Evidence map›Paper›PMID 29980346›Full record

ReviewJournal of pediatric surgery2019

New insights into necrotizing enterocolitis: From laboratory observation to personalized prevention and treatment.

David J Hackam, Chhinder P Sodhi, Misty Good

Abstract readReview
In one paragraph

Review in Journal of pediatric surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 60 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
60citing papers in PubMed, 1 pooled it
5.8field-weighted citation impact, top 3% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

60 citing papers in PubMed, 1 synthesis or guideline pooled it, 89 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Is necrotizing enterocolitis associated with the 896A/G polymorphism in the toll-like receptor 4 (TLR4) gene?Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2026
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  11. Finite Element Modeling of Abdominal Near-Infrared Spectroscopy for Infant Splanchnic Oximetry.International journal for numerical methods in biomedical engineering · 2025
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  19. Observational
  20. DNA methylation in necrotizing enterocolitis.Expert reviews in molecular medicine · 2024
    Review
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

3 authors at 2 institutions in 1 country.

David J HackamDivision of Pediatric Surgery and the Department of Surgery at the Johns Hopkins University, Baltimore, Maryland. Electronic address: dhackam1@jhmi.edu.
Chhinder P SodhiDivision of Pediatric Surgery and the Department of Surgery at the Johns Hopkins University, Baltimore, Maryland.
Misty GoodDivision of Newborn Medicine and the Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri.
Johns Hopkins University · USWashington University in St. Louis · US

Funding

Clinical and Laboratory Research Training for Gastrointestinal SurgeonsT32DK007713 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI DAVID J HACKAM · 1996 to 2026
$5.2M
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
Maternal-Fetal AHR Signaling in the Pathogenesis and Treatment of Necrotizing EnterocolitisR01DK117186 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI HACKAM, DAVID J · 2018 to 2021
$1.5M
Novel Anti-Inflammatory Properties of Breast Milk in Necrotizing EnterocolitisK08DK101608 · NIDDK · WASHINGTON UNIVERSITY · PI GOOD, MISTY L · 2014 to 2017
$584k
Aryl hydrocarbon receptor signaling in the pathogenesis of necrotizing enterocolitisR03DK111473 · NIDDK · WASHINGTON UNIVERSITY · PI GOOD, MISTY L · 2017 to 2018
$153k
NIDDK NIH HHS K08 DK101608NIDDK NIH HHS R01 DK083752NIDDK NIH HHS R01 DK117186NIDDK NIH HHS R03 DK111473NIDDK NIH HHS T32 DK007713NIGMS NIH HHS R01 GM078238
6 · The paper itself

Abstract

background/purposeNecrotizing enterocolitis (NEC) is a devastating disease of prematurity that develops after feeding, often without warning, and results in diffuse intestinal necrosis leading to sepsis and death in many cases. The lack of improvement in overall survival is influenced by nonspecific diagnostic modalities as well as inexact and nonpersonalized treatment strategies. METHODS/

resultsRecently, we and others have shown that NEC develops in response to exaggerated bacterial signaling in the premature intestine, as a consequence of elevated expression and activity of the bacterial receptor toll-like receptor 4 (TLR4), which is important for normal gut development. Breast milk is a powerful TLR4 inhibitor, while mutations in TLR4 genes lead to increased NEC risk in humans, providing proof-of-concept for its role in NEC. Recently, a drug discovery approach has revealed a novel class of TLR4 inhibitors which are being developed for personalized approaches to NEC treatment.

conclusionThis review will highlight the current understanding of the role of bacterial signaling in NEC pathogenesis, and will describe advances in diagnosis, prevention and treatment of NEC that may hopefully improve survival for these most fragile patients. SYSTEMATIC REVIEW: Level of Evidence: Level II.

Indexed as

AnimalsEnterocolitis, NecrotizingFemaleGenetic Predisposition to DiseaseHumansInfant, NewbornInfant, PrematureIntestinesMilk, HumanMutationPrecision MedicineRisk FactorsSignal TransductionToll-Like Receptor 4TLR4 protein, humanToll-Like Receptor 4Breast milkInnate immunityNecrotizing enterocolitis (NEC)PrematurityProbioticsToll-like receptor 4 (TLR4)

Identifiers

PMID29980346
PMCPMC6344311
OpenAlexW2809504655

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.