Comparative effects of probiotics and pentoxifylline on intestinal injury biomarkers (HMGB-1, I-FABP) in preterm neonates with necrotizing enterocolitis: A randomized controlled trial

CFU daily via feeding tube). Serum HMGB-1, I-FABP, and TAC levels were measured at diagnosis (before adjunctive therapy) and at discharge.ResultsAfter treatment, all groups showed significant decreases in HMGB-1 and I-FABP and significant increases in TAC (p < 0.05). Both pentoxifylline and probiotics showed greater biomarker improvement. The probiotic group had the largest reduction in I-FABP (p < 0.05). Hospital stay was significantly shorter in the pentoxifylline and probiotic groups, with the shortest duration observed in the probiotic group (p < 0.05). Mortality and progression to stage III NEC occurred only in the antibiotic group; however, the study was not powered to detect differences in major clinical outcomes. Higher HMGB-1 and I-FABP levels were associated with longer hospitalization.ConclusionPentoxifylline and probiotics may serve as beneficial adjunctive therapies in the treatment of stage IIA NEC, with probiotics showing greater improvements in biomarkers. Further large-scale studies are needed to confirm clinical benefit.