The role of human milk in necrotizing enterocolitis.

The role of human milk in necrotizing enterocolitis.
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人乳在坏死性小肠结肠炎中的作用。

DOI:
10.1007/978-1-4615-0559-4_9
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发表时间:
2002
影响因子:
--
通讯作者:
Jilling,Tamas
Jilling,Tamas
中科院分区:
医学4区
文献类型:
--
作者:
Caplan,MichaelS;Amer,Michael;Jilling,Tamas

文献摘要

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坏死性小肠结肠炎(NEC)是早产儿最常见的胃肠道急症,并且在世界范围内造成显著的发病率和死亡率(Kliegman等人,1984; Uauy等人,1991年)。虽然表征这种疾病的肠道炎症和坏死的病因学仍然知之甚少,但研究表明人乳喂养显著降低了其发病率(Lucas等人,1990年)。与新生儿配方相比,母乳具有无数的生物活性成分,其提供免疫保护和宿主防御,这可能有助于有益效果(Goldman,2000; Goldman等人,1990; Hanson,1999)。母乳的一个关键组分可以是PAF-乙酰水解酶(PAF-AH),其是一种在人类新生儿中缺乏的特异性PAF降解酶,并且已经在动物模型中显示出显著改变新生儿NEC的发展(Caplan等人,1990 a; Caplan等人,1997 b; Farr等人,1983年)。由于数据强烈支持内源性PAF在肠损伤起始中的作用(Hsueh等人,1994; Hsueh等人,1987),PAF-AH的存在或不存在可能是新生儿疾病的病理生理学中的关键因素。
Necrotizing enterocolitis (NEC) is the most common gastrointestinal emergency of premature infants, and accounts for significant morbidity and mortality worldwide (Kliegman et al., 1984; Uauy et al., 1991). Although the etiology of intestinal inflammation and necrosis that characterizes this disease remains poorly understood, studies have suggested that human milk feedings reduce its’ incidence significantly (Lucas et al., 1990). As compared to neonatal formula, mother’s milk has a myriad of bioactive components that provide immunoprotection and host defense that presumably contribute to the beneficial effects (Goldman, 2000; Goldman et al., 1990; Hanson, 1999). One key component of breast milk may be PAF-acetylhydrolase (PAF-AH), a specific PAF degrading enzyme that is deficient in human newborns, and has been shown in animal models to markedly alter the development of neonatal NEC (Caplan et al., 1990a; Caplan et al., 1997b; Farr et al., 1983). Since data strongly support the role of endogenous PAF in the initiation of intestinal injury (Hsueh et al., 1994; Hsueh et al., 1987), the presence or absence of PAF-AH may be a critical factor in the pathophysiology of the neonatal disease.