Robertson Katharina M, Cermack Katherine, Woodruff Talia, Carter Stewart R, Jala Venkatakrishna Rao, Buonpane Christie
Division of Pediatric Surgery, Norton Children's Hospital/University of Louisville, Louisville, KY, USA.
Pediatric Research Institute, Department of Pediatrics, University of Louisville, Louisville, KY, USA.
Gut Microbes. 2025 Dec;17(1):2551117. doi: 10.1080/19490976.2025.2551117. Epub 2025 Aug 31.
Preterm birth interrupts the development of the human gastrointestinal tract, resulting in an immature permeable gut barrier with increased risk of intestinal pathology, such as necrotizing enterocolitis (NEC). The gut microbiota metabolize dietary components into bioactive metabolites that play a crucial role in maintaining intestinal homeostasis. While the roles of microbial metabolites have been studied in relation to adult gastrointestinal diseases, their specific impact on preterm infants remains unexplored. This review aims to identify how microbial metabolites interact with the developing gut barrier in preterm infants, focusing on their role in gut inflammation and NEC. Metabolites include short-chain and conjugated fatty acids, indole derivatives, bile acids, polyamines, and polyphenolic compounds. An overview of the unique features of the premature gut barrier physiology is provided, including perinatal developmental changes in cellular structure, cell junctions, and the gut microbiome. Potential benefits and molecular mechanisms of microbial metabolites in the premature intestine and environmental factors responsible for NEC are discussed. In summary, microbiome-derived mediators have the potential to strengthen preterm gut barrier integrity and alleviate inflammatory stress. Further research may reveal clinically relevant preventative or therapeutic treatment targets for NEC in preterm infants.
早产会中断人类胃肠道的发育,导致肠道屏障不成熟且具有渗透性,增加肠道病变的风险,如坏死性小肠结肠炎(NEC)。肠道微生物群将膳食成分代谢为生物活性代谢物,这些代谢物在维持肠道内环境稳定方面发挥着关键作用。虽然微生物代谢物在成人胃肠道疾病方面的作用已得到研究,但其对早产儿的具体影响仍未得到探索。本综述旨在确定微生物代谢物如何与早产儿发育中的肠道屏障相互作用,重点关注它们在肠道炎症和NEC中的作用。代谢物包括短链脂肪酸和共轭脂肪酸、吲哚衍生物、胆汁酸、多胺和多酚类化合物。本文概述了早产肠道屏障生理学的独特特征,包括围产期细胞结构、细胞连接和肠道微生物群的发育变化。讨论了微生物代谢物在早产肠道中的潜在益处和分子机制以及导致NEC的环境因素。总之,微生物群衍生的介质有可能加强早产肠道屏障的完整性并减轻炎症应激。进一步的研究可能会揭示针对早产儿NEC的临床相关预防或治疗靶点。
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