e: The role of the microbiome in human health and disease: an introduction for clinicians : Relative abundances of Gammaproteobacteria and relative paucity of anerobic bacteria precede Necrotising Enterocolitis in low birth weight baby

by authors 1] Professor Pranab Kumar Bhattacharya MD(calcutta University) FIC path (India)  Professor of PathologyMurshidabad Medical College , West Bengal India Berhampore Station Road, Berhampore Court, Murshidabad ,West Bengal, India

2] Sumona Mukherjee MD( Pathology), Associate Professor of Pathology CSTM kolkata -73 W.B, India; Upasana Bhattacharya(3); Rupak Bhattacharya(3); Ritwick Bhattacharya(3) ; Rupsa Bhattacharya(3) ; Dalia Mukherjee(3) ; Ayeishi Mukherjee(3) ;Oaindrila mukherjee(3); Debasisa Mukherjee(3) ; Hindole Banerjee(3) of Residence 7/51 Purbapali; PO-Sodepur; 24 parganas (North) ;Kolkata-110 West Bengal; India and  ( 4)Rnna Mitra Social worker BK Mitra palliative care Barrackpore 24 parganas(North) West Bengal India

Published at British Medical journal as rapid response  for the article Clinical Review

State of the Art ReviewThe role of the microbiome in human health and disease: an introduction for clinicians

BMJ 2017; 356 doi: https://doi.org/10.1136/bmj.j831 (Published 15 March 2017)

Cite this as: BMJ 2017;356:j831 

Necrotising enterocolitis is a catastrophic necro inflammatory injury to the intestine in low birth weight infants (5-10% of very low birth weight babies) through out the age of 2 months-9 months, and their mortality rate is about 25% and present treatment is bowel resections. Necrotising enterocolitis is associated positively with various antibiotics and found negatively with human milk and very costly probiotics. DNA analysis of stool culture in study of gut microbes shows commonly organisms such as Gram negative bacilli, Actinobacteria, and firmicutis, Propionibacteria, Bifidobacteria, and bacteriods are preventives of necrotising enterocolitis when overproduction of Gram negative facultative baccili and potentially pathogenic organisms such as E coli Enterobacter, Klebsiella and other obligate anaerobic bacteria particularly clostridia develops in the infant guts before necrotising enterocolitis and results in dysbiosis and ultimately necrotising enterocolitis.

The question is whether these Gram negative bacteria are associated with necrotising enterocolitis and result from dysbiosis. These Gram negative bacteria elicit mucosal injury to the bowel that resembles necrotising enterocolitis and we find that antibiotics can, however, diminish mucosal injury. TLR 4 which binds with bacterial lipopolysaccharides is implicated in cellular processes that actually underlie the cause of necrotising enterocolitis.

Anaerobic bacteria responding to microbiota-accessible carbohydrates produce short chain fatty acids, especially acetate, propionate and butyrate, which are anti-inflammatory too. Oral aminoglycosides which reduce populations of Gram negative gut bacteria but do not inhibit anaerobic bacteria may thus protect against necrotising enterocolitis though it is said that antibiotics use is a risk factor for necrotising enterocolitis and associated with lower proportion of protective anaerobes and lower proportion of Gamma proteobacteria.

Necrotising enterocolitis may be related to a lack of gut bacterial diversity.

So the question is, can probiotics with Bifidobacterium breve prevent necrotising enterocolitis?

Please note  it very carefully that, The Copy Right of this article belongs only 
to Professor Pranab kumarBhattacharya MD(cal) FIC path(Ind) and other authors

 in chronological order  , as per copy right rules of IPR 1996 applicable in India-2006
 under sections 307/ 306/ 3D/107/2012 and PIP Acts of US 2012, SPARC authors amended 
Copy Right rules-2006  of US  when & if accepted for any other blogs, as a reference, or publication  or Research  or  reference material  or published as paper or article in open access journals as a commissioned article  and then  also this article will be under RDF Copy Right rules of 
IPR of Prof PK Bhattacharya.

 No persons/  nor any Private care Hospitals/ nor any Nursing homes/ and their health care
 provider doctors nurses paramedical staffs from any states of  country India or any citizen of India or of Indian origin are for ever authorized by Professor Pranab kumar Bhattacharya to use  any  scientifically meaningful  syllables/words  /sentences/ new drugs/protocolos/  change of Health care by implementation from this  published blog article in the Blogs of Prof Pranab kumar Bhattacharya MD(cal) FIC path(ind.) in Blog spot.com  without  his / future copy right  owner ‘s written permission  &copy Right clearance, even for any

 one’s personal or for his/her fair use even/ treatment of his or her patients/ dissemination of  

any information( Will be considered  then as Plagiarism) , [except such all permission is always

 remain granted to other authors ,their first degree blood relatives in what ever manner they want 

to use this article  for ever from the date of publication in ProfPranab Kumars Bhattacharya 

MD(cal) FIC path(ind)  Blog at blog spot.com   or for digital preservation of  the article in National

 Level Science Library(NSDL) US or of other countries.- by declaration- 

SD/ Professor Pranab kumar Bhattachary