Biomarkers for Necrotising Enterocolitis-Are We There Yet?

Area of Science:

• Neonatal medicine
• Gastroenterology
• Biomarker research

Background:

• Necrotising enterocolitis (NEC) presents diagnostic challenges, often mimicking other neonatal conditions like late-onset sepsis (LOS) and focal intestinal perforation (FIP).
• Accurate and timely diagnosis of NEC is crucial due to its significant impact on neonatal mortality and neurodevelopmental outcomes.
• Current diagnostic methods for NEC can be non-specific, necessitating the exploration of novel biomarkers.

Purpose of the Study:

• To review non-invasive biomarkers for NEC diagnosis using stool, urine, and saliva samples.
• To focus on biomarkers suitable for point-of-care testing (POCT) in clinical settings.
• To identify the most promising non-invasive biomarkers for NEC and highlight areas needing further research.

Main Methods:

• Narrative review of existing literature on non-invasive biomarkers for NEC.
• Focus on biomarkers detectable in stool, urine, and saliva.
• Evaluation of biomarkers with potential for point-of-care application.

Main Results:

• Faecal calprotectin and urinary intestinal fatty acid-binding protein (IFABP) demonstrate the most robust data for clinical use in larger studies.
• These biomarkers are strong candidates for translation into clinical practice as non-invasive diagnostic tools.
• Saliva remains an under-researched area for NEC biomarker development.

Conclusions:

• Non-invasive biomarkers, particularly faecal calprotectin and urinary IFABP, hold significant potential for improving NEC diagnosis in neonates.
• Further research is needed to enhance the specificity of these biomarkers, especially in differentiating NEC from LOS and FIP.
• Developing non-invasive POCTs for NEC biomarkers could revolutionize neonatal care and improve patient outcomes.