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Necrotizing enterocolitis (NEC) is a severe gastrointestinal complication of prematurity. Using suspension and imaging mass cytometry coupled with single-cell RNA sequencing, we demonstrate severe inflammation in patients with NEC. NEC mucosa could be subtyped by an influx of three distinct neutrophil phenotypes (immature, newly emigrated, and aged). Furthermore, CD16+CD163+ monocytes/Mϕ, correlated with newly emigrated neutrophils, were specifically enriched in NEC mucosa, found adjacent to the blood vessels, and increased in circulation of infants with surgical NEC, suggesting trafficking from the periphery to areas of inflammation. NEC-specific monocytes/Mϕ transcribed inflammatory genes, including TREM1, IL1A, IL1B, and calprotectin, and neutrophil recruitment genes IL8, CXCL1, CXCL2, CXCL5 and had enrichment of gene sets in pathways involved in chemotaxis, migration, phagocytosis, and reactive oxygen species generation. In summary, we identify a novel subtype of inflammatory monocytes/Mϕ associated with NEC that should be further evaluated as a potential biomarker of surgical NEC and a target for the development of NEC-specific therapeutics.
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http://dx.doi.org/10.1084/jem.20200344 | DOI Listing |
Khirurgiia (Mosk)
September 2025
Sevastopol City Hospital No. 5 - Center for Maternal and Child Health Protection, Sevastopol, Russia.
Objective: To analyze clinical data and predictors of mortality neonatal spontaneous gastric perforation (SGP).
Material And Methods: A two-center retrospective cohort study included neonates diagnosed with SGP between 1999 and 2023. This cohort was divided into survivors and dead neonates to identify prognostic factors of mortality.
World J Pediatr Surg
September 2025
Department of Neonatology, Loma Linda University Children's Hospital, Loma Linda, California, USA.
Background: Necrotizing enterocolitis (NEC) is a gastrointestinal emergency in premature neonates. NEC is mediated by toll-like receptor-4 (TLR-4) and associated with lung injury. Previously, we showed that prenatal heparin-binding epidermal growth factor (HB-EGF) administration decreases the incidence of intestinal injury in a rat model of NEC.
View Article and Find Full Text PDFCureus
August 2025
Division of Neonatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, JPN.
This case report describes the implementation of Family-Centered Care (FCC) and developmental occupational therapy (OT) for an extremely preterm infant born at 22 weeks and one day of gestation, weighing 448 g. The infant experienced multiple complications, including necrotizing enterocolitis, sepsis, intraventricular hemorrhage, and respiratory distress, requiring prolonged intensive care. Due to physiological fragility and immature neurobehavior, a structured rehabilitation approach was introduced, integrating OT and caregiver participation based on FCC principles.
View Article and Find Full Text PDFJAMA Netw Open
September 2025
Division of Neonatology, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland.
Importance: Preterm children face a higher risk of cardiovascular conditions, including hypertension. However, studies have not isolated the associations of prematurity with cardiovascular conditions from the associations of subsequent complications with cardiovascular conditions, especially among those admitted to a neonatal intensive care unit (NICU).
Objective: To investigate prospective associations of prematurity and NICU complications with childhood hypertension while accounting for prenatal and perinatal factors.
Lancet Child Adolesc Health
October 2025
The Ritchie Centre, Hudson Institute of Medical Research, Melbourne, VIC, Australia; Monash Newborn, Monash Children's Hospital, Melbourne, VIC, Australia; Department of Paediatrics, Monash University, Melbourne, VIC, Australia.
Background: More than 85% of very preterm infants (born <32 weeks' gestation) breathe spontaneously within 1 min of birth, however, more than 60% of infants receive positive pressure ventilation. Face mask application soon after birth might suppress breathing through the trigeminal nerve reflex, causing vocal cord closure and hypoxia. We aimed to investigate whether nasal mask continuous positive airway pressure (nCPAP) would improve CPAP success, reducing the need for positive pressure ventilation and intubation at birth, compared with face mask CPAP (fCPAP).
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