Pathogenesis of neonatal necrotizing enterocolitis

Although necrotizing enterocolitis (NEC) is the most lethal gastrointestinal disease in the neonatal population, its pathogenesis is poorly understood. Risk factors include prematurity, bacterial colonization, and formula feeding. This review examines how mucosal injury permits opportunistic pathoge...

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Bibliographic Details
Published inPediatric surgery international Vol. 31; no. 6; pp. 509 - 518
Main Authors Lim, Joanna C., Golden, Jamie M., Ford, Henri R.
Format Journal Article
LanguageEnglish
Published Berlin/Heidelberg Springer Berlin Heidelberg 01.06.2015
Springer Nature B.V
Subjects
Enterocolitis, Necrotizing - pathology
Humans
Infant, Newborn
Infant, Newborn, Diseases - pathology
Intestinal Mucosa - pathology
Intestines - pathology
Medicine
Medicine & Public Health
Pediatric Surgery
Pediatrics
Review Article
Surgery
Necrotizing enterocolitis
Pathophysiology
Pediatric surgery
Neonatal intensive care unit
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Summary:Although necrotizing enterocolitis (NEC) is the most lethal gastrointestinal disease in the neonatal population, its pathogenesis is poorly understood. Risk factors include prematurity, bacterial colonization, and formula feeding. This review examines how mucosal injury permits opportunistic pathogens to breach the gut barrier and incite an inflammatory response that leads to sustained overproduction of mediators such as nitric oxide and its potent adduct, peroxynitrite. These mediators not only exacerbate the initial mucosal injury, but they also suppress the intestinal repair mechanisms, which further compromises the gut barrier and culminates in bacterial translocation, sepsis, and full-blown NEC.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-3
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ObjectType-Review-1
ISSN:0179-0358
1437-9813
DOI:10.1007/s00383-015-3697-9