Current Research on the Epidemiology, Pathogenesis, and Management of Necrotizing Enterocolitis

Eaton, Simon; Rees, Clare M.; Hall, Nigel

doi:10.1159/000458462

Cited by 113 publications

(87 citation statements)

References 91 publications

(98 reference statements)

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“…Although the aetiology is incompletely understood, it is thought to relate to aberrant intestinal mucosal colonisation by bacteria. Research efforts have focused on therapeutics designed to restore this balance to prevent NEC or minimise the severity once it has occurred (Denning et al 2017;Eaton et al 2017;Frost et al 2017). In 2014, a Cochrane review found that the use of probiotics reduced the occurrence of NEC (typical RR 0.35; 95% CI: 0.24 to 0.52, NNT 25) and death (typical RR 0.40; 95% CI 0.27 to 0.60, NNT 25) in premature infants with a birthweight of <1500 g (AlFaleh & Anabrees 2014).…”

Section: Necrotising Enterocolitismentioning

confidence: 99%

Probiotics for human use

Sanders¹,

et al. 2018

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Probiotics have become a popular approach for managing digestive and immune health and are being recommended more frequently as effective therapeutic interventions by medical professionals. Introduced early in the 20th century, the science of probiotics has advanced considerably, especially in the past two decades. Researchers have adopted a consensus definition, begun to understand many of the mechanisms of action, defined characteristics important to probiotic function and have obtained clinical evidence supporting probiotic health benefits and product quality. Nonetheless, a need remains for clear, evidence‐based communications to consumers on the role of probiotics in a healthy diet and to healthcare providers regarding clinical use. However, regulatory frameworks in many countries have restricted progress on this front. There is a need for additional research to further clarify the most effective probiotics for given health outcomes and to identify people most likely to respond to specific probiotic interventions. This review provides current perspective on the probiotic concept, discusses evidence‐based probiotic interventions, considers fermented foods with regard to probiotics and addresses some regulatory challenges facing the probiotic field.

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Section: Necrotising Enterocolitismentioning

confidence: 99%

Probiotics for human use

Sanders¹,

et al. 2018

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“…These include necrotising enterocolitis (NEC), late-onset (hospital-acquired) infection, and associated slow growth and developmental faltering secondary to nutritional deficiency [1]. Late-onset infection affects about 20% and NEC occurs in about 5% of all very preterm infants [2, 3]. The attributable mortality can be in excess of 20%, especially for severe NEC and gram-negative bacterial, enterococcal or fungal infections.…”

Section: Introductionmentioning

confidence: 99%

Immunonutrition for Preterm Infants

Walsh

McGuire²

2019

Neonatology

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Care and outcomes for very preterm infants continue to improve, but important causes of mortality and acute and long-term morbidity associated with prolonged hospitalisation remain. Necrotising enterocolitis (NEC) and late-onset infection have emerged as the major causes of death beyond the early neonatal period and of neurodisability in very preterm infants. Although the pathogenesis of these conditions is incompletely understood, it appears to be related to the content and mode of delivery of the enteral diet, particularly the impact of immunonutrients from human breast milk on the microbial and metabolic balance within the immature intestine. Evidence exists to support investment in measures to help mothers to express breast milk as the primary source of nutrition for their very preterm infants. In the absence of maternal milk, pasteurised donor breast milk provides protection against NEC, but its nutritive adequacy is not clear and its cost-effectiveness is uncertain. Supplementation with individual immunonutrients, including immunoglobulins and lactoferrin, has not been shown to be effective in preventing NEC or infection in randomised controlled trials. The evidence base for prebiotics and probiotics is stronger, but concerns exist about the choice, safety and availability of formulations. Other strategies – including avoidance of drugs such as gastric acid suppressants that compromise innate immunity, as well as evidence-based progressive feeding strategies that reduce exposure to invasive interventions – are emerging as key components of care packages to reduce the burden of NEC, infection and associated growth and developmental faltering for very preterm infants.

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“…The poor outcomes of these diseases have improved over the past decade due to significant advances in neonatal intensive care, especially for premature newborns, and the use of glucocorticoids and pulmonary surfactants. At present, the clinical treatment of premature diseases mainly includes auxiliary ventilation, drug therapy, supportive therapy and surgical treatment [9][10][11]. For example, the application of glucocorticoid in BPD can inhibit the occurrence of inflammatory reaction, reduce bronchial and pulmonary edema, promote the production of antioxidant enzymes and pulmonary surfactants in the lung, rapidly improve…”

Section: Introductionmentioning

confidence: 99%

Mesenchymal stem cell-derived secretomes for therapeutic potential of premature infant diseases

et al. 2020

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Preterm birth is a complex syndrome and remains a substantial public health problem globally. Its common complications include periventricular leukomalacia (PVL), bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC) and retinopathy of prematurity (ROP). Despite great advances in the comprehension of the pathogenesis and improvements in neonatal intensive care and associated medicine, preterm birth-related diseases remain essentially without adequate treatment and can lead to high morbidity and mortality. The therapeutic potential of mesenchymal stem/stromal cells (MSCs) appears promising as evidenced by their efficacy in preclinical models of pathologies relevant to premature infant complications. MSC-based therapeutic efficacy is closely associated with MSC secretomes and a subsequent paracrine action response to tissue injuries, which are complex and abundant in response to the local microenvironment. In the current review, we summarize the paracrine mechanisms of MSC secretomes underlying diverse preterm birth-related diseases, including PVL, BPD, NEC and ROP, are summarized, and focus is placed on MSC-conditioned media (CM) and MSC-derived extracellular vesicles (EVs) as key mediators of modulatory action, thereby providing new insights for future therapies in newborn medicine.lung function and help to remove the ventilator as soon as possible [12]. However, many studies have reported that glucocorticoid can increase the risk of adverse reactions, such as those by the nervous system, in the early or late stages, and its dose and course of treatment are not certain [13,14]. In terms of surgical treatment, preterm infants with surgical NEC are at risk of significant growth reduction and neurodevelopmental impairment (NDI), including cerebral palsy, deafness and blindness [15,16]. These sequelae and complications of prematurity-related diseases affect not only the neonatal period, but also infancy and childhood, and even adolescence and adulthood [17][18][19]. Currently, although various treatment methods have been found to achieve certain curative effects, there still exist several side effects and disputes above. Thus, it is necessary to explore and develop new therapies for the treatment and prevention of premature infant diseases.Accumulating studies have established the importance and feasibility of stem cell-based therapies to ameliorate many degenerative and inflammatory diseases. Among these stem/progenitor cell types, mesenchymal stem/stromal cells (MSCs) have received more extensive attention because they are easily extracted, exert anti-inflammatory effects, have low immunogenicity and can renew themselves. The therapeutic potential of MSCs has been demonstrated in many diseases such as cancer [20,21] and cardiovascular [22,23] and lung [24][25][26] diseases. MSCs also represent a promising and growing approach to the targeting of various pathological processes and cellular impairments underlying the major abnormalities in premature infant and preterm-associated neonatal diseases [27][28]...

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Current Research on the Epidemiology, Pathogenesis, and Management of Necrotizing Enterocolitis

Cited by 113 publications

References 91 publications

Probiotics for human use

Probiotics for human use

Immunonutrition for Preterm Infants

Mesenchymal stem cell-derived secretomes for therapeutic potential of premature infant diseases

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