Neutrophil extracellular traps in neonatal necrotizing enterocolitis: from developmental maturation to immunothrombotic injury
Year: 2026
Type: review
Abstract: Neonatal necrotizing enterocolitis (NEC) is best understood as a syndrome of intestinal necrosis arising in a developmentally susceptible host, with overlapping inflammatory, ischemic, infectious, cardiac-related, and transfusion-associated triggers. Neutrophil extracellular traps (NETs) are extracellular DNA networks decorated with histones, neutrophil elastase, myeloperoxidase, and other granule proteins. They may limit pathogen dissemination, yet persistent NET formation or impaired NET clearance can injure epithelium and microvascular endothelium and amplify immunothrombosis. This review focuses specifically on NETs in NEC. We first condense the general NEC background and then appraise human, animal, and mechanistic evidence with explicit attention to model system, intervention timing, NET detection method, infection burden, and NEC subtype. The neonatal NET-inhibitory factor (nNIF)/NET-maturation window is presented as a testable developmental hypothesis rather than an established quantitative rule. We synthesize biomarker and intervention literature and conclude that the translational question is not simply whether NETs are "good" or "bad", but which infants, at which disease phase, defined by which combination of formation, clearance, platelet, endothelial, microbial, and imaging signals, may benefit from inhibition, clearance, or preservation of NET function.
Source: Frontiers in Immunology
Authors: Yang Chen, Mengru Zhu
Institution: First Hospital of Jilin University
Language: English
Subfield: Immunology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7223041227