Clinical and microbiological pathogenetic parallels with necrotizing enterocolitis in preterm infants Evidence-based prevention opportunities

Abstract

There are summarized data of domestic and foreign publications on the issue of necrotizing enterocolitis (NEC) in children born prematurely. There is presented the trend of the prevalence of this pathology in the last decade, especially epidemiology and significance of NEC in the structure of perinatal morbidity and mortality. There were analyzed new concepts on etiology and pathogenesis of the disease. In recent years, there was descripted the key role of some risk factors for the development of NEC - immatureness of intestinal barrier functions, local and systemic immunity, reduced tolerance to enteral nutrition (especially in the absence of breast-feeding), inadequate microbial colonization of the immature gastrointestinal tract. Modern research methods allow us to decipher subtle mechanisms of activation of the cascade of the intestinal inflammation and breakdown of the immune defense mechanisms. There are established cellular and humoral compartments of the immune response in NEC; there were revealed typical deviations in intestinal microbiota. The investigation of etiopathogenetical NEC factors is the basis for the development of targeted methods of the prevention and treatment of this severe disease in premature infants, including with the use of probiotics. There are presented data that the use of probiotics significantly reduces the incidence of severe NEC and mortality risk from NEC.