Talk:Gastrointestinal Tract - Postnatal
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Cite this page: Hill, M.A. (2026, October 5) Embryology Gastrointestinal Tract - Postnatal. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Talk:Gastrointestinal_Tract_-_Postnatal |
2011
Necrotizing enterocolitis: An update
Semin Fetal Neonatal Med. 2011 Apr 20. [Epub ahead of print] Berman L, Moss RL. Source Department of Surgery, Yale University School of Medicine, 333 Cedar Street, FMB 132, New Haven, CT 06520-8062, USA.
Abstract
Necrotizing enterocolitis (NEC) is a leading cause of death among patients in the neonatal intensive care unit, carrying a mortality rate of 15-30%. Its pathogenesis is multifactorial and involves an overreactive response of the immune system to an insult. This leads to increased intestinal permeability, bacterial translocation, and sepsis. There are many inflammatory mediators involved in this process, but thus far none has been shown to be a suitable target for preventive or therapeutic measures. NEC usually occurs in the second week of life after the initiation of enteral feeds, and the diagnosis is made based on physical examination findings, laboratory studies, and abdominal radiographs. Neonates with NEC are followed with serial abdominal examinations and radiographs, and may require surgery or primary peritoneal drainage for perforation or necrosis. Many survivors are plagued with long term complications including short bowel syndrome, abnormal growth, and neurodevelopmental delay. Several evidence-based strategies exist that may decrease the incidence of NEC including promotion of human breast milk feeding, careful feeding advancement, and prophylactic probiotic administration in at-risk patients. Prevention is likely to have the greatest impact on decreasing mortality and morbidity related to NEC, as little progress has been made with regard to improving outcomes for neonates once the disease process is underway.
Copyright © 2011. Published by Elsevier Ltd.
PMID: 21514258 http://www.ncbi.nlm.nih.gov/pubmed/21514258
2010
Milk epidermal growth factor and gut protection
J Pediatr. 2010 Feb;156(2 Suppl):S31-5.
Dvorak B. Source Department of Pediatrics, University of Arizona, Tucson, AZ, USA. dvorakb@peds.arizona.edu
Abstract
Maternal milk is a complex fluid, with multifunctional roles within the developing gastrointestinal tract. Epidermal growth factor (EGF) and heparin-binding EGF-like growth factor (HB-EGF) are members of the family of EGF-related peptides. Biological actions of these growth factors are mediated via interaction with the EGF-receptor (EGF-R). In the early postnatal period, breast milk is the major source of EGF for the developing intestinal mucosa. HB-EGF is also detected in breast milk, but in concentrations 2 to 3 times lower than EGF. With normal physiological conditions, the intestinal epithelium undergoes a continuing process of cell proliferation, differentiation, and maturation. EGF plays an important role in these processes. In pathophysiologic situations, EGF contributes to epithelial protection from injury and post-injury mucosal repair. Necrotizing enterocolitis (NEC) is a devastating disease affecting infants born prematurely. The pathogenesis of NEC is not known, and there is no effective treatment for this disease. In an experimental NEC model, oral administration of a physiological dose of EGF significantly reduces the incidence and severity of NEC. HB-EGF provides similar protection against NEC, but only when pharmacological doses are used. Further studies are necessary before EGF can be introduced as an efficient therapeutic approach of intestinal injury.
Copyright 2010 Mosby, Inc. All rights reserved.
PMID: 20105663 http://www.ncbi.nlm.nih.gov/pubmed/20105663
