Modeling the interactions of bacteria and Toll-like receptor-mediated inflammation in necrotizing enterocolitis

Julia Arciero*, G. Bard Ermentrout, Richard Siggers, Amin Afrazi, David Hackam, Yoram Vodovotz, Jonathan Rubin

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


Necrotizing enterocolitis (NEC) is a severe disease of the gastrointestinal tract in premature infants, characterized by a disrupted intestinal epithelium and an exaggerated pro-inflammatory response. Since the activation of Toll-like receptor-4 (TLR4) blocks cell migration and proliferation and contributes to an uncontrolled inflammatory response within the intestine, this receptor has been identified as a key contributor to the development of NEC. Toll-like receptor-9 (TLR9) has been shown to sense bacterial genome components (CpG DNA) and to play an anti-inflammatory role in NEC. We present in vitro results demonstrating direct inhibition of TLR4 activation by CpG DNA, and we develop a mathematical model of bacteria-immune interactions within the intestine to investigate how such inhibition of TLR4 signaling might alter inflammation, associated bacterial invasion of tissue, and resulting outcomes. The model predicts that TLR9 can inhibit both the beneficial and detrimental effects of TLR4, and thus a proper balance of action by these two receptors is needed to promote intestinal health. The model results are also used to explore three interventions that could potentially prevent the development of NEC: reducing bacteria in the mucus layer, administering probiotic treatment, and blocking TLR4 activation. While the model shows that these interventions would be successful in most cases, the model is also used to identify situations in which the proposed treatments might be harmful.

Original languageEnglish
Pages (from-to)83-99
Number of pages17
JournalJournal of Theoretical Biology
StatePublished - 1 Mar 2013
Externally publishedYes


  • Inflammatory response
  • Intestine
  • Mathematical model
  • TLR4
  • TLR9


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