Pathogenesis of Necrotising Enterocolitis Associated with Faecal Microbiome among Preterm Infants: A Review
DOI:
https://doi.org/10.47430/ujmr.1942.010Keywords:
Faecal Microbiome,, Gastrointenstinal Necrotizing Enterocolitis,, Preterm,, PathogenesisAbstract
Necrotizing enterocolitis (NEC) is primarily a disease process of the gastrointestinal (GI) tract of premature neonates that results in inflammation and bacterial invasion of the bowel wall. It is the most common gastrointestinal (GI) emergency in neonatal intensive care units (NICUs), making it one of the leading causes of long-term disability in preterm infants. Despite advances in the care of premature infants, NEC remains one of the leading causes of morbidity and mortality in this population. It occurs in 1-5% of all neonatal intensive care admissions and 5-10% of all very low birth weight (<1500 g) infants. Necrotizing enterocolitis (NEC) is primarily a disease of premature infants, but may also be present in 10% of term and near term babies. Preterm infants show delayed colonization by “healthy commensal” organisms, especially bifidobacteria and lactobacilli. Data suggest that low colonization of Bifidobacterium and Lactobacillus in preterm Very Low Birth Weight (VLBW) infants may serve as a predisposing factor in microbial infection and NEC. The presence of a higher proportion of Proteobacteria has an association with faecal microbiome among preterm infants. Thus, the focus of this review is to provide an in-depth summary of the current knowledge regarding its association with faecal microbiome among preterm infants. Different search engines were carefully employed in analyzing scientific articles, journals, and online published data. Preventing NEC is instrumental in decreasing the morbidity and mortality from this gastrointestinal emergency. Human milk (breastfeeding) has been proved to be protective against NEC likewise probiotic supplementation has reduced both incidence and severity of necrotising enterocolitis in preterm neonates. Also, the intervention of surgery, laparotomy andthe use of stem cells in clinical neonatology is therapeutic options with huge potential.With its multifactorial pathogenesis, disease prevention remains a challenge, although, probiotic supplementation has reduced both incidence and severity of necrotising enterocolitis in preterm neonates.
Downloads
References
Abdulkadir, B., Aisha, A., Hayatudeen, M.R., Musa S. K., Abdullahi, S., Sani, A., Baha'uddeen, S. D.(2018). The Impact of Probiotics as Dietary Supplementation In The
Abdulkadir, B., Nelson, A., Skeath, T., Marrs, E.C.L., Perry, J.D., Cummings, S.P. (2016). Stool bacterial load in preterm infants with necrotising enterocolitis. Early Hum Dev.95:1-2.
https://doi.org/10.1016/j.earlhumdev.2016.01.018
Ahn, S.Y.,Chang, Y.S., Sung, D.K., Sung, S.I., Ahn,J.Y., Park,W.S (2017). Pivotal Role of Brain-Derived Neutrophic Factor Secreted by Mesenchymal Stem Cells in Severe Intraventrucular Hemorrhage in Newborn Rats. Cell Transplant. 26(1):145-156.
https://doi.org/10.3727/096368916X692861
Arboleya, S, Ang, L.,, Margolles, A., Yiyuan, L., Dongya, Z., Liang, X., Solís, G., Fernández, N., de Los Reyes-Gavilán, C.G., Gueimonde, M. (2012).Deep 16S rRNA metagenomics and quantitative PCR analyses of the premature infant fecal microbiota. Anaerobe Journal.18:378-80.
https://doi.org/10.1016/j.anaerobe.2012.04.013
Barron, L.K., Warner, B.B., Tarr, P.I., Shannon, W.D., Deych, E., Warner, B.W. (2017). Independence of gut bacterial content and neonatal necrotizing enterocolitis severity. J Pediatr Surg. Jun; 52(6):993-998. .
https://doi.org/10.1016/j.jpedsurg.2017.03.029
Blakely, M.L., Tyson, J.E., Lally, K.P. (2006). Laparotomy versus peritoneal drainage for necrotizing enterocolitis or isolated intestinal perforation in extremely low birth weight infants: outcomes through 18 months adjusted age. Pediatrics Journal. 117(4):e680-e687.
https://doi.org/10.1542/peds.2005-1273
Claud, E.C, Savidge, T., Walker, W.A. (2003). Modulation of human intestinal epithelial cell IL-8 secretion by human milk factors. Pediatr Res.53(3):419-425.
https://doi.org/10.1203/01.PDR.0000050141.73528.AD
Cloherty, J.P., Eichenwald, E.C., Stark, A.R. (2012). Manual of neonatal care. 7th edition. Philadelphia: Lippincott Williams and Wilkins; 340-349.
Diego, F.N., Chhinder, P. S., David, J.H. (2016). Necrotizing enterocolitis: new insights into pathogenesis and mechanisms. Nature Reviews Gastroenterology & HepatologyJournal13, 590-600.
https://doi.org/10.1038/nrgastro.2016.119
Erika, C.C (2009). Necrotizing Enterocolitis. In: Walker G, Kleinman S, Shneider S, editors. Pediatric Gastrointestinal Disease Pathophysiology, Diagnosis, Management. 4. BC Decker;Cananda.
