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Swanson JR, Hair A, Clark RH, Gordon PV. Spontaneous intestinal perforation (SIP) will soon become the most common form of surgical bowel disease in the extremely low birth weight (ELBW) infant. J Perinatol 2022; 42:423-429. [PMID: 35177793 DOI: 10.1038/s41372-022-01347-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 01/25/2022] [Accepted: 02/03/2022] [Indexed: 12/12/2022]
Abstract
Recent data have revealed declines in the prevalence rates of NEC over the last decade in premature infants. In contrast, SIP has either remained steady or risen during the same epoch. These trends are consistent with our knowledge of the clinical arena. The ability to discern SIP contamination within NEC datasets has slowly improved. Additionally, quality improvement efforts are being utilized to reduce NEC through stewardship of antibiotics, acid inhibitors, central lines and blood products, as well as optimization of human milk diets. These forces are moving us to a new era, where NEC will no longer be the dominant surgical intestinal disease of the extremely preterm neonate. Indeed, in the extremely low birth weight (ELBW) population, SIP may already be the most prevalent reason for abdominal surgery. In this perspective, the reader will find supporting data and references for these assertions as well as predictions for the future.
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Affiliation(s)
- Jonathan R Swanson
- Division of Neonatology, University of Virginia Children's Hospital, Charlottesville, VA, USA.
| | - Amy Hair
- Section of Neonatology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA
| | - Reese H Clark
- Pediatrix-Obstetrix Center for Research and Education, Sunrise, FL, USA
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Lu FZ, Jiang ZY, Wang XX, Luo YH, Li XF, Liu HL. Role of the insulin-like growth factor system in epiphyseal cartilage on the development of Langshan and Arbor Acres chickens, Gallus domesticus. Poult Sci 2010; 89:956-65. [PMID: 20371848 DOI: 10.3382/ps.2008-00556] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We measured the mRNA transcript expression patterns for members of the insulin-like growth factor (IGF) system during embryonic and postnatal development in epiphyseal cartilage from Langshan (LS) and Arbor Acres (AA) chickens. Insulin-like growth factor binding protein (IGFBP)-2 expression was positively correlated with IGF-I from embryonic day (E) 14 to postnatal d (P) 0 and with IGF-II from E14 to P14 but negatively correlated with IGF-I from P0 to P42 and IGF-II from P14 to P42. Expression of IGFBP-5 correlated positively with IGF-I from E14 to P0 but negatively from P0 to P28. The results suggest that these genes are regulated in a coordinated fashion during development. A negative correlation was found between IGFBP-7 and IGF-II during P0 to P42. A positive correlation was found between IGFBP-3 (E14 to E18, P14 to P42) and IGF-IR and between IGFBP-3 (E14 to P0, P14 to P42) and IGF-I. The endocrine factors can be integrated with nutrition to regulate animal growth. In our study, AA chickens were fed a nutrient-rich AA diet, and LS chickens were fed either an AA diet or a less-rich diet. The LS and AA chickens fed the same AA diet showed no differences in IGF-I, IGF-I receptor, IGFBP-2, IGFBP-5, IGFBP-7, and IGFBP-3 but did still show differences in IGF-II. Our data indicate that these select genes may show linked expression during certain periods of development and that differences in gene expression respond differently to nutrient intake in LS and AA chickens.
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Affiliation(s)
- F Z Lu
- College of Animal Science and Technology, Nanjing Agricultural University, Nanjing, 210095, P. R. China
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Maheshwari A, Kurundkar AR, Shaik SS, Kelly DR, Hartman Y, Zhang W, Dimmitt R, Saeed S, Randolph DA, Aprahamian C, Datta G, Ohls RK. Epithelial cells in fetal intestine produce chemerin to recruit macrophages. Am J Physiol Gastrointest Liver Physiol 2009; 297:G1-G10. [PMID: 19443732 PMCID: PMC2711762 DOI: 10.1152/ajpgi.90730.2008] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Macrophages are first seen in the fetal intestine at 11-12 wk and rapidly increase in number during the 12- to 22-wk period of gestation. The development of macrophage populations in the fetal intestine precedes the appearance of lymphocytes and neutrophils and does not require the presence of dietary or microbial antigens. In this study, we investigated the role of chemerin, a recently discovered, relatively selective chemoattractant for macrophages, in the recruitment of macrophage precursors to the fetal intestine. Chemerin mRNA/protein expression was measured in jejunoileal tissue from 10- to 24-wk human fetuses, neonates operated for intestinal obstruction, and adults undergoing bariatric surgery. The expression of chemerin in intestinal epithelial cells (IECs) was confirmed by using cultured primary IECs and IEC-like cell lines in vitro. The regulatory mechanisms involved in chemerin expression were investigated by in silico and immunolocalization techniques. IECs in the fetal, but not mature, intestine express chemerin. Chemerin expression peaked in the fetal intestine at 20-24 wk and then decreased to original low levels by full term. During the 10- to 24-wk period, chemerin accounted for most of the macrophage chemotactic activity of cultured fetal IECs. The maturational changes in chemerin expression correlated with the expression of retinoic acid receptor-beta in the intestine. Chemerin is an important mediator of epithelial-macrophage cross talk in the fetal/premature, but not in the mature, intestine. Understanding the regulation of the gut macrophage pool is an important step in development of novel strategies to boost mucosal immunity in premature infants and other patient populations at risk of microbial translocation.
