Review
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Apr 14, 2008; 14(14): 2142-2161
Published online Apr 14, 2008. doi: 10.3748/wjg.14.2142
Necrotizing enterocolitis: A multifactorial disease with no cure
Kareena L Schnabl, John E Van Aerde, Alan BR Thomson, Michael T Clandinin
Kareena L Schnabl, Nutrition and Metabolism Research Groups, Department of Medicine, University of Alberta, Edmonton T6G 2P5, Canada
John E Van Aerde, Department of Pediatrics, University of Alberta, Edmonton T6G 2P5, Canada
Alan BR Thomson, Department of Medicine, Division of Gastroenterology, University of Alberta, Edmonton T6G 2P5, Canada
Michael T Clandinin, Alberta Institute for Human Nutrition, University of Alberta, Edmonton T6G 2P5, Canada
Author contributions: All authors contributed to drafting the manuscript; Clandinin MT is senior author supervising all aspects.
Correspondence to: Professor Michael T Clandinin, Alberta Institute for Human Nutrition, 4-10 Ag/For Centre, University of Alberta, Edmonton, Alberta T6G 2P5, Canada. tom.clandinin@ualberta.ca
Telephone: +1-780-4925188
Fax: +1-780-4928855
Received: October 2, 2007
Revised: November 30, 2007
Published online: April 14, 2008
Abstract

Necrotizing 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.

Keywords: Necrotizing enterocolitis, Diagnosis, Pathogenesis, Prevention, Disease models, Vasoactive/inflammatory mediators