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Remote ischemic conditioning in necrotizing enterocolitis.

Niloofar Ganji1, George Biouss1, Stella Sabbatini2

  • 1Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada; Translational Medicine, Hospital for Sick Children Research Institute, University of Toronto, Toronto, ON, Canada.

Seminars in Pediatric Surgery
|June 9, 2023
PubMed
Summary
This summary is machine-generated.

Remote ischemic conditioning (RIC) shows promise for treating necrotizing enterocolitis (NEC) in premature infants. This non-invasive method protects the intestine by improving blood flow, with ongoing trials evaluating its clinical feasibility.

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Area of Science:

  • Neonatal Medicine
  • Gastroenterology
  • Cardiovascular Research

Background:

  • Necrotizing enterocolitis (NEC) is a severe intestinal disease in premature infants with high mortality.
  • NEC involves intestinal inflammation, ischemia, and impaired microcirculation.
  • Current treatments for NEC have limited efficacy, necessitating novel therapeutic strategies.

Approach:

  • Remote ischemic conditioning (RIC) utilizes brief, reversible limb ischemia to activate protective pathways.
  • RIC enhances intestinal microcirculation, reducing ischemia-induced damage.
  • Preclinical and Phase I studies demonstrate RIC's safety and potential efficacy in experimental NEC models.

Key Points:

  • RIC has shown significant protective effects against intestinal damage in experimental NEC.
  • Phase I trials confirmed RIC's safety in preterm infants with NEC.
  • A multi-center Phase II trial is currently evaluating RIC's feasibility for early-stage NEC treatment.

Conclusions:

  • RIC represents a promising, non-invasive therapeutic approach for necrotizing enterocolitis.
  • Further clinical evaluation is warranted to establish RIC's role in managing NEC in preterm neonates.
  • This review highlights the translational journey of RIC from bench to bedside for NEC treatment.