TY - JOUR
T1 - Enteral Feeding Interventions in the Prevention of Necrotizing Enterocolitis
T2 - A Systematic Review of Experimental and Clinical Studies
AU - de Lange, Ilse H.
AU - van Gorp, Charlotte
AU - Eeftinck Schattenkerk, Laurens D.
AU - van Gemert, Wim G.
AU - Derikx, Joep P. M.
AU - Wolfs, Tim G. A. M.
N1 - Funding Information:
Funding: This research received no external funding. It was internally funded by the funded by the NUTRIM Graduate Programme (grant to I.H.d.L.)
Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021/5
Y1 - 2021/5
N2 - Necrotizing enterocolitis (NEC), which is characterized by severe intestinal inflammation and in advanced stages necrosis, is a gastrointestinal emergency in the neonate with high mortality and morbidity. Despite advancing medical care, effective prevention strategies remain sparse. Factors contributing to the complex pathogenesis of NEC include immaturity of the intestinal immune defense, barrier function, motility and local circulatory regulation and abnormal microbial colonization. Interestingly, enteral feeding is regarded as an important modifiable factor influencing NEC pathogenesis. Moreover, breast milk, which forms the currently most effective prevention strategy, contains many bioactive components that are known to support neonatal immune development and promote healthy gut colonization. This systematic review describes the effect of different enteral feeding interventions on the prevention of NEC incidence and severity and the effect on pathophysiological mechanisms of NEC, in both experimental NEC models and clinical NEC. Besides, pathophysiological mechanisms involved in human NEC development are briefly described to give context for the findings of altered pathophysiological mechanisms of NEC by enteral feeding interventions.
AB - Necrotizing enterocolitis (NEC), which is characterized by severe intestinal inflammation and in advanced stages necrosis, is a gastrointestinal emergency in the neonate with high mortality and morbidity. Despite advancing medical care, effective prevention strategies remain sparse. Factors contributing to the complex pathogenesis of NEC include immaturity of the intestinal immune defense, barrier function, motility and local circulatory regulation and abnormal microbial colonization. Interestingly, enteral feeding is regarded as an important modifiable factor influencing NEC pathogenesis. Moreover, breast milk, which forms the currently most effective prevention strategy, contains many bioactive components that are known to support neonatal immune development and promote healthy gut colonization. This systematic review describes the effect of different enteral feeding interventions on the prevention of NEC incidence and severity and the effect on pathophysiological mechanisms of NEC, in both experimental NEC models and clinical NEC. Besides, pathophysiological mechanisms involved in human NEC development are briefly described to give context for the findings of altered pathophysiological mechanisms of NEC by enteral feeding interventions.
KW - BIRTH-WEIGHT INFANTS
KW - ENDOPLASMIC-RETICULUM STRESS
KW - EPIDERMAL-GROWTH-FACTOR
KW - EXTREMELY PRETERM INFANTS
KW - INTESTINAL BARRIER DYSFUNCTION
KW - NEONATAL-RAT MODEL
KW - NITRIC-OXIDE SYNTHASE
KW - ORAL GLUTAMINE SUPPLEMENTATION
KW - PLATELET-ACTIVATING-FACTOR
KW - REUTERI DSM 17938
KW - enteral nutrition
KW - inflammation
KW - intestinal barrier function
KW - microbial colonization
KW - necrotizing enterocolitis
U2 - 10.3390/nu13051726
DO - 10.3390/nu13051726
M3 - (Systematic) Review article
C2 - 34069699
SN - 2072-6643
VL - 13
JO - Nutrients
JF - Nutrients
IS - 5
M1 - 1726
ER -