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Affiliation(s)
- Akhil Maheshwari
- Pediatrics/Neonatology, Univ. of Alabama at Birmingham, VH648C, 1670 Univ. Blvd., Birmingham, AL 35294, USA.
| | - Ashish R. Kurundkar
- Departments of Pediatrics, Cell Biology, Pathology, Surgery, and Internal Medicine, University of Alabama at Birmingham (UAB), Birmingham, Alabama; Translational Research in Normal and Disordered Development (TReNDD) Program, UAB Department of Pediatrics; and Department of Pediatrics, University of New Mexico, Albuquerque, New Mexico
| | - Sadiq S. Shaik
- Departments of Pediatrics, Cell Biology, Pathology, Surgery, and Internal Medicine, University of Alabama at Birmingham (UAB), Birmingham, Alabama; Translational Research in Normal and Disordered Development (TReNDD) Program, UAB Department of Pediatrics; and Department of Pediatrics, University of New Mexico, Albuquerque, New Mexico
| | - David R. Kelly
- Departments of Pediatrics, Cell Biology, Pathology, Surgery, and Internal Medicine, University of Alabama at Birmingham (UAB), Birmingham, Alabama; Translational Research in Normal and Disordered Development (TReNDD) Program, UAB Department of Pediatrics; and Department of Pediatrics, University of New Mexico, Albuquerque, New Mexico
| | - Yolanda Hartman
- Departments of Pediatrics, Cell Biology, Pathology, Surgery, and Internal Medicine, University of Alabama at Birmingham (UAB), Birmingham, Alabama; Translational Research in Normal and Disordered Development (TReNDD) Program, UAB Department of Pediatrics; and Department of Pediatrics, University of New Mexico, Albuquerque, New Mexico
| | - Wei Zhang
- Departments of Pediatrics, Cell Biology, Pathology, Surgery, and Internal Medicine, University of Alabama at Birmingham (UAB), Birmingham, Alabama; Translational Research in Normal and Disordered Development (TReNDD) Program, UAB Department of Pediatrics; and Department of Pediatrics, University of New Mexico, Albuquerque, New Mexico
| | - Reed Dimmitt
- Departments of Pediatrics, Cell Biology, Pathology, Surgery, and Internal Medicine, University of Alabama at Birmingham (UAB), Birmingham, Alabama; Translational Research in Normal and Disordered Development (TReNDD) Program, UAB Department of Pediatrics; and Department of Pediatrics, University of New Mexico, Albuquerque, New Mexico
| | - Shehzad Saeed
- Departments of Pediatrics, Cell Biology, Pathology, Surgery, and Internal Medicine, University of Alabama at Birmingham (UAB), Birmingham, Alabama; Translational Research in Normal and Disordered Development (TReNDD) Program, UAB Department of Pediatrics; and Department of Pediatrics, University of New Mexico, Albuquerque, New Mexico
| | - David A. Randolph
- Departments of Pediatrics, Cell Biology, Pathology, Surgery, and Internal Medicine, University of Alabama at Birmingham (UAB), Birmingham, Alabama; Translational Research in Normal and Disordered Development (TReNDD) Program, UAB Department of Pediatrics; and Department of Pediatrics, University of New Mexico, Albuquerque, New Mexico
| | - Charles Aprahamian
- Departments of Pediatrics, Cell Biology, Pathology, Surgery, and Internal Medicine, University of Alabama at Birmingham (UAB), Birmingham, Alabama; Translational Research in Normal and Disordered Development (TReNDD) Program, UAB Department of Pediatrics; and Department of Pediatrics, University of New Mexico, Albuquerque, New Mexico
| | - Geeta Datta
- Departments of Pediatrics, Cell Biology, Pathology, Surgery, and Internal Medicine, University of Alabama at Birmingham (UAB), Birmingham, Alabama; Translational Research in Normal and Disordered Development (TReNDD) Program, UAB Department of Pediatrics; and Department of Pediatrics, University of New Mexico, Albuquerque, New Mexico
| | - Robin K. Ohls
- Departments of Pediatrics, Cell Biology, Pathology, Surgery, and Internal Medicine, University of Alabama at Birmingham (UAB), Birmingham, Alabama; Translational Research in Normal and Disordered Development (TReNDD) Program, UAB Department of Pediatrics; and Department of Pediatrics, University of New Mexico, Albuquerque, New Mexico
