Advances in necrotizing enterocolitis

Oliveira, Nelson Diniz de; Miyoshi, Milton Harumi

doi:10.2223/jped.1296

Cited by 3 publications

(3 citation statements)

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“…NEC is a leading cause of morbidity and mortality among premature infants in the neonatal intensive care unit (NICU) [19,20]. The mortality of NEC ranges from 20 to 50% [19,[21][22][23][24][25]. The exact pathophysiology of NEC has not been defined, but prematurity, exaggerated inflammatory response, aberrant bacterial colonization, hypoxia, and intestinal ischemia have all been implicated [19,22,25].…”

Section: Discussionmentioning

confidence: 99%

A Rabbit Model for Optimization of Amniotic Fluid Components in the EXTrauterine Environment for Newborn Development (EXTEND) System

et al. 2020

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In this model article, we present a protocol for continuous amniotic fluid exchange in rabbits using a novel system to test the effects of growth factor-deficient, artificial amniotic fluid on bowel development. Background: Ideally, the EXTrauterine Environment for Neonatal Development (EXTEND) will provide physiologic support to the extreme premature infant. An important component of that environment is the amniotic fluid. Thus, we developed an animal model to study the growth factors found within amniotic fluid and inform design of a synthetic fluid to optimize fetal development. Methods: We designed a model of amniotic fluid exchange within the pregnant rabbit, continuously removing the natural fluid from around 2 fetuses per doe and replacing it with a physiologic electrolyte solution during the final 100 h of gestation. Two fetuses from the contralateral uterine horn were used as sham-operated controls. Thirty-eight fetuses were analyzed, 19 in each group. We analyzed the fetal growth and bowel development. Results: Ultrasound after 100 h of exchange showed equivalent fluid volumes, p = 0.63. Cultures were negative for bacterial colonization. Final fluid protein concentrations were 11.6% that of control fluid (mean 1,451 ± 224.2 vs. 12,491 ± 849.2 μg/mL). There was no significant difference in fetal growth, with experimental weights 91.4% of control weights, p = 0.07. Fetal bowel weights (90.1%, p = 0.16) and lengths (94.2%, p = 0.49) were also not significantly less compared to controls. There was no significant difference in villous height or crypt depth measurements between the groups, and absorptive capacity of the bowel was not different between groups, p = 0.44. Conclusion: This animal model allows for manipulation of the components of amniotic fluid. Marked reduction of natural amniotic fluid proteins during gestation does not appear to significantly impair fetal growth or bowel development. Further work with this model will assess the importance of amniotic fluid components for normal development to inform design of a synthetic fluid for use during EXTEND.

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Section: Discussionmentioning

confidence: 99%

A Rabbit Model for Optimization of Amniotic Fluid Components in the EXTrauterine Environment for Newborn Development (EXTEND) System

et al. 2020

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“…Each slide was examined by a blinded observer under an optical binocular microscope. A standard analysis of the slides was performed to assess tissue damage levels, according to the protocol by Dvorak et al and modified by Granger et al 25,26 . During the microscopic evaluation, three histological parameters were measured: villous flattening, reduction in the number of villi and thinning of the intestinal wall, of mild, moderate, and severe intensity.…”

Section: Methodsmentioning

confidence: 99%

Use of sildenafil and l-arginine in an experimental rat model for the prevention of neonatal necrotizing enterocolitis

Moreira

Dias

Cadena

et al. 2022

Sci Rep

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Necrotizing enterocolitis (NEC) has a 45% mortality in neonatal intensive care units. This paper aimed to evaluate the isolated and combined effects of sildenafil and l-arginine in the prevention of necrotizing enterocolitis. Neonatal rats were fed formula milk and submitted to hypoxia under a 100% N2 atmosphere for 70 s. Then, animals were subjected to hypothermia (4 °C for 10 min), twice a day for 3 days. Forty neonatal rats were divided into five groups: negative control—not submitted to the protocol (n = 5), sildenafil group—NEC protocol (n = 9), l-arginine group—NEC protocol (n = 9), l-arginine and sildenafil group—NEC protocol (n = 9) and positive control—NEC protocol and intraperitoneal saline solution (n = 8). Jejunum and terminal ileus were removed for histopathologic and immunohistochemical Ki-67 analysis. Kruskal–Wallis test was used to analyze mortality, survival, body weight, intestinal injury score and Ki-67 proliferation index. All animals submitted to the protocol developed enterocolitis. Mortality rate was higher in group that received only l-arginine (p = 0.0293). The Ki-67 analysis showed a higher proliferative index in groups that received interventional drugs (p = 0.017). In conclusion, sildenafil and l-arginine were not effective to reduce intestinal injury.

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“…5 The high mortality and morbidity from NEC have not significantly improved during the last 40 years. 5,6 Although extensive research has investigated the pathophysiology of NEC, a complete understanding has not been fully elucidated.…”

Section: Introductionmentioning

confidence: 99%

Oral L-arginine supplementation and faecal calprotectin levels in very low birth weight neonates

et al. 2012

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Advances in necrotizing enterocolitis

Cited by 3 publications

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A Rabbit Model for Optimization of Amniotic Fluid Components in the EXTrauterine Environment for Newborn Development (EXTEND) System

A Rabbit Model for Optimization of Amniotic Fluid Components in the EXTrauterine Environment for Newborn Development (EXTEND) System

Use of sildenafil and l-arginine in an experimental rat model for the prevention of neonatal necrotizing enterocolitis

Oral L-arginine supplementation and faecal calprotectin levels in very low birth weight neonates

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