The role of intestinal epithelial barrier function in the development of NEC.
The intestinal epithelial barrier plays an important role in maintaining host health. Breakdown of intestinal barrier function is known to play a role in many diseases such as infectious enteritis, idiopathic inflammatory bowel disease, and neonatal inflammatory bowel diseases. Recently, increasing research has demonstrated the importance of understanding how intestinal epithelial barrier function develops in the premature neonate in order to develop strategies to promote its maturation. Optimizing intestinal barrier function is thought to be key to preventing neonatal inflammatory bowel diseases such as necrotizing enterocolitis. In this review, we will first summarize the key components of the intestinal epithelial barrier, what is known about its development, and how this may explain NEC pathogenesis. Finally, we will review what therapeutic strategies may be used to promote optimal development of neonatal intestinal barrier function in order to reduce the incidence and severity of NEC.
Department of Pediatrics; The University of Arizona ; Tucson, AZ USA.
Melissa D
MD
Halpern
Department of Pediatrics; Emory University School of Medicine ; Atlanta, GA USA.
Patricia W
PW
Denning
AJ, adherens junctions; AJC, apical junction complex; BAs, bile acids; EGF, epidermal growth factor; Bb, Bifidobacterium bifidum; Bi, Bifidobacterium infantis; EPO, erythropoietin; IFNγ, interferon gamma; IEL, intestinal epithelial lymphocytes; NEC, necrotizing enterocolitis; NICU, neonatal intensive care unit; Necrotizing enterocolitis (NEC); TCRγδ, T-cell receptor gamma-delta; TGF-β, transforming growth factor-beta; TJ, tight junctions; TNFα, tumor necrosis factor alpha; TPN, total parenteral nutrition; apical junctional complex; commensal bacteria; intestinal epithelial barrier; prematurity; probiotics; tight junctions