Necrotizing enterocolitis: current concepts of etiopathogenesis with an emphasis on microbiome and metabolomics

Authors / Institutions

Natal'ya A. Petrova / V.A.Almazov Federal Medical Research Centre, St.Petersburg, Russian Federation

Alexandra V. Kaplina / V.A.Almazov Federal Medical Research Centre, St.Petersburg, Russian Federation

Anatoliy I. Khavkin / Research Clinical Institute of Childhood, Ministry of Health of the Moscow Region, Moscow, Russian Federation / Belgorod State National Research University, Belgorod, the Russian Federation

Tatyana М. Pervunina / V.A.Almazov Federal Medical Research Centre, St.Petersburg, Russian Federation

Eduard V.Komlichenko / V.A.Almazov Federal Medical Research Centre, St.Petersburg, Russian Federation

Vladimir G. Nikiforov / V.A.Almazov Federal Medical Research Centre, St.Petersburg, Russian Federation

Stanislav I. Sitkin / State Research Institute of Highly Pure Biological Products of the Federal Medical and Biological Agency, Saint Petersburg, Russian Federation

Necrotizing enterocolitis (NEC) develops primarily in premature infants and is characterized by high mortality. The most significant factors of NEC pathogenesis are gut dysbiosis, bottle feeding, and excessive inflammation. The intestinal microbiota of premature infants is characterized by lower bacterial diversity, increased proportion of potentially pathogenic microorganisms (such as Proteobacteria, Enterobacteriaceae), and decreased abundance of anti-inflammatory commensal bacteria. Molecular mechanisms of NEC pathogenesis and intestinal dysbiosis involve immune disorders, including excessive TLR4 signaling in response to bacterial lipopolysaccharides, as well as metabolic dysfunction associated with prematurity, enteral nutrition, and changes in the functional activity of the microbiota. Comprehensive pathophysiological mechanisms underlying NEC require innovative approaches to their investigation, such as metagenomics, metabolomics, and proteomics. Identification of potential biomarkers of NEC development and progression using omics technologies is one of the most promising methods to study this pathological condition.
Key words: biomarkers, gut dysbiosis, metabiotics, metabolomics, metagenomics, microbiome, necrotizing enterocolitis, probiotics, proteomics, etiopathogenesis
For citation: Petrova N.A., Kaplina A.V., Khavkin A.I., Pervunina T.M., Komlichenko E.V., Nikiforov V.G., Sitkin S.I. Necrotizing enterocolitis: current concepts of etiopathogenesis with an emphasis on microbiome and metabolomics. Vopr. prakt. pediatr. (Clinical Practice in Pediatrics). 2021; 16(4): 98–105. (In Russian). DOI: 10.20953/1817-7646-2021-4-98-105