Role of the host defense system and intestinal microbial flora in the pathogenesis of necrotizing enterocolitis.
BACKGROUND
Necrotizing enterocolitis (NEC) is a devastating disease that affects primarily the intestine of premature infants. Despite recent advances in neonatology, NEC remains a major cause of morbidity and mortality in neonates. Neonatal mucosal defenses and adherence of bacterial pathogens may play an important role in the pathogenesis of NEC.


METHODS
Review and synthesis of pertinent literature.


RESULTS
Putative factors that have been implicated in the pathogenesis of NEC include abnormal patterns of gut colonization by bacteria, immaturity of the host immune system and mucosal defense mechanisms, intestinal ischemia, formula feeding, and loss of intestinal epithelial barrier integrity.


CONCLUSIONS
Host defenses and intestinal microbial ecology are believed to play important roles in the pathogenesis of NEC. Commensal bacteria and probiotic therapy may be of therapeutic utility in the maintenance of the gut epithelial barrier.
Emami
Claudia N
CN
Department of Surgery, Childrens Hospital Los Angeles, Keck School of Medicine of University of Southern California, Los Angeles, California 90027, USA.
Petrosyan
Mikael
M
Giuliani
Stefano
S
Williams
Monica
M
Hunter
Catherine
C
Prasadarao
Nemani V
NV
Ford
Henri R
HR
D000818:Animals; D020345:Enterocolitis, Necrotizing / Q000276:immunology / Q000382:microbiology / Q000503:physiopathology; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000276:immunology / Q000382:microbiology / Q000503:physiopathology; D007413:Intestinal Mucosa / Q000382:microbiology*