Emerging role of non-coding RNAs as biomarkers and therapeutic targets in preterm infants with necrotizing enterocolitis.

Abstract

Necrotizing enterocolitis (NEC) is a leading cause of morbidity and mortality in preterm infants, marked by intestinal necrosis, inflammation, hemorrhage, and impaired repair. Despite advances in neonatal care, early diagnostics and targeted therapies remain limited. Emerging evidence shows that non-coding RNAs (ncRNAs), including microRNAs, long ncRNAs, and tRNA-derived fragments, regulate key inflammatory, cell-death, angiogenic, and immune pathways in NEC. Distinct ncRNA signatures correlate with histopathology, and plasma-derived exosomal ncRNAs show promise as early biomarkers. Human milk exosomal microRNAs exhibit protective effects, while ncRNA-microbiome interactions may influence disease susceptibility. Larger studies using high-throughput sequencing are needed to advance biomarker-driven precision care.Copyright © The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc 2026.