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Pathogenesis of neonatal necrotizing enterocolitis

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Abstract

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.

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Authors and Affiliations

  1. Division of Pediatric Surgery, Children’s Hospital Los Angeles, 4650 Sunset Blvd., Mailstop #72, Los Angeles, CA, 90027, USA

    Joanna C. Lim, Jamie M. Golden & Henri R. Ford

  2. Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA

    Henri R. Ford

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  1. Joanna C. Lim
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  2. Jamie M. Golden
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  3. Henri R. Ford
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Correspondence to Henri R. Ford.

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Lim, J.C., Golden, J.M. & Ford, H.R. Pathogenesis of neonatal necrotizing enterocolitis. Pediatr Surg Int 31, 509–518 (2015). https://doi.org/10.1007/s00383-015-3697-9

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  • DOI: https://doi.org/10.1007/s00383-015-3697-9

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