Necrotizing enterocolitis: The intestinal microbiome, metabolome and inflammatory mediators

Area of Science:

• Neonatal medicine
• Microbiology
• Immunology

Background:

• Necrotizing enterocolitis (NEC) is a severe intestinal disease in preterm infants, linked to high mortality and morbidity.
• Gut microbial dysbiosis, characterized by an increase in Proteobacteria, is implicated in NEC pathogenesis.
• Factors like antibiotic use and H2 blockers disrupt the gut microbiome, potentially increasing NEC incidence.

Purpose of the Study:

• To explore the role of microbial dysbiosis and its associated inflammatory pathways in NEC.
• To investigate the potential of microbial metabolites, such as short-chain fatty acids, in modulating NEC-related processes.
• To identify microbiome and metabolome-based biomarkers for early NEC diagnosis and therapeutic interventions.

Main Methods:

• Analysis of gut microbiome composition, focusing on bacterial phyla like Proteobacteria.
• Assessment of inflammatory markers, including Toll-like receptor signaling and nuclear factor kappa-β activation.
• Metabolomic profiling to identify key microbial metabolites, such as acetate and butyrate.

Main Results:

• Microbial dysbiosis, particularly Proteobacteria bloom, is associated with NEC.
• Upregulated inflammatory processes, including TLR signaling and NF-κB translocation, are observed in NEC.
• Microbial metabolites like SCFAs may influence immunity, intestinal integrity, and epigenetic regulation.

Conclusions:

• Understanding the interplay between the microbiome, inflammation, and metabolites is crucial for NEC pathogenesis.
• Microbiome and metabolome evaluations hold promise for early NEC diagnosis.
• Targeting microbial dysbiosis presents a potential therapeutic avenue for NEC.