Circulating Pro- and Counterinflammatory Cytokine Levels and Severity in Necrotizing Enterocolitis

Edelson, Mary B.; Bagwell, Charles E.; Rozycki, Henry J.

doi:10.1542/peds.103.4.766

Cited by 226 publications

(168 citation statements)

References 26 publications

Supporting

Mentioning

157

Contrasting

Unclassified

Order By: Relevance

“…Identification of a biological marker for early disease should allow more timely diagnosis and treatment, but no ideal marker has yet been identified. The serum of symptomatic infants tends to contain high concentrations of certain cytokines such as interleukin-8 (IL-8) [15] . Some studies suggest that serum concentrations of fatty acid binding protein in the intestine and liver (I-FABP and L-FABP) could also be used as markers for NEC [16,17] .…”

Section: Diagnostic Methodsmentioning

confidence: 99%

“…In fact, intraperitoneal IL-10 injections in a mouse model of ischemia/reperfusion injury reduced local and systemic inflammatory reactions [126] . Edelson [15] noticed significantly increased concentrations of IL-10 with severe NEC. IL-10 has also been shown to decrease the production of metalloproteinases [127] and suppress iNOS mRNA and NO expression in small bowel, liver and serum [128] .…”

Section: Il-4mentioning

confidence: 97%

“…Elevated IL-1β has been detected in full thickness specimens of NEC intestine [101] . Studies measuring plasma/serum IL-1β in NEC babies have not consistently reported elevated levels [15] . The difference in results may suggest that IL-1β is more predominant in the intestinal tissue in patients with NEC.…”

Section: Il-1βmentioning

confidence: 98%

See 2 more Smart Citations

Necrotizing enterocolitis: A multifactorial disease with no cure

Schnabl

Aerde²,

Thomson³

et al. 2008

WJG

157

120

View full text Add to dashboard Cite

INTRODUCTIONNecrotizing enterocolitis (NEC) is an inflammatory bowel disease of neonates and remains one of the most common gastrointestinal emergencies in newborn infants [1] . Onset of NEC is often within the first three months of life and neonates who are of extremely low birth weight (< 1000 g) and under 28 wk gestation are the most susceptible [2] . Full term neonates account for 10% of all NEC cases while premature infants account for 90% [3] . With an incidence rate of 1%-5% for all newborns admitted to the NICU [1] , a prevalence of 7%-14% of very low birth weight infants (VLBW, 500-1500 g) [4] and a mortality rate approaching 20%-50% [5] , NEC continues to represent a significant clinical problem. In Canada, the incidence rate is 1.8 per 100 live births with a prevalence of 7% of VLBW infants [1] . Advances in obstetric and neonatal care have improved survival rates for smaller, more immature infants, and as more VLBW preterm infants survive the neonatal period, the population at risk for NEC increases [1] .No consistent association between sex, race, and rates of NEC has been identified. However, male VLBW infants and black infants are at greater risk of death [6] . Due to inadequate treatments and no effective preventative strategy, an estimated 20%-40% of babies with NEC require surgery [1] and 10%-30% experience significant morbidity including neurodevelopmental impairment, vision and hearing impairment, failure to thrive, feeding abnormalities, diarrhea, bowel obstruction, and short bowel syndrome [1,2,7] . The case fatality rate with surgical intervention is as high as 50% [1] . NEC is also a financial burden to the health care system with yearly hospital charges reported to be as high as $6.5 million in the US [8] . Thus, NEC continues to be an important health issue for preterm neonates. DIAGNOSIS Clinical signs and symptomsThe onset of NEC can occur suddenly within a few AbstractNecrotizing enterocolitis is an inflammatory bowel disease of neonates with significant morbidity and mortality in preterm infants. Due to the multifactorial nature of the disease and limitations in disease models, early diagnosis remains challenging and the pathogenesis elusive. Although preterm birth, hypoxic-ischemic events, formula feeding, and abnormal bacteria colonization are established risk factors, the role of genetics and vasoactive/inflammatory mediators is unclear. Consequently, treatments do not target the specific underlying disease processes and are symptomatic and surgically invasive. Breast-feeding is the most effective preventative measure. Recent advances in the prevention of necrotizing enterocolitis have focused on bioactive nutrients and trophic factors in human milk. Development of new disease models including the aspect of prematurity that consistently predisposes neonates to the disease with multiple risk factors will improve our understanding of the pathogenesis and lead to discovery of innovative therapeutics.

show abstract

Section: Diagnostic Methodsmentioning

confidence: 99%

Section: Il-4mentioning

confidence: 97%

See 1 more Smart Citation

Necrotizing enterocolitis: A multifactorial disease with no cure

Schnabl

Aerde²,

Thomson³

et al. 2008

WJG

157

120

View full text Add to dashboard Cite

show abstract

“…Inflammatory mediators implicated in NEC pathogenesis include platelet-activating factor (PAF), tumour necrosis factor (TNF-) and pro-inflammatory cytokines such as IL-6, IL-8 and IL-12 (Edelson et al, 1999).…”

Section: Necrotising Enterocolitismentioning

confidence: 99%

The Role of Intestinal Barrier Function in Early Life in the Development of Colitis

Anderson¹,

Dalziel²,

Gopal³

et al. 2012

Colitis

View full text Add to dashboard Cite

“…In animal studies acetic and butyric acids have been shown to induce intestinal mucosal injury similar to NEC pathology in preterm infants [14,15] . Several groups have investigated the role of cytokines in the development, progression and severity of NEC [16][17][18] . Others have found that there is an alteration of intestinal bacterial colonization and lack of bacterial diversity in infants with NEC leading to a loss or suppression of healthy bacterial flora [19][20][21] .…”

Section: Discussionmentioning

confidence: 99%

Case reports: necrotizing enterocolitis

Cerone

Munshi

Clark

2014

CRCP

View full text Add to dashboard Cite

Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency and cause of significant morbidity and mortality in preterm infants. The typical presentation is that of a preterm infant beyond first week of age on substantial enteral feeding who suddenly presents with gastrointestinal symptoms. The diagnosis of NEC is confirmed by abdominal x-ray findings. The precise mechanism for initiation of the inflammatory cascade in NEC is still unknown; two major risk factors are prematurity and advancing enteral feeds. Less commonly it can occur in term or preterm infants, without being fed, who have suffered a hypoxic ischemic injury to the intestine. In either case, there is intestinal wall inflammation with necrosis and sub-mucosal gas formation. The severity of inflammation and extent of bowel involvement is variable resulting in a spectrum from medically managed NEC to surgical NEC or profoundly unstable, metabolic acidosis and death. Early recognition, bowel rest, antimicrobial therapy, periodic radiological evaluation, supportive therapy of fluids, electrolytes and nutrition are the mainstays of management. We present 3 cases of NEC in preterm infants with varying degree of severity and different outcomes.

show abstract

Circulating Pro- and Counterinflammatory Cytokine Levels and Severity in Necrotizing Enterocolitis

Cited by 226 publications

References 26 publications

Necrotizing enterocolitis: A multifactorial disease with no cure

Necrotizing enterocolitis: A multifactorial disease with no cure

The Role of Intestinal Barrier Function in Early Life in the Development of Colitis

Case reports: necrotizing enterocolitis

Contact Info

Product

Resources

About