Ginger (Zingiber officinale Roscoe) for the treatment and prevention of necrotizing enterocolitis

J Ethnopharmacol. 2018 Oct 28:225:297-308. doi: 10.1016/j.jep.2018.07.009. Epub 2018 Jul 11.


Ethnopharmacological relevance: Necrotizing enterocolitis (NEC) is the most important gastrointestinal emergency affecting especially preterm infants and causes severe morbidities and mortality. However, there is no cure. Oxidant stress, inflammation, apoptosis, as well as prematurity are believed to responsible in the pathogenesis of the disease. Ginger and its compounds have anti-inflammatory, antimicrobial, anti-oxidant properties and immunomodulatory, cytoprotective/regenerative actions.

Aim of the study: This study aimed to evaluate the beneficial effects of ginger on the intestinal damage in an experimental rat model of NEC.

Materials and methods: Thirty newborn Wistar rats were divided into three groups: NEC, NEC + ginger and control in this experimental study. NEC was induced by injection of intraperitoneal lipopolysaccharide, feeding with enteral formula, hypoxia-hyperoxia and cold stress exposure. The pups in the NEC + ginger group were orally administered ginger at a dose of 1000 mg/kg/day. Proximal colon and ileum were excised. Histopathological, immunohistochemical (TUNEL for apoptosis, caspase 3 and 8) and biochemical assays including xanthine oxidase (XO), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), malonaldehyde (MDA) and myeloperoxidase (MPO), tumor necrosis factor-α (TNF-α), interleukin1β (IL-1β), and interleukin 6 (IL-6) activity were evaluated.

Results: Compared with the NEC group, the rat pups in the NEC + ginger group had better clinical disease scores and weight gain (p < 0.05). Macroscopic evaluation, Histopathologic and apoptosis assessment (TUNEL, caspase 3 and 8) releaved that severity of intestinal damage were significantly lower in the NEC + ginger group (p < 0.05). The levels of TNF-α, IL-1β and IL-6 in the ginger treated group were significantly decreased (P < 0.05). The GSH-Px and SOD levels of the ginger treated group were significantly preserved in the NEC + ginger group (p < 0.05). The tissue XO, MDA and MPO levels of the NEC + ginger group were significantly lower than those in the NEC group (P < 0.05).

Conclusion: Ginger therapy efficiently ameliorated the severity of intestinal damage in NEC and may be a promising treatment option.

Keywords: Anti-inflammation; Ginger, anti-oxidation; Necrotizing enterocolitis; Newborn; Prevention; Rat.

MeSH terms

  • Animals
  • Anti-Inflammatory Agents / pharmacology
  • Anti-Inflammatory Agents / therapeutic use*
  • Apoptosis / drug effects
  • Caspase 3 / metabolism
  • Caspase 8 / metabolism
  • Cytokines / metabolism
  • Enterocolitis, Necrotizing / drug therapy*
  • Enterocolitis, Necrotizing / metabolism
  • Enterocolitis, Necrotizing / prevention & control
  • Glutathione Peroxidase / metabolism
  • Intestinal Mucosa / metabolism
  • Intestines / drug effects
  • Intestines / pathology
  • Malondialdehyde / metabolism
  • Peroxidase / metabolism
  • Phytotherapy
  • Plant Extracts / pharmacology
  • Plant Extracts / therapeutic use*
  • Rats, Wistar
  • Superoxide Dismutase / metabolism
  • Xanthine Oxidase / metabolism
  • Zingiber officinale*


  • Anti-Inflammatory Agents
  • Cytokines
  • Plant Extracts
  • Malondialdehyde
  • Peroxidase
  • Glutathione Peroxidase
  • Superoxide Dismutase
  • Xanthine Oxidase
  • Casp3 protein, rat
  • Casp8 protein, rat
  • Caspase 3
  • Caspase 8