TITLE:
Protective Effects of Vitamin D in Necrotizing Enterocolitis of Preterm Infants: From Basic Research to Clinical Translation
AUTHORS:
Jiping Luo, Xiaofang Zhu
KEYWORDS:
Vitamin D, Necrotizing Enterocolitis, Preterm Infants
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.14 No.3,
March
3,
2026
ABSTRACT: Necrotizing enterocolitis (NEC) is one of the most severe gastrointestinal emergencies in preterm infants, characterized by high morbidity, high mortality, and significant long-term sequelae, posing a major challenge to neonatal intensive care. Vitamin D (VitD), a pleiotropic steroid hormone precursor, exerts wide-ranging biological effects through its nuclear receptor (VDR). It plays crucial roles in maintaining intestinal barrier integrity, regulating immune homeostasis, modulating microbial balance, and mitigating oxidative stress. Increasing clinical evidence indicates that VitD deficiency in preterm infants is strongly associated with an elevated risk of NEC, whereas VitD supplementation reduces disease incidence and improves outcomes. This review systematically summarizes the protective roles and underlying molecular mechanisms of the VitD/VDR signaling axis in NEC, including reinforcement of epithelial tight junctions and mucosal barrier integrity, suppression of key inflammatory pathways, such as TLR4/NF-κB, modulation of both innate and adaptive immune responses, optimization of gut microbial composition, and activation of antioxidative and anti-apoptotic signaling pathways. In addition, we discuss the influence of VDR gene polymorphisms on NEC susceptibility, the dose-response relationship and safety profile of VitD supplementation, and potential synergistic strategies involving combined interventions. Finally, we highlight future research directions based on multi-omics approaches and precision medicine, with the aim of facilitating the translational application of VitD from bench to bedside for the prevention and management of NEC in preterm infants.