A roadmap for understanding and preventing necrotizing enterocolitis.

Necrotizing enterocolitis (NEC) is the most common severe gastrointestinal emergency that affects newborns. Its etiology is still undetermined. Most of our knowledge of this disease stems from epidemiologic studies, clinical experience, and studies using animal models that do not directly represent the disease in premature infants. An immature intestine that is colonized by bacteria is a prerequisite for the pathogenesis of NEC. Although causative microbes have not been found, newly developed analytic techniques now allow the detection of noncultivatable microbes and the determination of their overall diversity and metabolic capabilities. The National Institutes of Health Human Microbiome Roadmap Project is likely to generate new information highly germane to understanding NEC. Newly developed proteomic and metabolomic approaches also offer exciting new potential for early diagnosis and prevention of this disease in infants at highest risk.