Necrotizing enterocolitis: the role of intestinal alkaline phosphatase in the developing gut
Necrotizing enterocolitis: the role of intestinal alkaline phosphatase in the developing gut
Necrotizing enterocolitis (NEC) is a serious and life-threatening bowel disease that mainly affects babies born before the normal gestational time. In these infants, the intestine is still immature and reacts too strongly to bacteria, leading to inflammation and damage of the gut. Despite advances in neonatal care, NEC remains difficult to prevent and treat, and its causes are not yet fully understood.
This thesis of Raquel Santos Martins focuses on a protective protein in the intestine called intestinal alkaline phosphatase (IAP). IAP helps neutralize harmful bacterial substances and reduce excessive inflammation. By studying intestinal tissue from infants with NEC, we found that IAP levels and activity were lower in babies with NEC than in those without intestinal disease. We also showed that IAP is closely localized to an inflammatory protein called TLR4, suggesting that IAP normally helps keep inflammation under control in the developing gut. Studies using tissue from fetuses revealed that this protective system needs its time to be fully developed, which may help explain why they are particularly vulnerable to NEC.
In addition, it was discovered that babies with blood group AB have a higher risk of developing severe NEC and of dying from the disease, pointing to previously unrecognized biological factors that may influence disease severity.
Overall, this research improves our understanding of why NEC occurs and highlights IAP as a promising target for future treatments aimed at protecting the intestines of vulnerable babies born before the normal gestational time.