Impact of corticosteroid on intestinal injury in a gastroschisis rat model: morphometric analysis

Bittencourt, Daniel Guimarães; Barreto, Maria Weber Guimarães; França, Willy Marcus; Gonçalves, Anderson; Sbragia, Lourenço

doi:10.1016/j.jpedsurg.2005.11.050

Cited by 25 publications

(17 citation statements)

References 29 publications

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“…Based on the hypothesis that prolonged exposure of the fetal gut to amniotic fluid is a significant factor in the development of the typical bowel damage [6][7][8]15], much debate has taken place regarding the possible benefit of preterm delivery. On the other hand, prematurity and low birth weight seem to correlate with adverse outcome, such as higher occurrence of sepsis and longer time to full feeds and hospitalization period [1,10,16].…”

Section: Discussionmentioning

confidence: 99%

Factors determining outcome in gastroschisis: clinical experience over 18 years

Jager

Heij

2007

Pediatr Surg Int

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Although the survival in gastroschisis has improved to more than 85%, serious morbidity with consequent long hospital stay is still very common. Alternative strategies such as planned early delivery and amniotic fluid exchange are being explored. In order to evaluate these approaches, adequate risk stratification of patients with gastroschisis is required. The aim of this study was to identify the risk factors associated with increased morbidity and mortality. A retrospective analysis of all patients with gastroschisis treated at our institution between 1988 and 2005 was conducted. Patients' data were collected from the files and compared for statistical significance with three outcome measures: (1) complicated post-operative course; (2) time to full enteral feeding (TFE); (3) length of hospital stay (LOS). SPSS was used for statistical analysis. Fifty-nine newborns with gastroschisis were admitted during the study period. Antenatal diagnosis was made in 40 cases (68%). Associated malformations (other than intestinal anomalies) were present in eight patients. One patient with trisomy 13 was excluded from the analysis. Ten patients (17%) had compromised bowel (atresia, severe ischaemia or a combination). Primary repair was successful in 47 (81%) and in 11 patients a silo was applied. Overall survival was 54/58 children (93%), four patients died. Complications associated with closure occurred in eight patients. Postoperative course was uncomplicated in 45 patients and complicated in 13. The RR for patients with compromised bowel to have a complicated post-operative course is 9 (95% CI 2-39) and the RR to die is 20 (95% CI 2-222) for these patients. Risk stratification of patients with gastroschisis appears possible based on the presence of compromised bowel before closure.

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Section: Discussionmentioning

confidence: 99%

Factors determining outcome in gastroschisis: clinical experience over 18 years

Jager

Heij

2007

Pediatr Surg Int

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“…Corticosteroid-reversible inflammatory reactions have been observed in studies on gastroschisis, when the bowels are exposed to intrauterine trauma [9]. MM seems to present a similar pattern due to spinal exposure, but the effect of corticosteroids in this setting is unclear [10].…”

Section: Introductionmentioning

confidence: 99%

Corticosteroids Reduce Glial Fibrillary Acidic Protein Expression in Response to Spinal Cord Injury in a Fetal Rat Model of Dysraphism

Melo-Filho¹,

Barreto²,

Nassr³

et al. 2009

Pediatr Neurosurg

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Background: Exposure of the spinal cord in myelomeningocele (MM) throughout gestation increases spinal injury. Astrocyte activation evidenced by glial fibrillary acidic proteins (GFAP) indicates the extent of injury. Corticosteroids modulate GFAP synthesis, but their effect in MM is unclear. The purpose of this study was to evaluate the GFAP expression in a fetal rat model of dysraphism and the effect of corticosteroid treatment on this marker and on clinical neurological disabilities. Methods: Dysraphism was surgically created in 2 groups of 48 rat fetuses; group 1: control, and group 2: treated with corticosteroid. Each group was subdivided into fetuses with surgically created MM, controls and shams on day 18.5 of gestation (term = 22 days). Fetuses were harvested on day 21.5, examined for evidence of neurological deficits, and the following clinical parameters were registered: kyphosis, tail deformities, leg deformities, leg paralysis or paresis and pain perception. The fetuses were fixed for GFAP immunostaining. Results: All fetuses with MM in group 1 presented neurological deficits and glial reactions with GFAP expression, as opposed to controls and shams. In group 2, corticosteroid treatment prevented some neurological deficits (18–25%), reducing glial response and GFAP expression. Conclusions: Experimentally induced dysraphism in the rat fetus is related to glial response and increased GFAP expression in the spinal cord. Corticoid treatment clinically improved nerve injury in some fetuses. It reduced glial reaction and GFAP expression.

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“…An attempt to overcome these difficulties was to create an experimental model with the surgical introduction of brain tissue fragments directly into the lung. Among the various models of experimental intrauterine fetal surgery, we chose the experimental model of gastroschisis described by Bittencourt et al . (2006), with some modifications.…”

Section: Discussionmentioning

confidence: 99%

Development of an experimental model of brain tissue heterotopia in the lung

Quemelo

Sbragia

Peres

2007

Int J Experimental Path

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The presence of heterotopic brain tissue in the lung is a rare abnormality. The cases reported thus far are usually associated with neural tube defects (NTD). As there are no reports of experimental models of NTD that present this abnormality, the objective of the present study was to develop a surgical method of brain tissue heterotopia in the lung. We used 24 pregnant Swiss mice divided into two groups of 12 animals each, denoted 17GD and 18GD according to the gestational day (GD) when caesarean section was performed to collect the fetuses. Surgery was performed on the 15th GD, one fetus was removed by hysterectomy and its brain tissue was cut into small fragments and implanted in the lung of its litter mates. Thirty-four live fetuses were obtained from the 17GD group. Of these, eight (23.5%) were used as control (C), eight (23.5%) were sham operated (S) and 18 (52.9%) were used for pulmonary brain tissue implantation (PBI). Thirty live fetuses were obtained from the females of the 18GD group. Of these, eight (26.6%) were C, eight (26.6%) S and 14 (46.6%) were used for PBI. Histological examination of the fetal trunks showed implantation of GFAP-positive brain tissue in 85% of the fetuses of the 17GD group and in 100% of those of the 18GD group, with no significant difference between groups for any of the parameters analysed. The experimental model proved to be efficient and of relatively simple execution, showing complete integration of the brain tissue with pulmonary and pleural tissue and thus representing a model that will permit the study of different aspects of cell implantation and interaction.

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Impact of corticosteroid on intestinal injury in a gastroschisis rat model: morphometric analysis

Cited by 25 publications

References 29 publications

Factors determining outcome in gastroschisis: clinical experience over 18 years

Factors determining outcome in gastroschisis: clinical experience over 18 years

Corticosteroids Reduce Glial Fibrillary Acidic Protein Expression in Response to Spinal Cord Injury in a Fetal Rat Model of Dysraphism

Development of an experimental model of brain tissue heterotopia in the lung

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