Role of platelet-activating factor in the pathophysiology of necrotizing enterocolitis.
Necrotizing enterocolitis (NEC) is a devastating gastrointestinal illness that affects predominantly preterm infants. Treatment options are limited and NEC remains a significant cause of morbidity and mortality. The precise aetiology of NEC remains unclear but evidence strongly suggests that the cause is multifactorial and there are four main aetiological factors: prematurity, hypoxia, enteral feeding and bacterial colonization. The presence of similar intestinal lesions, regardless of aetiological trigger, strongly implicates a final common pathway in the pathogenesis. There is now a substantial body of evidence to indicate that endogenous inflammatory mediators, particularly platelet-activating factor (PAF), play a vital role in this final pathway.


CONCLUSIONS
The use of agents that antagonize PAF may provide therapeutic options in the management of NEC.
Birmingham Women's Hospital and University of Birmingham, Edgbaston, Birmingham, UK. a.k.ewer@bham.ac.uk
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D000818:Animals; D000831:Animals, Newborn; D004195:Disease Models, Animal; D020345:Enterocolitis, Necrotizing / Q000188:drug therapy* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000188:drug therapy* / Q000503:physiopathology*; D018836:Inflammation Mediators / Q000378:metabolism; D007413:Intestinal Mucosa / Q000378:metabolism / Q000473:pathology; D008297:Male; D010972:Platelet Activating Factor / Q000032:analysis / Q000096:biosynthesis*; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology; D011379:Prognosis; D051381:Rats; D018570:Risk Assessment; D013552:Swine
D018836:Inflammation Mediators; D010972:Platelet Activating Factor; D010975:Platelet Aggregation Inhibitors