Recent Discoveries of Mechanisms Contributing to Necrotizing Enterocolitis.

Necrotizing enterocolitis (NEC) is a devastating neonatal intestinal disease driven by complex interactions between prematurity, microbial dysbiosis, immune dysregulation, and impaired intestinal barrier function. This article highlights recent advances in NEC pathogenesis, focusing on the role of toll-like receptor 4-mediated inflammatory signaling and the contribution of maternal inflammation and chorioamnionitis to disease susceptibility. Transcriptomic and spatial profiling studies further demonstrate that classical NEC and cardiac NEC possess distinct molecular signatures and identify diverse inflammatory endotypes within classical NEC. These findings support a precision medicine approach to NEC prevention and treatment.