards the Th2 pathway to protect the foetus from the mother’s system Limited exposure of antigens in utero Still no memory has been build up
32. A ntibodies alone serve to transmit the mother's immunologic experience to the fetus and infant; these, and not the fetal T cells, protect the child while its own immune system matures Zinkernagel RM NEJM 2001
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38. Commensal Probiotic Fermented milk Pr e biotic supplementation Pr o biotic supplementation Enhance intestinal epithelial barrier Anti-inflammatory effects in intestinal epithelial cells Balanced Th1/Th2 response promoting tolerance and reducing inflamatory, auto-immune and allergic diseaeses Interrest of commensal probiotic stimulation
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40. T he protective effect of breast feeding against atopy might be attributed to its high content in ω-6 . In addition, its modulatory influences on Th1 and Th2 responses. Th e favorable action on Th1 and Th2 responses may depend on the ratio between ω -3 and ω -6 fatty acids. A higher ratio of ω -6 to ω -3 favors an enhancement in the Th1 response, whereas a decrease in the ratio between ω -6 to ω -3 may favor the Th2 response . lipids Das UN 2002
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42. SO Risks of artificial feeding Interferes with bonding More diarrhoea and respiratory infections Malnutrition & Vitamin A deficiency More allergy and milk intolerance Increased risk of some chronic diseases Overweight Lower scores on intelligence tests May become pregnant sooner Increased risk of anaemia, ovarian and breast cancer Adapted from: Breastfeeding counseling: A training course. Geneva, World Health Organization, 1993 (WHO/CDR/93.6). Slide 2.26
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45. Summary & conclusion A newborn’s immune system needs special measures of protection and support Breast milk strengthens an infant’s immune system, leading to less infections and allergies
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47. 5/2 UNICEF/HQ92-0369/ Roger Lemoyne, Thailand Beginning Breastfeeding within ONE . hour : ( Beginning life with “life”)
Furthermore in newborns, the immune response of thymus-derived immune cells, the so-called T-lymphocytes, is skewed towards a reaction which is associated with an increased risk to develop an allergic state, the Th2 pathway. This reaction includes the synthesis of the antibody Immunoglobulin E (IgE), which is involved in the allergic reaction. In adults, the mature and healthy immune system is skewed towards the Th1 pathway, which is steered towards an efficient anti-microbial response including IgG synthesis.
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