Evidence map›Paper›PMID 23762089›Full record

ReviewClinical & developmental immunology2013

Innate immune signaling in the pathogenesis of necrotizing enterocolitis.

David J Hackam, Amin Afrazi, Misty Good, Chhinder P Sodhi

Registry-linked trialOpen access · goldAbstract readReview
In one paragraph

Review in Clinical & developmental immunology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02552706 (The Efficacy and Mechanisms of Oral Probiotics in Preventing Necrotizing Enterocolitis Among Very Low Birth Weight Infants With Formula-feeding), which is not on this map. Cited by 60 papers.

0numbers the graph read from it
0cells of the map it votes in
60citing papers in PubMed
9.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02552706 naunknown statusnot on this mapstarted 2014, after this paper: background citation

The Efficacy and Mechanisms of Oral Probiotics in Preventing Necrotizing Enterocolitis Among Very Low Birth Weight Infants With Formula-feeding

TypeinterventionalSponsorShenzhen Bao'an Maternal and Child Health HospitalRan2014 to 2017Enrolled270ConditionsNecrotizing Enterocolitis, DeathArmsprobiotics, glucose solution
3 · Its place in the literature

Who cites it

60 citing papers in PubMed, 87 citations in OpenAlex.

  1. Trial
  2. Review
  3. Article
  4. Review
  5. Review
  6. Review
  7. Article
  8. Necrotizing Enterocolitis: What's New and What's Next?International journal of molecular sciences · 2025
    Review
  9. Article
  10. Article
  11. Review
  12. Review
  13. Article
  14. Article
  15. Review
  16. Article
  17. Article
  18. Review
  19. PeptideFrontiers in nutrition · 2022
    Article
  20. Experimental Modeling of Necrotizing Enterocolitis in Human Infant Intestinal Enteroids.Journal of investigative surgery : the official journal of the Academy of Surgical Research · 2022
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

David J HackamDivision of Pediatric Surgery, Department of Surgery, Children's Hospital of Pittsburgh and University of Pittsburgh School of Medicine, One Children's Hospital Drive, 4401 Penn Avenue, Pittsburgh, PA 15224, USA. david.hackam@chp.edu
Amin Afrazi
Misty Good
Chhinder P Sodhi
University of Pittsburgh · US

Funding

Molecular Basis of Pediatric DiseaseK12HD052892 · NICHD · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI TERENCE S. DERMODY · 2007 to 2026
$6.5M
TLR4 Signaling in the Pathogenesis of Surgical Necrotizing EnterocolitisR01GM078238 · NIGMS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI HACKAM, DAVID J · 2006 to 2019
$3.9M
Modulation of TLR4 and TLR9 Signaling in NECR01DK083752 · NIDDK · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI HACKAM, DAVID J · 2008 to 2016
$3.4M
Regulation of TLR4 Signaling in Enterocytes in Necrotizing EnterocolitisF30DK085930 · NIDDK · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI AFRAZI, AMIN · 2009 to 2013
$234k
NICHD NIH HHS K12 HD052892NIDDK NIH HHS F30 DK085930NIDDK NIH HHS R01 DK083752NIDDK NIH HHS R01DK08752NIGMS NIH HHS R01 GM078238NIGMS NIH HHS R01GM078238
6 · The paper itself

Abstract

Necrotizing enterocolitis (NEC) is a challenging disease to treat, and caring for patients afflicted by it remains both frustrating and difficult. While NEC may develop quickly and without warning, it may also develop slowly, insidiously, and appear to take the caregiver by surprise. In seeking to understand the molecular and cellular processes that lead to NEC development, we have identified a critical role for the receptor for bacterial lipopolysaccharide (LPS) toll like receptor 4 (TLR4) in the pathogenesis of NEC, as its activation within the intestinal epithelium of the premature infant leads to mucosal injury and reduced epithelial repair. The expression and function of TLR4 were found to be particularly elevated within the intestinal mucosa of the premature as compared with the full-term infant, predisposing to NEC development. Importantly, factors within both the enterocyte itself, such as heat shock protein 70 (Hsp70), and in the extracellular environment, such as amniotic fluid, can curtail the extent of TLR4 signaling and reduce the propensity for NEC development. This review will highlight the critical TLR4-mediated steps that lead to NEC development, with a focus on the proinflammatory responses of TLR4 signaling that have such devastating consequences in the premature host.

Indexed as

Amniotic FluidApoptosisEnterocolitis, NecrotizingEnterocytesHSP70 Heat-Shock ProteinsHumansImmunity, InnateInfantInfant, NewbornInfant, PrematureInfant, Premature, DiseasesIntestinal MucosaLipopolysaccharidesSignal TransductionToll-Like Receptor 4HSP70 Heat-Shock ProteinsLipopolysaccharidesTLR4 protein, humanToll-Like Receptor 4

Identifiers

PMID23762089
PMCPMC3677005
OpenAlexW2147840037

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.