Necrotizing enterocolitis - bench to bedside: novel and emerging strategies

Yigit S. Guner, Nikunj Chokshi, Mikael Petrosyan, Jeffrey S. Upperman, Henri Ford, Tracy C. Grikscheit

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Necrotizing enterocolitis (NEC) is a devastating illness that predominantly affects premature neonates. The mortality associated with this disease has changed very little during the last two decades. Neonates with NEC fall into two categories: those who respond to medical management alone and those who require surgical treatment. The disease distribution may be focal, multifocal, or panintestinal. Surgical treatment should therefore be based on disease presentation. Recent studies have added significant insight into our understanding of the pathogenesis of NEC. Several groups have shown that upregulation of nitric oxide plays an integral role in the development of epithelial injury in NEC. As a result, some treatment strategies have been aimed at abrogating the toxic effects of nitric oxide. In addition, several investigators have reported the cytoprotective effect of epidermal growth factor, which is found in high levels in breast milk, on the intestinal epithelium. Thus, fortification of infant formula with specific growth factors could soon become a preferred strategy to accelerate intestinal maturation in the premature neonate to prevent the development of NEC. One of the most devastating complications of NEC is the development of short bowel syndrome (SBS). The current treatment of SBS involves intestinal lengthening procedures or bowel transplantation. A novel emerging method for treating SBS involves the use of tissue-engineered intestine. In laboratory animals, tissue-engineered small intestine has been shown to be successful in treating intestinal failure. This article examines recent data regarding surgical treatment options for NEC as well as emerging treatment modalities.

Original languageEnglish (US)
Pages (from-to)255-265
Number of pages11
JournalSeminars in Pediatric Surgery
Volume17
Issue number4
DOIs
StatePublished - Nov 1 2008
Externally publishedYes

Fingerprint

Necrotizing Enterocolitis
Short Bowel Syndrome
Nitric Oxide
Infant Formula
Poisons
Laboratory Animals
Human Milk
Intestinal Mucosa
Epidermal Growth Factor
Small Intestine
Intestines
Intercellular Signaling Peptides and Proteins
Up-Regulation
Transplantation
Research Personnel
Mortality
Wounds and Injuries

Keywords

  • Enterocolitis
  • Neonate
  • Short bowel syndrome
  • Tissue engineering

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

Cite this

Necrotizing enterocolitis - bench to bedside : novel and emerging strategies. / Guner, Yigit S.; Chokshi, Nikunj; Petrosyan, Mikael; Upperman, Jeffrey S.; Ford, Henri; Grikscheit, Tracy C.

In: Seminars in Pediatric Surgery, Vol. 17, No. 4, 01.11.2008, p. 255-265.

Research output: Contribution to journalArticle

Guner, YS, Chokshi, N, Petrosyan, M, Upperman, JS, Ford, H & Grikscheit, TC 2008, 'Necrotizing enterocolitis - bench to bedside: novel and emerging strategies', Seminars in Pediatric Surgery, vol. 17, no. 4, pp. 255-265. https://doi.org/10.1053/j.sempedsurg.2008.07.004
Guner, Yigit S. ; Chokshi, Nikunj ; Petrosyan, Mikael ; Upperman, Jeffrey S. ; Ford, Henri ; Grikscheit, Tracy C. / Necrotizing enterocolitis - bench to bedside : novel and emerging strategies. In: Seminars in Pediatric Surgery. 2008 ; Vol. 17, No. 4. pp. 255-265.
@article{7ce85e3443384ae297a4222be78642c0,
title = "Necrotizing enterocolitis - bench to bedside: novel and emerging strategies",
abstract = "Necrotizing enterocolitis (NEC) is a devastating illness that predominantly affects premature neonates. The mortality associated with this disease has changed very little during the last two decades. Neonates with NEC fall into two categories: those who respond to medical management alone and those who require surgical treatment. The disease distribution may be focal, multifocal, or panintestinal. Surgical treatment should therefore be based on disease presentation. Recent studies have added significant insight into our understanding of the pathogenesis of NEC. Several groups have shown that upregulation of nitric oxide plays an integral role in the development of epithelial injury in NEC. As a result, some treatment strategies have been aimed at abrogating the toxic effects of nitric oxide. In addition, several investigators have reported the cytoprotective effect of epidermal growth factor, which is found in high levels in breast milk, on the intestinal epithelium. Thus, fortification of infant formula with specific growth factors could soon become a preferred strategy to accelerate intestinal maturation in the premature neonate to prevent the development of NEC. One of the most devastating complications of NEC is the development of short bowel syndrome (SBS). The current treatment of SBS involves intestinal lengthening procedures or bowel transplantation. A novel emerging method for treating SBS involves the use of tissue-engineered intestine. In laboratory animals, tissue-engineered small intestine has been shown to be successful in treating intestinal failure. This article examines recent data regarding surgical treatment options for NEC as well as emerging treatment modalities.",
keywords = "Enterocolitis, Neonate, Short bowel syndrome, Tissue engineering",
author = "Guner, {Yigit S.} and Nikunj Chokshi and Mikael Petrosyan and Upperman, {Jeffrey S.} and Henri Ford and Grikscheit, {Tracy C.}",
year = "2008",
month = "11",
day = "1",
doi = "10.1053/j.sempedsurg.2008.07.004",
language = "English (US)",
volume = "17",
pages = "255--265",
journal = "Seminars in Pediatric Surgery",
issn = "1055-8586",
publisher = "W.B. Saunders Ltd",
number = "4",

