The altered gut microbiome and necrotizing enterocolitis

Roberto Murgas Torrazza, Josef Neu, Roberto Murgas Torrazza, Josef Neu

Abstract

Current evidence highlights the importance of developing a healthy intestinal microbiota in the neonate. Many aspects that promote health or disease are related to the homeostasis of these intestinal microbiota. Their delicate equilibrium could be strongly influenced by the intervention that physicians perform as part of the medical care of the neonate, especially preterm infants. As awareness of the importance of the development and maintenance of these intestinal flora increase and newer molecular techniques are developed, it will be possible to provide better care of infants with interventions that will have long-lasting effects.

Copyright © 2013 Elsevier Inc. All rights reserved.

Figures

Fig. 1
Fig. 1
Intestinal microbiota remain mostly uncultured by traditional culture-based methods. Black fills indicate phylotypes detected in cultivation-independent studies and white indicates species detected in cultivation-based studies.
Fig. 2
Fig. 2
Intestinal microbiota and the potential biologic functions and metabolites.
Fig. 3
Fig. 3
Factors influencing intestinal microbiota homeostasis and predisposing to NEC. The intestinal microbiota are in perfect equilibrium with bacteria that regulate and others that have the potential to cause inflammation. Disruption of this equilibrium (dysbiosis) for different factors leads to inflammation.
Fig. 4
Fig. 4
Simplified TLR signaling leading to NF-κB activation, inflammatory response, and possible NEC. Surface enterocytes can recognize MAMPs via TLRs. Each of these receptors recognizes a specific bacterial product. For example, TLR-2 recognizes products of gram-positive bacteria, TLR-4 recognizes LPS from gram-negative bacteria, and TLR-5 recognizes flagellin. Cell stimulation signals recruitment of MyD88, IRAK, and TRAF6, then triggers activation of IκB. NF-κB activates the transcription of genes, including cytokines and chemokines. IκB: inhibitor of kappa B.

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