Gut-Brain cross talk: The pathogenesis of neurodevelopmental impairment in necrotizing enterocolitis

Area of Science:

• Neonatal Medicine
• Neuroscience
• Gastroenterology

Background:

• Necrotizing enterocolitis (NEC) is a severe intestinal disease in premature infants, causing high morbidity and mortality.
• Survivors often experience long-term neurodevelopmental impairments (NDI), including cognitive, motor, sensory, and psychosocial deficits.
• The gut-brain axis (GBA) is increasingly recognized for its role in NEC and NDI development.

Purpose of the Study:

• To review the spectrum of NDI observed in NEC survivors.
• To elucidate the role of GBA alterations in NEC pathogenesis and NDI.
• To explore therapeutic strategies for preventing NEC-related brain injury and NDI.

Main Methods:

• This is a review article, synthesizing existing literature on NEC, NDI, and the GBA.
• It examines the proposed mechanisms linking gut dysbiosis, inflammation, and brain injury in NEC.
• It highlights current research on potential interventions targeting the GBA.

Main Results:

• Gut-brain axis dysregulation, characterized by microbial imbalance and bowel injury, can trigger systemic inflammation.
• This inflammation extends to the brain, causing white matter injury, impaired myelination, and delayed head growth.
• These pathological changes in the developing brain contribute to the observed neurodevelopmental impairments.

Conclusions:

• The gut-brain axis plays a critical role in the development of neurodevelopmental impairments following necrotizing enterocolitis.
• Understanding GBA mechanisms offers promising avenues for novel therapeutic interventions.
• Further research is needed to develop and validate therapies to mitigate NDI in NEC survivors.