Necrotizing enterocolitis--bench to bedside: novel and emerging strategies

Area of Science:

• Neonatology
• Gastroenterology
• Surgical Innovation

Background:

• Necrotizing enterocolitis (NEC) is a critical gastrointestinal disease affecting premature infants, with persistent high mortality rates.
• Current management strategies for NEC are categorized into medical and surgical interventions, with disease presentation dictating treatment approach.
• Understanding NEC pathogenesis has advanced, highlighting the role of nitric oxide and the protective effects of epidermal growth factor.

Purpose of the Study:

• To review current surgical treatment options for necrotizing enterocolitis (NEC).
• To examine emerging therapeutic strategies for NEC and its complications, such as short bowel syndrome (SBS).
• To discuss novel approaches like tissue-engineered intestine for managing intestinal failure.

Main Methods:

• Review of recent scientific literature on NEC pathogenesis and treatment.
• Analysis of data on surgical interventions for NEC based on disease presentation.
• Exploration of emerging modalities including growth factor fortification and tissue engineering.

Main Results:

• Upregulation of nitric oxide is implicated in NEC-induced epithelial injury.
• Epidermal growth factor, abundant in breast milk, demonstrates cytoprotective effects on the intestinal epithelium.
• Tissue-engineered intestine shows promise in preclinical models for treating intestinal failure secondary to NEC.

Conclusions:

• Targeting nitric oxide pathways and utilizing growth factors like epidermal growth factor represent potential preventive and therapeutic strategies for NEC.
• Tissue engineering offers a novel frontier for managing short bowel syndrome, a severe complication of NEC.
• Personalized surgical approaches tailored to NEC presentation, combined with innovative therapies, are crucial for improving outcomes in affected neonates.