Gut Microbiota and Short-Chain Fatty Acids in the Pathogenesis of Necrotizing Enterocolitis in Very Preterm Infants

Area of Science:

• Neonatal research
• Microbiome studies
• Gastroenterology

Background:

• The gut microbiome is critical for infant development but is unstable in very preterm infants.
• This instability, marked by low diversity and Proteobacteria dominance, increases necrotizing enterocolitis (NEC) risk.
• Short-chain fatty acids (SCFAs) are key microbial metabolites crucial for intestinal health and immune function.

Purpose of the Study:

• To review the role of gut microbiota and SCFAs in neonatal NEC.
• To explore potential diagnostic and therapeutic strategies involving SCFAs for NEC.

Main Methods:

• Review of clinical studies and experimental models concerning NEC and gut microbiota.
• Analysis of SCFA levels and bacterial metabolites in preterm infants with and without NEC.

Main Results:

• Clinical studies consistently show decreased total SCFA levels and specific metabolites in NEC patients.
• Experimental models corroborate the association between reduced SCFAs and NEC pathogenesis.
• A significant decrease in SCFAs is a hallmark of NEC in preterm infants.

Conclusions:

• Gut microbiota and SCFAs play a significant role in the pathogenesis of neonatal NEC.
• Further multi-center, multi-omics research with large cohorts is needed to clarify SCFA's diagnostic utility and therapeutic potential.
• Developing pro- and postbiotic strategies targeting SCFAs may offer new avenues for NEC prevention and treatment.