{"title":"Severe anemia predisposes very premature infants to transfusion-associated necrotizing enterocolitis.","authors":"Akhil Maheshwari","doi":"10.1016/j.siny.2025.101615","DOIUrl":null,"url":null,"abstract":"<p><p>Necrotizing enterocolitis (NEC) is a catastrophic inflammatory bowel necrosis of premature infants. The etiology is unknown, but 25-40 % of cases have a history of red blood cell (RBC) transfusions in the preceding 48 h. This association has been noted in retrospective case/case-control studies, and many meta-analyses, and in a murine model. However, we still need human studies with larger, adequately powered cohorts to confirm this association and determine the operant mechanisms. The murine model shows that severe anemia leads to macrophage infiltration in the gut mucosa. Subsequent RBC transfusions containing free hemoglobin, activate nuclear factor-kappa B-mediated inflammatory changes and cause NEC-like mucosal injury. This review summarizes current human and experimental data to evaluate ta-NEC and hitherto unanswered mechanistic questions. If a causal relationship between transfusions and NEC is proven, these data could help develop effective therapeutic strategies.</p>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":" ","pages":"101615"},"PeriodicalIF":2.9000,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Seminars in Fetal & Neonatal Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.siny.2025.101615","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
Necrotizing enterocolitis (NEC) is a catastrophic inflammatory bowel necrosis of premature infants. The etiology is unknown, but 25-40 % of cases have a history of red blood cell (RBC) transfusions in the preceding 48 h. This association has been noted in retrospective case/case-control studies, and many meta-analyses, and in a murine model. However, we still need human studies with larger, adequately powered cohorts to confirm this association and determine the operant mechanisms. The murine model shows that severe anemia leads to macrophage infiltration in the gut mucosa. Subsequent RBC transfusions containing free hemoglobin, activate nuclear factor-kappa B-mediated inflammatory changes and cause NEC-like mucosal injury. This review summarizes current human and experimental data to evaluate ta-NEC and hitherto unanswered mechanistic questions. If a causal relationship between transfusions and NEC is proven, these data could help develop effective therapeutic strategies.
期刊介绍：
Seminars in Fetal & Neonatal Medicine (formerly Seminars in Neonatology) is a bi-monthly journal which publishes topic-based issues, including current ''Hot Topics'' on the latest advances in fetal and neonatal medicine. The Journal is of interest to obstetricians and maternal-fetal medicine specialists.
The Journal commissions review-based content covering current clinical opinion on the care and treatment of the pregnant patient and the neonate and draws on the necessary specialist knowledge, including that of the pediatric pulmonologist, the pediatric infectious disease specialist, the surgeon, as well as the general pediatrician and obstetrician.
Each topic-based issue is edited by an authority in their field and contains 8-10 articles.
Seminars in Fetal & Neonatal Medicine provides:
• Coverage of major developments in neonatal care;
• Value to practising neonatologists, consultant and trainee pediatricians, obstetricians, midwives and fetal medicine specialists wishing to extend their knowledge in this field;
• Up-to-date information in an attractive and relevant format.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
