New insights into the pathogenesis and treatment of necrotizing enterocolitis: Toll-like receptors and beyond.
New insights into the pathogenesis and treatment of necrotizing enterocolitis: Toll-like receptors and beyond.
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DOI：
10.1203/pdr.0b013e3182093280
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发表时间：
2011-03
影响因子：
3.6
通讯作者：
Hackam DJ
中科院分区：
文献类型：
--
作者：
Afrazi A;Sodhi CP;Richardson W;Neal M;Good M;Siggers R;Hackam DJ
坏死性小肠结肠炎（NEC）是早产儿胃肠道疾病死亡的主要原因。目前NEC治疗的令人沮丧的结果突出了迫切需要更好地了解这种疾病的发病机制，以及发现新的分子特异性治疗方法的重要性。目前的理论表明，NEC的发展反映了早产儿对胃肠道微生物菌群的异常反应，尽管介导这些异常细菌-肠细胞相互作用的机制，以及早产儿对NEC发展特别易感性增加的原因仍未完全解释。最近的证据揭示了先天免疫系统的Toll样受体（TLR’s）在肠道细菌应答信号通路中的核心作用，导致NEC的发展。我们现在回顾了NEC领域的最新进展，并通过关注NEC发病机制中早肠中异常TLR4信号传导，确定了几种令人兴奋的潜在新治疗途径。在这样做的过程中，我们试图为受这种毁灭性疾病影响的患者及其家属带来新的希望。
Necrotizing enterocolitis (NEC) is the leading cause of death from gastrointestinal disease in the preterm infant. The dismal results of current treatment for NEC highlight the urgent need for greater understanding of the pathogenesis of this disease, and the importance of discovering novel, molecular-specific therapies for it. Current dogma indicates that NEC development reflects an abnormal response by the premature infant to the microbial flora that colonizes the gastrointestinal tract, although the mechanisms that mediate these abnormal bacterial-enterocyte interactions, and the reasons for the particularly increased susceptibility of the premature infant to the development of NEC remain incompletely explained. Recent evidence has shed light on an emerging role for the Toll like receptors (TLR's) of the innate immune system as central players in the pathways that signal in response to enteric bacteria resulting in the development of NEC. We now review recent advances in the field of NEC and identify several exciting potential avenues for novel treatments by focusing on abnormal TLR4 signaling in the premature intestine in the pathogenesis of NEC. In so doing, we seek to offer new hope to the patients and their families that are affected by this devastating disorder.