Emilio Jirillo, S. Topi, I. Charitos, L. Santacroce, Elona Gaxhja, Marica Colella
{"title":"Gut Microbiota and Immune System in Necrotizing Enterocolitis and Related Sepsis","authors":"Emilio Jirillo, S. Topi, I. Charitos, L. Santacroce, Elona Gaxhja, Marica Colella","doi":"10.3390/gidisord6020029","DOIUrl":null,"url":null,"abstract":"A severe condition of sepsis can be a complication of necrotizing enterocolitis (NEC), which can occur in premature infants and becomes a medical challenge in the neonatal intensive care unit (NICU). It is a multifactorial intestinal disease (can affect both the small and large intestine) that can lead to ischemia of the intestinal tissues that evolves into acute organ necrosis. One of these factors is that different types of nutrition can influence the onset or the progression of the disease. Cow-milk-based infant formulas have been shown to cause it in premature infants more frequently than human milk. Recently, nutrition has been shown to be beneficial after surgery. Several issues still under study, such as the pathogenesis and the insufficient and often difficult therapeutic approach, as well as the lack of a common and effective prevention strategy, make this disease an enigma in daily clinical practice. Recent studies outlined the emerging role of the host immune system and resident gut microbiota, showing their close connection in NEC pathophysiology. In its initial stages, broad-spectrum antibiotics, bowel rest, and breastfeeding are currently used, as well as probiotics to help the development of the intestinal microbiota and its eubiosis. This paper aims to present the current knowledge and potential fields of research in NEC pathophysiology and therapeutic assessment.","PeriodicalId":507842,"journal":{"name":"Gastrointestinal Disorders","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gastrointestinal Disorders","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3390/gidisord6020029","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
A severe condition of sepsis can be a complication of necrotizing enterocolitis (NEC), which can occur in premature infants and becomes a medical challenge in the neonatal intensive care unit (NICU). It is a multifactorial intestinal disease (can affect both the small and large intestine) that can lead to ischemia of the intestinal tissues that evolves into acute organ necrosis. One of these factors is that different types of nutrition can influence the onset or the progression of the disease. Cow-milk-based infant formulas have been shown to cause it in premature infants more frequently than human milk. Recently, nutrition has been shown to be beneficial after surgery. Several issues still under study, such as the pathogenesis and the insufficient and often difficult therapeutic approach, as well as the lack of a common and effective prevention strategy, make this disease an enigma in daily clinical practice. Recent studies outlined the emerging role of the host immune system and resident gut microbiota, showing their close connection in NEC pathophysiology. In its initial stages, broad-spectrum antibiotics, bowel rest, and breastfeeding are currently used, as well as probiotics to help the development of the intestinal microbiota and its eubiosis. This paper aims to present the current knowledge and potential fields of research in NEC pathophysiology and therapeutic assessment.
严重的败血症可能是坏死性小肠结肠炎(NEC)的并发症,NEC 可发生在早产儿身上,成为新生儿重症监护室(NICU)的医疗难题。这是一种多因素肠道疾病(可影响小肠和大肠),可导致肠道组织缺血,进而演变为急性器官坏死。其中一个因素是不同类型的营养会影响疾病的发生或发展。与人奶相比,以牛乳为基础的婴儿配方奶粉更容易导致早产儿发病。最近,营养在手术后被证明是有益的。目前仍在研究的几个问题,如发病机理、治疗方法不足且往往困难重重,以及缺乏通用而有效的预防策略,使这种疾病成为日常临床实践中的一个谜。最近的研究概述了宿主免疫系统和常驻肠道微生物群的新作用,显示了它们在 NEC 病理生理学中的密切联系。在NEC的初期阶段,目前主要使用广谱抗生素、肠道休息和母乳喂养,以及益生菌来帮助肠道微生物群的发育和优生。本文旨在介绍有关 NEC 病理生理学和治疗评估的现有知识和潜在研究领域。