Willem Alexander Children's Hospital, Division of Neonatology, Department of Pediatrics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands.
Willem Alexander Children's Hospital, Laboratory for Pediatric Immunology, Department of Pediatrics, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands.
Int J Mol Sci. 2022 Sep 18;23(18):10903. doi: 10.3390/ijms231810903.
Necrotizing enterocolitis (NEC) is a leading cause of mortality in premature infants. However, the pathophysiology and influence of regulatory T cells (Tregs) have not been sufficiently elucidated. We performed a scoping review to investigate current knowledge on the influence of Tregs in NEC, and to investigate the predictive value of Treg number in NEC development. Pubmed, Embase, Prospero and Cochrane Library were searched during December 2020. Primary research articles discussing Tregs and NEC development written in English were selected. Two reviewers screened title and abstract for relevance, after which full-text screening was performed. A total of 20 articles were selected-13 of the articles discussed studies performed in animal models, while 8 used human neonate data. One study discussed both animal and human data. It was shown that after NEC diagnosis or induction, Treg levels were decreased while Th17 levels were increased. No studies were found which investigated the predictive value of Treg number in NEC development. A reduced Treg level is found in animals and neonates with NEC. The question remains whether this effect is a factor on the causal pathway of NEC development or a bystander effect. Future research focusing on the pathophysiological timeline of NEC and the involvement of Tregs is required for better understanding of this disease.
坏死性小肠结肠炎（NEC）是早产儿死亡的主要原因。然而，其病理生理学和调节性 T 细胞（Tregs）的影响尚未得到充分阐明。我们进行了范围性综述，以调查 Tregs 在 NEC 中的影响的现有知识，并研究 Treg 数量对 NEC 发展的预测价值。于 2020 年 12 月在 Pubmed、Embase、Prospero 和 Cochrane Library 进行了检索。选择了以英文撰写、讨论 Tregs 和 NEC 发展的原始研究文章。两位审查员筛选了标题和摘要的相关性，然后进行了全文筛选。共选择了 20 篇文章-其中 13 篇文章讨论了在动物模型中进行的研究，而 8 篇文章使用了人类新生儿数据。有一项研究同时讨论了动物和人类的数据。结果表明，在 NEC 诊断或诱导后，Treg 水平降低，而 Th17 水平升高。未发现研究调查 Treg 数量对 NEC 发展的预测价值。在患有 NEC 的动物和新生儿中发现 Treg 水平降低。问题仍然是这种效应是 NEC 发展的因果途径的一个因素还是旁观者效应。需要进一步研究 NEC 的病理生理时间进程和 Tregs 的参与，以更好地理解这种疾病。
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