The Effects of Delivery Mode on the Gut Microbiota and Health: State of Art

Abstract

The delivery mode is an important factor driving alteration in the gut microbiota during the neonatal period. Several studies prove that the alteration of gut microbiota induced by cesarean section could influence the activation of intestinal epithelial cells and the development of immune system. Further, some autoimmune and metabolic disorders may be related to the microbiota dysbiosis in infants caused by cesarean section. It is noteworthy that probiotics could promote the intestinal microecology, which may further prevent and treat cesarean section related diseases. This review summarized the great significance of delivery mode on microbiota and health, as well as provided clinically feasible methods for the prevention and treatment of cesarean section related gut diseases.

Keywords: cesarean section; gut microbiota; immune system; intestinal epithelial cells; probiotics; vaginal delivery.

FIGURE 1

Intestinal epithelial cells mediate the crosstalk between gut microbiota and host immune responses. The mucosal barrier formed by intestinal epithelial cells can prevent the conflict between gut microbiota and host immune cells, and keep bacteria away from the epithelial surface. Microbial signals are captured by epithelial cells through their specific receptors directly or transmitted by dendritic cells (DCs) to activate other innate immune cells, including innate lymphocytes (ILC3) and macrophages (Mφ). Dendritic cells activated by bacteria are also involved in the recruitment and activation of adaptive immune cells. Plasma cells release IgA. Once IgA is attached to the polymeric immunoglobulin receptor (pIgR), it will enter the gut lumen in the form of secretory IgA (sIgA). Besides, various populations of CD4 + T cells are induced simultaneously, and their function is balanced to maintain physiological inflammation, especially under the control of Treg and IL-10. Th17 production (T helper 17).