Effect of DHA on Proinflammatory Cytokines Including Platelets Activating Factor (PAF) and it’s Role in Prevention of Necrotizing Enterocolitis in Preterm/Very Low Birth Weight Neonates

Abstract

ecrotizing enterocolitis (NEC) is a critical intestinal emergency condition, which mainly occurs in preterm low birth weight infants. Necrotizing enterocolitis (NEC) is the most devastating gastrointestinal disease in neonates. The pathogenesis of NEC is not well defined but evidence strongly suggests that it is multifactorial. Prematurity and enteral feeding are major risk factors for NEC. An excessive inflammatory response by the immature intestine to external stimuli, impaired intestinal barrier integrity and/or abnormal bacterial colonization are key factors implicated in pathophysiology of NEC. In Egypt, the incidence of feeding intolerance 2.6%, incidence of NEC is 9.6% with a mortality rate 20-30%. One of the key inflammatory mediators associated with NEC is Platelet activating factor (PAF). Platelet activating factor receptor (PAFR) blockade or enhanced intestinal PAF degradation via PAF acetylhydrolase (PAF-AH) supplementation reduces the incidence of NEC. We hypothesized that the protective effect of PUFA on NEC may be due to the ability of PUFA to suppress platelet-activating factor receptor (PAFR) gene expression. Premature infants are at increased risk of NEC because Long chain poly unsaturated fatty acids (LCPUFA) accretion