Tight junction proteins and intestinal health in preterm infants

The intestinal epithelial barrier consists of a single layer of cells that separate the gut lumen from the rest of the body. It regulates and protects the intestinal tract immunologically and mechanically. Necrotizing enterocolitis (NEC) is one of the most common conditions requiring emergency surgery in the neonatal intensive care unit and is associated with a septic shock-like state contributing to multi-organ dysfunction. NEC affects 6-10% of very low birthweight infants and remains a leading cause of death. This review presents current evidence of the role of tight junction (TJ) proteins in clinical neonatology and intestinal health using information from our own clinical and laboratory research in conjunction with information collected from an extensive search in the databases PubMed, EMBASE, and Scopus. The ability to measure the permeability of the intestinal barrier in real-time is essential to understanding the disease process of NEC and the subsequent morbidities. Detection of TJ proteins in blood and stool of preterm infants represents a potential biomarker for the early NEC diagnosis. Therapeutics targeting TJ proteins may also mitigate NEC severity and improve clinical outcomes.