Frank, D.N., Pace, N.R. (2008). Gastrointestinal microbiology enters the metagenomics era. CurrOpinGastroenterol24: 4-10.
https://doi.org/10.1097/MOG.0b013e3282f2b0e8
Gionchetti, P., Rizzello, F., Venturi, A., Campieri, M. (2000). Probiotics in infective diarrhoea and inflammatory bowel diseases. J GastroenterolHepatol.; 15(5):489-493.
https://doi.org/10.1046/j.1440-1746.2000.02162.x
Hintz, S.R., Kendrick, D.E, Stoll, B.J. (2005). Neurodevelopmental and growth outcomes of extremely low birth weight infants after necrotizing enterocolitis; J PediatrP115:696-703
https://doi.org/10.1542/peds.2004-0569
Jacquot, A., Neveu, D., Aujoulat, F. (2011). Dynamics and clinical evolution of bacterial gut microflora in extremely premature patients. J Pediatr;158(3):390-396.
https://doi.org/10.1016/j.jpeds.2010.09.007
Kastenberg, Z.J. and Sylvester, K.G. (2013). The surgical management of necrotizing enterocolitis. ClinPerinatol.40(1):135-148.
https://doi.org/10.1016/j.clp.2012.12.011
La Rosa, P.S., Warner, B.B., Zhou, Y., Weinstock, G.M., Sodergren, E., Hall-Moore, C.M., Stevens, H.J., Bennett, W.E., Shaikh, N., Linneman, L.A., Hoffmann ,J.A., Hamvas, A., Deych, E.,Shands, B.A., Shannon,W.D., Tarr, P.I.(2014). Patterned progression of bacterial populations in the premature infant gut. Proc Natl AcadSci U S A. 111:12522-7.
https://doi.org/10.1073/pnas.1409497111
Leaphart, C. L., Cavallo, J., Gribar, S. C. (2007). A critical role for TLR4 in the pathogenesis of necrotizing enterocolitis by modulating intestinal injury and repair. Journal of Immunology, 179:7 4808-4820
https://doi.org/10.4049/jimmunol.179.7.4808
Lijuan, W. and Hung-Chih, L. (2015). Role of Intestinal Microflora on Necrotizing Enterocolitis in Preterm Infants. J PediatrBiochem; 5:55-59.
Lin, J. (2004). Too much short chain fatty acids cause neonatal necrotizing enterocolitis. Med Hypotheses. 62(2):291-293.
https://doi.org/10.1016/S0306-9877(03)00333-5
Lin, P.W., Stoll, B.J (2006). Necrotizing enterocolitis. Lancet Journal. 368(9543):1271-1283.
https://doi.org/10.1016/S0140-6736(06)69525-1
Lu, P., Sodhi, C.P., Jia, H., Shaffiey, S., Good, M., Branca, M.F., Hackam, D.J. (2014) Animal models of gastrointestinal and liver diseases. Animal models of necrotizing enterocolitis:pathophysiology, translational relevance, and challenges. Am J Physiol Gastrointest Liver Physiol.;306:G917-G928.
https://doi.org/10.1152/ajpgi.00422.2013
Meha, T., Jaiswal, A.K., Raja, A., Sinha, A.K. (2016). Role of oral probiotics in prevention of necrotising enterocolitis in preterm neonates in a tertiary care centre in Northern India. Int J Contemp Pediatr. 3:1293-6.
https://doi.org/10.18203/2349-3291.ijcp20163663
Meinzen-Derr, J., Poindexter, B., Wrage, L., Morrow, A.L., Stoll, B., Donovan, E.F., (2009). Role of human milk in extremely low birth weight infants' risk of necrotizing enterocolitis or death.J Perinatol. ;29(1):57-62.
https://doi.org/10.1038/jp.2008.117
Melissa, D.H. and Patricia, W.D. (2015). The role of intestinal epithelial barrier function in the development of NEC. Tissue Barriers. 3:1-2, e1000707.
https://doi.org/10.1080/21688370.2014.1000707
Ng, P.C., Lam, H.S. (2012). Biomarkers in neonatology: the next generation of test. Neonatology Journal. 102(2):145-151.
https://doi.org/10.1159/000338587
Ozdemir, R., Yurttutan, S., Sari. F.N. (2012). Antioxidant effectsof N-acetylcysteine in a neonatal rat model of necrotizing enterocolitis. Journal of Pediatric Surgery 47:1652-1657.
https://doi.org/10.1016/j.jpedsurg.2012.02.016
Palmer, C., Bik, E.M., DiGiulio, D.B., D.A. Relman, Brown, P.O. (2007). Development of the human infant intestinal microbiotaPLoSBiol,5 (7) pp. 1556-1573.
https://doi.org/10.1371/journal.pbio.0050177
Puja, S. and Pierre, F. (2012). Necrotising enterocolitis. Continuing Education in anesthesia, Critical Care and Pain. 12 (1).
