Division of Pediatric Surgery, Oklahoma Children's Hospital, 1200 Everett Drive, ET NP 2320 Oklahoma City, OK 73104, United States; The University of Oklahoma Health Sciences Center, Department of Surgery, 800 Research Parkway, Suite 449, Oklahoma City, OK 73104, United States.
Division of Pediatric Surgery, Oklahoma Children's Hospital, 1200 Everett Drive, ET NP 2320 Oklahoma City, OK 73104, United States; The University of Oklahoma Health Sciences Center, Department of Surgery, 800 Research Parkway, Suite 449, Oklahoma City, OK 73104, United States.
Semin Pediatr Surg. 2023 Jun;32(3):151310. doi: 10.1016/j.sempedsurg.2023.151310. Epub 2023 Jun 1.
Necrotizing enterocolitis (NEC) is a devastating gastrointestinal disease that affects premature neonates. It frequently results in significant morbidity and mortality for those affected. Years of research into the pathophysiology of NEC have revealed it to be a variable and multifactorial disease. However, there are risk factors associated with NEC including low birth weight, prematurity, intestinal immaturity, alterations in microbial colonization, and history of rapid or formula based enteral feeds (Fig. 1). An accepted generalization of the pathogenesis of NEC includes a hyperresponsive immune reaction to insults such as ischemia, starting formula feeds, or alterations in the microbiome with pathologic bacterial colonization and translocation. This reaction causes a hyperinflammatory response disrupting the normal intestinal barrier, allowing abnormal bacterial translocation and ultimately sepsis. This review will focus specifically on the interactions with the microbiome and intestinal barrier function in NEC.
坏死性小肠结肠炎（NEC）是一种严重的胃肠道疾病，影响早产儿。它经常导致受影响的人出现重大的发病率和死亡率。多年来对 NEC 病理生理学的研究表明，它是一种多变的、多因素的疾病。然而，与 NEC 相关的风险因素包括低出生体重、早产、肠道不成熟、微生物定植改变以及快速或配方喂养的历史（图 1）。对 NEC 发病机制的公认概括包括对诸如缺血、开始配方喂养或微生物组改变等损伤的过度免疫反应，导致病理性细菌定植和易位。这种反应引起过度炎症反应，破坏正常的肠道屏障，允许异常细菌易位并最终导致败血症。本综述将专门关注 NEC 中与微生物组和肠道屏障功能的相互作用。
