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Enteric Nervous System in Neonatal Necrotizing Enterocolitis


Pavithra Chandramowlishwaran, Shreya Raja, Akhil Maheshwari* and Shanthi Srinivasan  


Background: The pathophysiology of necrotizing enterocolitis (NEC) is not clear, but increasing information suggests that the risk and severity of NEC may be influenced by abnormalities in the enteric nervous system (ENS).

Objective: The purpose of this review was to scope and examine the research related to ENS-associated abnormalities that have either been identified in NEC or have been noted in other inflammatory bowel disorders (IBDs) with histopathological abnormalities similar to NEC. The aim was to summarize the research findings, identify research gaps in existing literature, and disseminate them to key knowledge end-users to collaborate and address the same in future studies.

Methods: Articles that met the objectives of the study were identified through an extensive literature search in the databases PubMed, EMBASE, and Scopus.

Results: The sources identified through the literature search revealed that: (1) ENS may be involved in NEC development and post-NEC complications, (2) NEC development is associated with changes in the ENS, and (3) NEC-associated changes could be modulated by the ENS.

Conclusions: The findings from this review identify the enteric nervous as a target in the development and progression of NEC. Thus, factors that can protect the ENS can potentially prevent, and treat NEC and post-NEC complications. This review serves to summarize the existing literature and highlights a need for further research on the involvement of ENS in NEC.


Necrotizing enterocolitis, neonates, premature, enteric nervous system, intestinal inflammation, gut dysbiosis


Emory University School of Medicine, Department of Medicine, Decatur, Georgia, Emory University School of Medicine, Department of Medicine, Decatur, Georgia, Gastroenterology Research, Atlanta VA Medical Center, Decatur, GA, Emory University School of Medicine, Department of Medicine, Decatur, Georgia

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