Struggling to Understand the NEC Spectrum-Could the Integration of Metabolomics, Clinical-Laboratory Data, and Other Emerging Technologies Help Diagnosis?

Overview

Journal Metabolites

Publisher MDPI

Date 2024 Oct 25

PMID 39452903

Authors

Kosmas Sarafidis

Eleni Agakidou

Angeliki Kontou

Charalampos Agakidis

Josef Neu

Affiliations

Soon will be listed here.

Abstract

Necrotizing enterocolitis (NEC) is the most prevalent and potentially fatal intestinal injury mainly affecting premature infants, with significant long-term consequences for those who survive. This review explores the scale of the problem, highlighting advancements in epidemiology, the understanding of pathophysiology, and improvements in the prediction and diagnosis of this complex, multifactorial, and multifaced disease. Additionally, we focus on the potential role of metabolomics in distinguishing NEC from other conditions, which could allow for an earlier and more accurate classification of intestinal injuries in infants. By integrating metabolomic data with other diagnostic approaches, it is hoped to enhance our ability to predict outcomes and tailor treatments, ultimately improving care for affected infants.

References

Liu X, Zhang X, Li L, Wang J, Chen Y, Wu L . Bioinformatics analysis of potential key genes and pathways in neonatal necrotizing enterocolitis. BMC Pediatr. 2022; 22(1):658. PMC: 9652887. DOI: 10.1186/s12887-022-03721-4. View

Agakidou E, Agakidis C, Gika H, Sarafidis K . Emerging Biomarkers for Prediction and Early Diagnosis of Necrotizing Enterocolitis in the Era of Metabolomics and Proteomics. Front Pediatr. 2021; 8:602255. PMC: 7793899. DOI: 10.3389/fped.2020.602255. View

Luig M, Lui K . Epidemiology of necrotizing enterocolitis--Part II: Risks and susceptibility of premature infants during the surfactant era: a regional study. J Paediatr Child Health. 2005; 41(4):174-9. DOI: 10.1111/j.1440-1754.2005.00583.x. View

Gordon P, Swanson J, Attridge J, Clark R . Emerging trends in acquired neonatal intestinal disease: is it time to abandon Bell's criteria?. J Perinatol. 2007; 27(11):661-71. DOI: 10.1038/sj.jp.7211782. View

Frazer L, Yamaguchi Y, Singh D, Akopyants N, Good M . DNA methylation in necrotizing enterocolitis. Expert Rev Mol Med. 2024; 26:e16. PMC: 11140546. DOI: 10.1017/erm.2024.16. View

OConnell A . Applying the bronchopulmonary dysplasia framework to necrotizing enterocolitis. Front Pediatr. 2024; 12:1388392. PMC: 11135171. DOI: 10.3389/fped.2024.1388392. View

Carlisle E, Morowitz M . The intestinal microbiome and necrotizing enterocolitis. Curr Opin Pediatr. 2013; 25(3):382-7. DOI: 10.1097/MOP.0b013e3283600e91. View

Howarth C, Banerjee J, Leung T, Aladangady N . Could Near Infrared Spectroscopy (NIRS) be the new weapon in our fight against Necrotising Enterocolitis?. Front Pediatr. 2022; 10:1024566. PMC: 9679512. DOI: 10.3389/fped.2022.1024566. View

Pumberger W, Mayr M, Kohlhauser C, Weninger M . Spontaneous localized intestinal perforation in very-low-birth-weight infants: a distinct clinical entity different from necrotizing enterocolitis. J Am Coll Surg. 2002; 195(6):796-803. DOI: 10.1016/s1072-7515(02)01344-3. View

10.

Rehan V, Seshia M, Johnston B, Reed M, Wilmot D, Cook V . Observer variability in interpretation of abdominal radiographs of infants with suspected necrotizing enterocolitis. Clin Pediatr (Phila). 1999; 38(11):637-43. DOI: 10.1177/000992289903801102. View

11.

Soni R, Katana A, Curry J, Humphries P, Huertas-Ceballos A . How to use abdominal X-rays in preterm infants suspected of developing necrotising enterocolitis. Arch Dis Child Educ Pract Ed. 2019; 105(1):50-57. DOI: 10.1136/archdischild-2018-315252. View

12.

Grapov D, Fahrmann J, Wanichthanarak K, Khoomrung S . Rise of Deep Learning for Genomic, Proteomic, and Metabolomic Data Integration in Precision Medicine. OMICS. 2018; 22(10):630-636. PMC: 6207407. DOI: 10.1089/omi.2018.0097. View

13.

Cuna A, George L, Sampath V . Genetic predisposition to necrotizing enterocolitis in premature infants: Current knowledge, challenges, and future directions. Semin Fetal Neonatal Med. 2018; 23(6):387-393. PMC: 6626706. DOI: 10.1016/j.siny.2018.08.006. View

14.

Garg P, Garg P, Shenberger J . Is Necrotizing Enterocolitis and Spontaneous Intestinal Perforation Part of Same Disease Spectrum - New Insights?. Curr Pediatr Rev. 2024; . PMC: 11458834. DOI: 10.2174/0115733963298717240404032451. View

15.

OSullivan C, Tsai D, Wu I, Boselli E, Hughes C, Padmanabhan D . Machine learning applications on neonatal sepsis treatment: a scoping review. BMC Infect Dis. 2023; 23(1):441. PMC: 10308703. DOI: 10.1186/s12879-023-08409-3. View

16.

Moss R, Kalish L, Duggan C, Johnston P, Brandt M, Dunn J . Clinical parameters do not adequately predict outcome in necrotizing enterocolitis: a multi-institutional study. J Perinatol. 2008; 28(10):665-74. DOI: 10.1038/jp.2008.119. View

17.

Neu J, Walker W . Necrotizing enterocolitis. N Engl J Med. 2011; 364(3):255-64. PMC: 3628622. DOI: 10.1056/NEJMra1005408. View

18.

Klerk D, van Varsseveld O, Offringa M, Modi N, Lacher M, Zani A . Core Outcome Set for Necrotizing Enterocolitis Treatment Trials. Pediatrics. 2024; 153(6). DOI: 10.1542/peds.2023-065619. View

19.

Keane O, Dantes G, Dutreuil V, Do L, Rumbika S, Sylvestre P . Comparison of preoperative and intraoperative surgeon diagnosis and pathologic findings in spontaneous intestinal perforation vs necrotizing enterocolitis. J Perinatol. 2024; 44(4):568-574. DOI: 10.1038/s41372-024-01876-9. View

20.

Snyder K, Hunter C . Bugs and the barrier: A review of the gut microbiome and intestinal barrier in necrotizing enterocolitis. Semin Pediatr Surg. 2023; 32(3):151310. DOI: 10.1016/j.sempedsurg.2023.151310. View