Neonatal Necrotizing Enterocolitis -Inflammation and Intestinal Immaturity

Abstract

Neonatal necrotizing enterocolitis is a devastating inflammatory bowel disease of premature infants. The pathogenesis remains incompletely understood and there is no specific treatment. Efforts are ongoing to understand aspects of intestinal immaturity which contribute to susceptibility to this disease. This review focuses on bacterial colonization patterns, intestinal barrier function, and inflammatory responses of immature enterocytes leading to a unique vulnerability of the preterm gut. In addition the possible therapeutic potential of factors in human milk and probiotic bacteria is discussed.

Figures

Fig. 1

Aspects of immature intestinal host defense in the premature infant that may contribute to susceptibility to necrotizing enterocolitis. Reproduced with permission [146].

Fig. 2

Nuclear factor kappa B signaling cascade. Asterisks denote steps with differential response to inflammatory stimuli in immature and mature intestinal epithelial cells.