Digging deeper into necrotizing enterocolitis: bridging clinical, microbial, and molecular perspectives.

Area of Science:

• Neonatal Medicine
• Gastroenterology
• Microbiology

Background:

• Necrotizing enterocolitis (NEC) is a critical gastrointestinal inflammatory condition predominantly affecting preterm infants.
• Understanding NEC pathogenesis requires integrating clinical, microbial, and molecular insights.

Purpose of the Study:

• To consolidate evidence on NEC pathogenesis from diverse biomedical disciplines.
• To explore the therapeutic potential of probiotics and biologics in modulating NEC-related inflammation.
• To enhance etiological comprehension and inform preventive/curative strategies for NEC.

Main Methods:

• Comprehensive review of existing literature across clinical, microbial, and molecular studies.
• Analysis of gut microbiota dysbiosis, including bacterial and viral community imbalances.
• Summary of interactions between toll-like receptor 4 (TLR4), microvascular integrity, and immune activation.

Main Results:

• NEC pathogenesis is complex, involving gut inflammation, microbial dysbiosis, and immune system activation.
• Probiotics and novel biologics show potential in modulating NEC-associated inflammatory pathways.
• Imbalances in gut microbiota, particularly bacterial and viral communities, are implicated in NEC onset.
• Interactions involving TLR4, microvascular integrity, and the inflammatory milieu are crucial to NEC pathophysiology.

Conclusions:

• A sophisticated understanding of NEC pathophysiology is emerging from integrated biomedical research.
• Targeted therapeutic interventions for NEC can be developed by elucidating its complex etiology.
• Perinatal factors significantly impact the development of effective preventive and curative strategies for NEC.