The pathogenesis of necrotizing enterocolitis (NEC) is severe inflammatory injury in preterm infants, which resulted from macrophage polarization. Nuclear factor‐κB (NF‐κB) is implicated to be involved in macrophage polarization. We here evaluated the essential role of NF‐κB in macrophage polarization in NEC in human samples from neonates with NEC and the mouse experimental NEC model. Enhanced intestinal macrophage (IM) infiltration was presented in human neonates with NEC, the majority of which were M1 macrophages. Meanwhile, NF‐κB was activated in the IMs in human NEC samples. NF‐κB inhibition by BAY promoted the M1 to M2 macrophage polarization. Furthermore, glutaredoxin‐1 (Grx1) deficiency promoted M2 polarization via NF‐κB inactivation from the lipopolysaccharide‐induced proinflammatory macrophages. The IMs isolated from Grx1−/− mice presented with decreases in total numbers and less macrophage differentiation. Grx1−/− derived IM were effective in the increased survival in experimental NEC through inflammation blocking. Our study provides evidence that NF‐κB inactivation by Grx1 depletion contributed to the alleviation of NEC via inhibiting M1 macrophage polarization. The modulation to alternative macrophages in the intestines may provide a promising benefits for NEC treatment.
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