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坏死性小肠结肠炎:从实验台到病床旁的方法及增进我们对疾病发病机制的理解

Necrotizing enterocolitis: Bench to bedside approaches and advancing our understanding of disease pathogenesis.

作者信息

Singh Dhirendra K, Miller Claire M, Orgel Kelly A, Dave Mili, Mackay Stephen, Good Misty

机构信息

Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.

University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States.

出版信息

Front Pediatr. 2023 Jan 11;10:1107404. doi: 10.3389/fped.2022.1107404. eCollection 2022.

Abstract

Necrotizing enterocolitis (NEC) is a devastating, multifactorial disease mainly affecting the intestine of premature infants. Recent discoveries have significantly enhanced our understanding of risk factors, as well as, cellular and genetic mechanisms of this complex disease. Despite these advancements, no essential, single risk factor, nor the mechanism by which each risk factor affects NEC has been elucidated. Nonetheless, recent research indicates that maternal factors, antibiotic exposure, feeding, hypoxia, and altered gut microbiota pose a threat to the underdeveloped immunity of preterm infants. Here we review predisposing factors, status of unwarranted immune responses, and microbial pathogenesis in NEC based on currently available scientific evidence. We additionally discuss novel techniques and models used to study NEC and how this research translates from the bench to the bedside into potential treatment strategies.

摘要

坏死性小肠结肠炎(NEC)是一种主要影响早产儿肠道的毁灭性多因素疾病。最近的发现显著增进了我们对这种复杂疾病的风险因素以及细胞和遗传机制的理解。尽管有这些进展,但尚未阐明任何关键的单一风险因素,也未阐明每个风险因素影响NEC的机制。然而,最近的研究表明,母亲因素、抗生素暴露、喂养、缺氧和肠道微生物群改变对早产儿未发育成熟的免疫力构成威胁。在此,我们根据现有科学证据综述NEC的易感因素、不必要免疫反应的状态以及微生物发病机制。我们还将讨论用于研究NEC的新技术和模型,以及这项研究如何从实验室转化为床边的潜在治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da73/9874231/565d18f421ac/fped-10-1107404-g001.jpg

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