Immaturity of the intestinal epithelial barrier and the neonatal mucosal immune system predispose the premature infant to microbial invasion, which triggers the sequence of events leading to necrotizing enterocolitis (NEC). Stimulation of pro-inflammatory cytokines compromises intestinal defenses. An imbalance between epithelial cell injury and repair leads to a cycle of bacterial invasion, immune activation, uncontrolled inflammation, and gut barrier failure.
Reprinted by permission from Macmillan Publishers Ltd: Pediatric Research. Hunter CJ, Upperman JS, Ford HR, Camerini V. Understanding the Susceptibility of the Premature Infant to Necrotizing Enterocolitis (NEC). Pediatr Res 2008; 63:117. Copyright © 2008.
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