PANoptosis Genes as Novel Diagnostic Biomarkers for Neonatal Necrotizing Enterocolitis.

BACKGROUND

Necrotizing enterocolitis (NEC), a life-threatening neonatal gastrointestinal disease, lacks reliable biomarkers. This study explores PANoptosis-a novel inflammatory cell death pathway-in NEC pathogenesis.

MATERIALS AND

METHODS

Ileal transcriptomic profiles from surgical NEC and non-inflammatory controls were retrieved from GSE64801 and GSE46619. Data were standardized via log-transformation and quantile normalization. After identifying differentially expressed genes, we intersected them with 902 PANoptosis-related genes. A diagnostic model was developed using LASSO regression and validated via ROC, calibration, and decision curve analyses.

RESULTS

Fifty-five NEC-associated PANoptosis genes were identified, primarily enriched in inflammatory pathways. NFKBIA and PECAM1 emerged as pivotal biomarkers. The model achieved an AUC and C-index of 0.903, with calibration curves confirming reliability. DCA and clinical impact curves demonstrated significant clinical utility.

CONCLUSION

NFKBIA and PECAM1 are promising biomarkers for surgical NEC linked to PANoptosis. This study establishes a diagnostic framework and proposes therapeutic targets for advanced NEC management.