Gut microbiota and short-chain fatty acids in the pathogenesis of necrotizing enterocolitis in very preterm infants

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Abstract

The development of a symbiotic gut ecosystem is a crucial step in postnatal adaptation. The gut microbiome of very preterm infants is characterized by an overall instability, reduced microbial diversity, and a predominance of Gram-negative Proteobacteria, all factors associated with an increased risk of necrotizing enterocolitis (NEC). Short-chain fatty acids (SCFAs) are the key bacterial metabolites that are essential for maintaining intestinal homeostasis, supporting immune development, enhancing intestinal barrier integrity, and reducing inflammation. This review examines the role of gut microbiota and SCFAs in neonatal NEC, with a focus on potential diagnostic and therapeutic strategies. Clinical studies have consistently demonstrated a significant decrease in total SCFA levels and individual bacterial metabolites in preterm infants with NEC. This finding has been corroborated by various experimental models. Clarification of the role of SCFAs in NEC pathogenesis, determination of their diagnostic utility, and assessment of the feasibility of developing comprehensive pro- and postbiotic formulations require multi-center, multi-omics investigations that include a large cohort of very preterm infants.

About the authors

Evgenii N. Kukaev

National Medical Research Center for Obstetrics Gynecology and Perinatology Named after Academician V.I. Kulakov of the Ministry of Healthcare of Russian Federation; N.N. Semenov Federal Research Center for Chemical Physics, Russian Academy of Sciences

Author for correspondence.
Email: e_kukaev@oparina4.ru
ORCID iD: 0000-0002-8397-3574
SPIN-code: 3377-5462
Scopus Author ID: 6507367648
ResearcherId: C-9408-2014

V.L. Talrose Institute for Energy Problems of Chemical Physics, N.N. Semenov Federal Research Center for Chemical Physics, Russian Academy of Sciences

Russian Federation, Moscow, 117997; Moscow, 119991

Alisa O. Tokareva

National Medical Research Center for Obstetrics Gynecology and Perinatology Named after Academician V.I. Kulakov of the Ministry of Healthcare of Russian Federation

Email: a_tokareva@oparina4.ru
SPIN-code: 8552-7215
Russian Federation, Moscow, 117997

Olga A. Krogh-Jensen

National Medical Research Center for Obstetrics Gynecology and Perinatology Named after Academician V.I. Kulakov of the Ministry of Healthcare of Russian Federation; Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University)

Email: o_krogh@oparina4.ru
ORCID iD: 0000-0002-5178-5659
SPIN-code: 9546-0975
Scopus Author ID: 57214220453
Russian Federation, Moscow, 117997; Moscow, 119048

Anna A. Lenyushkina

National Medical Research Center for Obstetrics Gynecology and Perinatology Named after Academician V.I. Kulakov of the Ministry of Healthcare of Russian Federation

Email: a-lenushkina@yandex.ru
ORCID iD: 0000-0001-8929-2991
SPIN-code: 5464-0656
Scopus Author ID: 57202802436
ResearcherId: AAJ-6896-2021
Russian Federation, Moscow, 117997

Nataliia L. Starodubtseva

National Medical Research Center for Obstetrics Gynecology and Perinatology Named after Academician V.I. Kulakov of the Ministry of Healthcare of Russian Federation; Moscow Institute of Physics and Technology

Email: n_starodubtseva@oparina4.ru
ORCID iD: 0000-0001-6650-5915
SPIN-code: 3673-7263
Scopus Author ID: 50462424600
ResearcherId: Y-6378-2019
Russian Federation, Moscow, 117997; Dolgoprudny, Moscow region, 141701

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