de Kroon Rimke Romee, de Baat Tessa, Senger Stefania, van Weissenbruch Mirjam Maria
Department of Neonatology, Amsterdam University Medical Center, Amsterdam, Netherlands.
Department of Mucosal Immunology and Biology Research Center, Massachusetts General Hospital for Children, Boston, MA, United States.
Front Pediatr. 2022 Mar 14;10:859805. doi: 10.3389/fped.2022.859805. eCollection 2022.
Necrotizing enterocolitis (NEC) is a common and potentially fatal disease that typically affects preterm (PIs) and very low birth weight infants (VLBWIs). Although NEC has been extensively studied, the current therapeutic approaches are unsatisfactory. Due to the similarities in the composition between human amniotic fluid (AF) and human breast milk (BM), which plays a protective role in the development of NEC in PIs and VLBWIs, it has been postulated that AF has similar effects on the outcome of NEC and potential therapeutic implications. AF has been long used for its diagnostic purposes and is often discarded after birth as "biological waste". However, researchers have started to elucidate its therapeutic potential. Experimental studies in animal models have shown that diseases of various organ systems can possibly benefit from AF-based therapy. Hence, we have identified three approaches which show promising results for future clinical application in the prevention and/or treatment of NEC: (1) administration of processed AF (PAF) isolated from donor mothers, (2) administration of AF stem cells (AFSCs), and (3) administration of simulated AF (SAF) formulated to mimic the composition of physiological AF. We have highlighted the most important aspects that should be taken into account to guide further research on the clinical application of AF-based therapy. We hope that this review can provide a framework to identify the challenges of AF-based therapy and help to design future studies to better evaluate AF-based approaches for the treatment and/or prevention of NEC in PIs and VLBWIs.
坏死性小肠结肠炎（NEC）是一种常见且可能致命的疾病，通常影响早产儿（PI）和极低出生体重儿（VLBWI）。尽管对NEC已进行了广泛研究，但目前的治疗方法并不令人满意。由于人羊水（AF）和人母乳（BM）的成分相似，而母乳在PI和VLBWI的NEC发展中起保护作用，因此推测AF对NEC的结局具有类似影响及潜在治疗意义。AF长期以来一直用于诊断目的，出生后常作为“生物废物”被丢弃。然而，研究人员已开始阐明其治疗潜力。动物模型的实验研究表明，各种器官系统疾病可能受益于基于AF的治疗。因此，我们确定了三种方法，它们在预防和/或治疗NEC的未来临床应用中显示出有希望的结果：（1）给予从供体母亲分离的加工羊水（PAF），（2）给予羊水干细胞（AFSC），以及（3）给予模拟羊水（SAF），其配方旨在模拟生理羊水的成分。我们强调了指导基于AF的治疗临床应用的进一步研究应考虑的最重要方面。我们希望这篇综述能够提供一个框架，以识别基于AF的治疗的挑战，并有助于设计未来的研究，以更好地评估基于AF的方法在PI和VLBWI中治疗和/或预防NEC的效果。
