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Journal of Indian Association of Pediatric Surgeons
     Journal of Indian Association of Pediatric Surgeons
Official journal of the Indian Association of Pediatric Surgeons         
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Year : 1999  |  Volume : 4  |  Issue : 4  |  Page : 178-185

Free Oxygen radicals in pathogenesis of neonatal necrotising enterocolitis :the role of antioxidants.

Department of Neonatal and Pediatric Surgery, University of Manchester Manchester, United Kingdom

Correspondence Address:
A Minocha
Department of Neonatal and Pediatric Surgery, University of Manchester Manchester, United Kingdom

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Source of Support: None, Conflict of Interest: None

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ABSTRACT: The etiology of neonatal necrotising enterocolitis (Nec) remains elusive although most investigators agree that it results from the injury to the newborn's highly vulnerable intestinal mucosa. Mucosal ischemia leading to gut injury is accepted as the most plausible cause for this event. This can result from many stressful situations experienced by premature infants. Hypoxia is known to be one of the commonest physiological stress to which the neonates are exposed. It has been associated with NEC in clinical and experimental situations. Hypoxia results in decreased intestinal perfusion, which may lead to bowel necrosis. If the period of ischemia or hypoxia is not long enough to injure the tissue irreversibly, most of it can be salvaged by reperfusing the tissue and therefore reintroducing oxygen and other nutrients. Reintroduction of O2 to an ischemic or hypoxic tissue could cause and additonal damage to the tissue which is mediated by free oxygen radicals. If the hypoxia or ischemia is partial, it is the reoxygenation/reperfusion injury to the tissue which will determine the ultimate damage to the tissue. An endogenous antioxidant mechanism already exists to counteract the effect of free radicals in the tissues. This defence system can be overwhelmed either due to the excess of free radical generation or inadequate stores of endogenous antixidants, as in sick premature infant. There may be a possible window opportunity to prevent the aggravation of injury to the gut and other body tissues. This may be possible by providing the antioxidant supplementation before the onset of free radical damage to the tissue. Recent research have shown promising possibilities with the use of simple antioxidants. We are currently assessing the role of selenium, vitamin C and vitamin E in a rat model of NEC.

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