The human gut is host to trillions of microbes that from birth begin interacting with our immune system. Over time this relationship is thought to shape critical aspects of human function such as metabolism, brain development, immune response, and overall gut health. Recent advances in technology have allowed us to begin understanding this complex relationship and have demonstrated that microbes within the gut ecosystem can be influenced by a variety of factors including mode of delivery, diet, and medication exposure, all of which can impact host health in either positive or detrimental ways. Perturbations of gut homeostasis have been implicated in many forms of digestive disease such as inflammatory bowel disease, irritable bowel syndrome, Helicobacter pylori infection, and even in cases of antibiotic-associated diarrhea. As such, researchers have sought methods to either restore gut homeostasis or prevent dysregulation of the gut community, also known as dysbiosis, through an emerging field known as microbial therapeutics. Examples of existing modalities are reviewed here such as prebiotics, probiotics, fecal microbial transplantation, and dietary therapy. As these therapies become further substantiated through research and increasingly desired by patients and their families, there is a need for providers caring for children to familiarize themselves with the existing data and indications for use. As we look to the future, machine-learning algorithms and more readily available next-generation sequencing of fecal samples may allow us to harness data from a person's gut microbiota to predict response to a particular intervention and tailor therapeutic options with an aim toward precision medicine. [Pediatr Ann. 2021;50(8):e336-e342.].

中文翻译：

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小儿消化系统健康和肠道微生物组：现有疗法和展望未来。

人类肠道是数以万亿计的微生物的宿主，这些微生物从出生就开始与我们的免疫系统相互作用。随着时间的推移，这种关系被认为会影响人体功能的关键方面，例如新陈代谢、大脑发育、免疫反应和整体肠道健康。最近的技术进步让我们开始了解这种复杂的关系，并证明肠道生态系统中的微生物会受到多种因素的影响，包括分娩方式、饮食和药物暴露，所有这些都会影响宿主健康积极或有害的方式。肠道稳态的扰动与多种形式的消化系统疾病有关，例如炎症性肠病、肠易激综合征、幽门螺杆菌感染，甚至与抗生素相关的腹泻。像这样，研究人员一直在寻找通过微生物疗法这一新兴领域恢复肠道稳态或防止肠道菌群失调（也称为生态失调）的方法。现有方式的示例在此进行了综述，例如益生元、益生菌、粪便微生物移植和饮食疗法。随着这些疗法通过研究得到进一步证实，并且越来越受到患者及其家人的欢迎，因此需要照顾儿童的提供者熟悉现有的数据和使用适应症。展望未来，机器学习算法和更容易获得的粪便样本的下一代测序可能使我们能够利用来自一个人的数据。肠道微生物群预测对特定干预的反应并定制治疗方案，以实现精准医学。[小儿安。2021;50(8):e336-e342.]。