Para-probiotics for Preterm Neonates—The Next Frontier
Open accessAbstract
Current evidence supports the use of probiotics in preterm neonates for prevention of necrotizing enterocolitis, mortality and late onset sepsis. Despite the strong evidence, the uptake of this intervention has not been universal due to concerns including probiotic sepsis, pro-inflammatory response and transmission of antibiotic resistance. Critically ill extremely preterm neonates with potentially compromised gut integrity are at higher risk of probiotic sepsis due to translocation. In most countries, probiotics are sold as food supplements with poor quality control. The traditional definition of probiotics as “live microorganisms” has been challenged as many experts have questioned the importance of viability in the context of the beneficial effects of probiotics. Paraprobiotics (ghost probiotics), are defined as non-viable microbial cells (intact or broken) or crude cell extracts (i.e., with complex chemical composition), which, when administered (orally or topically) in adequate amounts, confer a benefit on the human or animal consumer. Current evidence indicates that paraprobiotics could be safe alternatives to probiotics in preterm neonates. High-quality pre-clinical and clinical studies including adequately powered randomised controlled trials (RCTs) are warranted in preterm neonates to explore this new frontier.
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Inactivation methods may affect structural components of the cell differently, and therefore their biological activities.
“Importantly, these methods of inactivation may affect structural components of the cell differently, and therefore their biological activities [264, 265].”
From International Society of Sports Nutrition Position Stand: Probiotics (2019) · cites this paper as [265]
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- Authors
- Deshpande, G., Athalye-Jape, G., & Patole, S.
- Affiliations
- The University of Sydney (AU)
- Department of Neonatology, King Edward Memorial Hospital for Women, Perth, WA 6008, Australia
- King Edward Memorial Hospital (AU)
- Corresponding author
- Patole, Sanjay
- Venue
- Nutrients
- Publisher
- MDPI AG
- Published
- 2018-07-05
- Volume
- 10
- Issue
- 7
- Pages
- 871
- ISSN
- 2072-6643 (ISSN-L)
- PMC
- PMC6073938
- OpenAlex
- W2810457622
- Cited by
- 164
- References
- 81
- Citations by year
- 2026: 13 · 2025: 25 · 2024: 23 · 2023: 19 · 2022: 23 · 2021: 30 · 2020: 15 · 2019: 13 · 2018: 3
- FWCI
- 1.95
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- Nutrients (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Infant Nutrition and Health
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Neonatal and Maternal Infections
- Keywords
- paraprobiotics, preterm infants, probiotics, necrotizing enterocolitis, intestinal barrier integrity, cell extracts, antibiotic resistance transmission, probiotic safety, extremely preterm infants
- MeSH terms
- Gastrointestinal Microbiome, Animals, Gestational Age, Humans, Infant, Infant Mortality, Infant, Newborn, Infant, Premature, Risk Factors, Sepsis, Evidence-Based Medicine, Probiotics, Enterocolitis, Necrotizing, Gastrointestinal Tract, Premature Birth
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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