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Related Concept Videos

Necrosis01:16

Necrosis

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Necrosis is considered as an “accidental” or unexpected form of cell death that ends in cell lysis. The first noticeable mention of “necrosis” was in 1859 when Rudolf Virchow used this term to describe advanced tissue breakdown in his compilation titled “Cell Pathology”.
Morphological Manifestations of Necrosis
Necrotic cells show different types of morphological appearance depending on the type of tissue and infection. In coagulative necrosis, cells become...
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Author Spotlight: Enhancing Understanding and Treatment Strategies with the NEC-on-a-Chip Model
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Exploring the Complex Pathophysiology of Necrotizing Enterocolitis in Preterm Neonates.

Bo Li1, Mina Yeganeh1, Dorothy Lee1

  • 1Translational Medicine Program, Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada;

Annual Review of Pathology
|September 15, 2025
PubMed
Summary

Necrotizing enterocolitis (NEC), a serious condition in preterm infants, is better understood through a new model. This framework integrates factors like gut health and blood flow to explain NEC development and guide future treatments.

Keywords:
NECNEC pathogenesisintestinal microcirculationmucosal immunitynecrotizing enterocolitispreterm neonates

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Area of Science:

  • Neonatal Medicine
  • Gastroenterology
  • Developmental Biology

Background:

  • Necrotizing enterocolitis (NEC) is a critical gastrointestinal emergency affecting preterm neonates.
  • Advanced NEC cases have a high mortality rate (30-50%).
  • The complex pathophysiology of NEC remains incompletely understood despite extensive research.

Purpose of the Study:

  • To review recent advancements in NEC research.
  • To propose an integrative theoretical framework for NEC pathogenesis.
  • To identify potential therapeutic interventions for NEC.

Main Methods:

  • Literature review of recent experimental and clinical findings on NEC.
  • Analysis of key contributing factors: intestinal vascular development, mucosal immunity, regeneration, enteric nervous system, and gut microbiome.
  • Development of a sequential model for NEC pathogenesis.

Main Results:

  • Prematurity disrupts critical developmental processes, increasing NEC susceptibility.
  • A proposed model links impaired intestinal microcirculation and ischemia to NEC progression.
  • Key factors include epithelial barrier dysfunction, inflammation, impaired regeneration, and enteric nervous system disruption.

Conclusions:

  • An integrative framework enhances understanding of NEC initiation in preterm neonates.
  • Impaired microcirculation and subsequent ischemia are central to NEC pathogenesis.
  • This comprehensive perspective highlights avenues for future research and novel therapeutic strategies.