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Meta-Analysis
. 2024 Mar 14;16(6):832.
doi: 10.3390/nu16060832.

Plant-Derived Substances for Prevention of Necrotising Enterocolitis: A Systematic Review of Animal Studies

Cheryl Anne Mackay  1 , Chandra Rath  1   2   3 , Shripada Rao  2   3 , Sanjay Patole  1   3
Affiliations
Meta-Analysis

Plant-Derived Substances for Prevention of Necrotising Enterocolitis: A Systematic Review of Animal Studies

Cheryl Anne Mackay et al. Nutrients. .

Abstract

Inflammation, oxidative injury, and gut dysbiosis play an important role in the pathogenesis of necrotising enterocolitis (NEC). Plant-derived substances have historically been used as therapeutic agents due to their anti-inflammatory, antioxidant, and antimicrobial properties. We aimed to review pre-clinical evidence for plant-derived substances in the prevention and treatment of NEC. A systematic review was conducted using the following databases: PubMed, EMBASE, EMCARE, MEDLINE and Cochrane Library (PROSPERO CRD42022365477). Randomized controlled trials (RCTs) and quasi-RCTs that evaluated a plant-derived substance as an intervention for NEC in an animal model of the illness and compared pre-stated outcomes (e.g., clinical severity, severity of intestinal injury, mortality, laboratory markers of inflammation and oxidative injury) were included. Sixteen studies (n = 610) were included in the systematic review. Ten of the sixteen included RCTs (Preterm rat pups: 15, Mice: 1) reported mortality and all reported NEC-related histology. Meta-analysis showed decreased mortality [12/134 vs. 27/135; RR: 0.48 (95% CI: 0.26 to 0.87); p = 0.02, 10 RCTs] and decreased NEC in the experimental group [24/126 vs. 55/79; RR: 0.34 (95% CI: 0.22 to 0.52); p < 0.001, 6 RCTs]. Markers of inflammation (n = 11) and oxidative stress (n = 13) improved in all the studies that have reported this outcome. There was no significant publication bias for the outcome of mortality. Plant-derived substances have the potential to reduce the incidence and severity of histologically diagnosed NEC and mortality in rodent models. These findings are helpful in guiding further pre-clinical studies towards developing a food supplement for the prevention of NEC in preterm infants.

Keywords: animal; necrotizing enterocolitis; newborn; plant-derived substance.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow chart for study selection.
Figure 2
Figure 2
Forrest plot for the outcome of mortality in the included studies [25,27,33,35,36,37,39,43,44,45].
Figure 3
Figure 3
Forrest plot for the outcome of NEC histology in the included studies [35,36,37,41,42,44].
Figure 4
Figure 4
Funnel plot for the outcome of mortality.
See this image and copyright information in PMC

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