Necrotizing enterocolitis (NEC) is an often devastating gastrointestinal illness, affecting as many as 1 in 5 preterm infants. Rather than diminishing as neonatal care improves, the incidence of NEC is rising along with increased survival of more extremely immature infants. Prematurity, enteral feeding, introduction of bacteria, and hypoxia-ischemia of the gut are the major known risk factors. Breast milk feeding is protective for the development of NEC.

A promising line of research has produced a potential means to reduce NEC among preterm infants. Epidermal growth factor (EGF), a polypeptide normally found in human milk but not in commercial formula, is important in the development and maintenance of the gastrointestinal tract. Using a rat model in which NEC was induced with formula feeding, asphyxia, and cold stress, researchers previously found that supplementing formula with EGF results in a dramatic, 50% reduction in the incidence of NEC.1

New research examines the impact of heparin-binding EGF on the cellular events that result in NEC. Heparin-binding EGF-like growth factor (HB-EGF) is structurally similar to EGF but is cytoprotective for intestinal epithelial cells and has high binding affinity, which may improve its biological activity. HB-EGF reduces the incidence and severity of NEC in a neonatal rat model by decreasing apoptosis of intestinal cells that leads to gut barrier failure and simultaneously preserving gut barrier integrity.2,3 These results support the use of HB-EGF-based clinical regimens for the treatment of NEC.3

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