https://doi.org/10.1093/bjaceaccp/mkr043
Phani, K.Y., Shree, V.R., Andrew, K.E. (2013).Necrotizing Enterocolitis: Current Perspectives. Journal of Research and Reports in Neonatology, 4:31-42.
https://doi.org/10.2147/RRN.S36576
Rich, B.S and Dolgin, S.E (2017). Necrotizing Enterocolitis. Pediatrics in Review. 38 (12): 552-559.
https://doi.org/10.1542/pir.2017-0002
Scott, M.T., Taylor, F., Berryhill, James L. Ellenburg, Tamas J.G.,Dava S.C., Robin G., Colin, A.M. (2015).Pathogenesis of Necrotizing Enterocolitis; Modeling the Innate Immune Response. Am J Pathol . 185 (1).
https://doi.org/10.1016/j.ajpath.2014.08.028
Sharma, R., Hudak, M.L. (2013). A clinical perspective of necrotizing enterocolitis: past, present, and future. ClinPerinatol.40(1):27-51.
https://doi.org/10.1016/j.clp.2012.12.012
Sherman, M.P. (2013). Lactoferrin and Necrotizing Enterocolitis. ClinPerinatol. 40(1):79-91.
https://doi.org/10.1016/j.clp.2012.12.006
Stewart,C.J.,Embleton,N.D.,Marrs,E.C.L.,Smith,D.P.,Nelson,A.,Abdulkadir,B.,Skeath,T.,Petrosino,J.F., Perry, J.D., Berrington, J.E., Cummings, S.P.(2016). Temporal bacterial and metabolic development of the preterm gut reveals specific signatures in health and diseases. BioMed Central Microbiome.4:67.
https://doi.org/10.1186/s40168-016-0216-8
Sullivan, S., Schanler, R.J., Kim, J.H. (2010). An exclusively human milk-based diet is associated with a lower rate of necrotizing enterocolitis than a diet of human milk and bovine milk-based products. J Pediatr156(4):562.e1-567.
https://doi.org/10.1016/j.jpeds.2009.10.040
Tepas, J.J., Sharma, R., Leaphart, C.L. (2010). Timing of surgical intervention in necrotizing enterocolitis can be determined by trajectory of metabolic derangement. J Pediatr Surg.45(2):310-313.
https://doi.org/10.1016/j.jpedsurg.2009.10.069
Terrin, G., Scipione, A., De Curtis, M. (2014). Update in pathogenesis and prospective in treatment of necrotizing enterocolitis. BioMed research international.2014:543765.
https://doi.org/10.1155/2014/543765
Thompson, A.J and Bizarro, M.J (2008). Necrotizing enterocolitis in newborns: pathogenesis, prevention and management. US National Library of Medicine National Institutes of HealthPubmed. 68(9):1227-38.
https://doi.org/10.2165/00003495-200868090-00004
Torrazza, R.M., Li, N., Neu, J.(2014). Decoding the enigma of necrotizing enterocolitis in premature infants. Pathophysiology21:21-27.
https://doi.org/10.1016/j.pathophys.2013.11.011
Tran, L., Ferris, M., Norris, J. (2013). Necrotizing enterocolitis and cytomegalovirus infection in a premature infant. Pediatrics Journal, vol. 131, no. 1, pp. e318-e322, 2013.
https://doi.org/10.1542/peds.2011-1971
Troy, A.M., Holly, E., Brenda, B.P. (2014). Predicting disease severity of necrotizing enterocolitis: How to identify infants for future novel therapies. (3) 1 pp 1.
https://doi.org/10.4103/2249-4847.128717
Turnbaugh, P.J, Ley, R.E., Hamady, M., Fraser-Liggett, C.M., Knight, R. (2007). The human microbiome project. Nature 449: 804-810.
https://doi.org/10.1038/nature06244
Vongbhavit, K. and Underwood, M.A.(2016). Prevention of necrotizing enterocolitis through manipulation of the intestinal microbiota of the premature infant. ClinTher. 38:716-32.
https://doi.org/10.1016/j.clinthera.2016.01.006
Wang, Y., Hoenig, J.D., Malin, K.J, Qamar, S., Petrof, E.O., Su, J, Antonopoulos, D.A, Chang, E.B., Claud, E.C. (2009). 16S rRNA gene-based analysis of fecal microbiota from preterm infants with and without necrotizing enterocolitis. ISME J.3(8):944-954.
https://doi.org/10.1038/ismej.2009.37
Yang, Y., Guo, Y., Kan, Q., Zhou, X.G., Zhou, X.Y., Li, Y. (2014). A meta-analysis of probiotics for preventing necrotizing enterocolitis in preterm neonates. Braz J Med Biol Res.47(9):804-10.
https://doi.org/10.1590/1414-431X20143857
Zhang, H.Y., Wang, F., Feng, J.X.(2013). Intestinal microcirculatory dysfunction and neonatal necrotizing enterocolitis. Chinese Medical Journal.126(9) 1771-1778.
Ziegler, E.E. and Carlson, S.J. (2009). Early nutrition of very low birth weight infants. J. Matern Fetal Neonatal. Med.22 (3): 191-7.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 UMYU Journal of Microbiology Research
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