}

TY - JOUR

T1 - Necrotizing enterocolitis - bench to bedside

T2 - novel and emerging strategies

AU - Guner, Yigit S.

AU - Chokshi, Nikunj

AU - Petrosyan, Mikael

AU - Upperman, Jeffrey S.

AU - Ford, Henri

AU - Grikscheit, Tracy C.

PY - 2008/11/1

Y1 - 2008/11/1

N2 - Necrotizing enterocolitis (NEC) is a devastating illness that predominantly affects premature neonates. The mortality associated with this disease has changed very little during the last two decades. Neonates with NEC fall into two categories: those who respond to medical management alone and those who require surgical treatment. The disease distribution may be focal, multifocal, or panintestinal. Surgical treatment should therefore be based on disease presentation. Recent studies have added significant insight into our understanding of the pathogenesis of NEC. Several groups have shown that upregulation of nitric oxide plays an integral role in the development of epithelial injury in NEC. As a result, some treatment strategies have been aimed at abrogating the toxic effects of nitric oxide. In addition, several investigators have reported the cytoprotective effect of epidermal growth factor, which is found in high levels in breast milk, on the intestinal epithelium. Thus, fortification of infant formula with specific growth factors could soon become a preferred strategy to accelerate intestinal maturation in the premature neonate to prevent the development of NEC. One of the most devastating complications of NEC is the development of short bowel syndrome (SBS). The current treatment of SBS involves intestinal lengthening procedures or bowel transplantation. A novel emerging method for treating SBS involves the use of tissue-engineered intestine. In laboratory animals, tissue-engineered small intestine has been shown to be successful in treating intestinal failure. This article examines recent data regarding surgical treatment options for NEC as well as emerging treatment modalities.

AB - Necrotizing enterocolitis (NEC) is a devastating illness that predominantly affects premature neonates. The mortality associated with this disease has changed very little during the last two decades. Neonates with NEC fall into two categories: those who respond to medical management alone and those who require surgical treatment. The disease distribution may be focal, multifocal, or panintestinal. Surgical treatment should therefore be based on disease presentation. Recent studies have added significant insight into our understanding of the pathogenesis of NEC. Several groups have shown that upregulation of nitric oxide plays an integral role in the development of epithelial injury in NEC. As a result, some treatment strategies have been aimed at abrogating the toxic effects of nitric oxide. In addition, several investigators have reported the cytoprotective effect of epidermal growth factor, which is found in high levels in breast milk, on the intestinal epithelium. Thus, fortification of infant formula with specific growth factors could soon become a preferred strategy to accelerate intestinal maturation in the premature neonate to prevent the development of NEC. One of the most devastating complications of NEC is the development of short bowel syndrome (SBS). The current treatment of SBS involves intestinal lengthening procedures or bowel transplantation. A novel emerging method for treating SBS involves the use of tissue-engineered intestine. In laboratory animals, tissue-engineered small intestine has been shown to be successful in treating intestinal failure. This article examines recent data regarding surgical treatment options for NEC as well as emerging treatment modalities.

KW - Enterocolitis

KW - Neonate

KW - Short bowel syndrome

KW - Tissue engineering

UR - http://www.scopus.com/inward/record.url?scp=53049101907&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=53049101907&partnerID=8YFLogxK

U2 - 10.1053/j.sempedsurg.2008.07.004

DO - 10.1053/j.sempedsurg.2008.07.004

M3 - Article

C2 - 19019294

AN - SCOPUS:53049101907

VL - 17

SP - 255

EP - 265

JO - Seminars in Pediatric Surgery

JF - Seminars in Pediatric Surgery

SN - 1055-8586

IS - 4

ER -