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Abstract
Spontaneous intestinal perforation (SIP) occurs commonly in extremely low birth weight (ELBW) infants. Our understanding of its etiologies has improved dramatically over the last decade. Included in this comprehension is an ongoing reconciliation of the iatrogenic risk factors, the microbiology, and the histopathology. The latter shows focal perforations with necrosis of the muscularis externa and no sign of ischemic damage (typically characterized by mucosal necrosis in the preterm bowel). Associations include extreme prematurity, early postnatal steroids (EPS), early use of indomethacin (EUI), and two common pathogens (Candida and Staphylococcus epidermis). Animal models of SIP suggest that all risk factors converge on a common collection of signaling pathways: those of nitric oxide synthases (NOS), insulin-like growth factors (IGFs), and epidermal growth factors (EGFs). Many of these factors skew trophism of the ileum (defined as thinning of the submucosa concomitant with hyperplasia of the muscosa). Global depletion of NOS is associated with disturbed intestinal motility and diminished transforming growth factor-alpha (TGF-alpha) in the muscularis externa. This constellation of insults seems to make the distal intestine vulnerable to perforation during recovery of motility.
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Affiliation(s)
- Phillip V Gordon
- Department of Pediatrics, Ochsner Health System, New Orleans, Louisiana, 70121, USA.
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Lu FZ, Wang XX, Pan QX, Huang RH, Liu HL. Expression of genes involved in the somatotropic, thyrotropic, and corticotropic axes during development of Langshan and Arbor Acres chickens. Poult Sci 2008; 87:2087-97. [PMID: 18809871 DOI: 10.3382/ps.2007-00493] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We investigated changes in mRNA expression of the somatotropic, thyrotropic, and corticotropic axes of Langshan (LS) and Arbor Acres (AA) broiler chickens during embryonic and postnatal development. We found an inverse expression profile between pituitary growth hormone (GH) and hepatic GH receptor mRNA [postnatal d (P)28 to P42], insulin-like growth factor (IGF)-I, and IGF-IR (P0 to P42), respectively. Hepatic IGF-I was a major point of control in the GH-IGF axis from P0 to P28. Pituitary GH-releasing hormone receptor may serve an autocrine-paracrine function from P0 to P28, and hypothalamic ghrelin may affect growth by stimulating the release of hepatic IGF-I from embryonic d (E)8 to P28. Hypothalamic ghrelin might interact with corticotropin-releasing hormone (CRH) from P0 to P28. Hepatic IGF-binding protein-2 regulated growth by regulating hepatic IGF-II bioavailability from P0 to P42. Hepatic IGF-binding protein-5 was an important IGF mediator. A coexpression profile was found between hypothalamic GH-releasing hormone (E10 to E16 and P0 to P42), somatostatin (SS; P0 to P28), thyrotropin-releasing hormone (E10 to E16 and P0 to P28), ghrelin (P0 to P42), and pituitary GH mRNA, hypothalamic SS (P0 to P28), corticotropin-releasing hormone (P0 to P42), thyrotropin-releasing hormone (E10 to E18 and P0-P42), and thyroid-stimulating hormone-beta mRNA, respectively. Moreover, AA chickens were fed a nutrient-rich AA diet (as a control group) and LS chickens were fed either a less nutritious LS diet or the AA diet. Langshan and AA chickens fed the same AA diet showed no differences in pituitary GH, hypothalamic SS, ghrelin, hepatic IGF-I, or GH receptor mRNA. Our data indicate that select genes may show parallel expression during certain periods of development, and that differences in BW and gene expression respond differently to nutrient intake in LS and AA chickens. Our findings may help improve the molecular breeding of chickens.
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Affiliation(s)
- F Z Lu
- College of Animal Science and Technology, Nanjing Agricultural University, Nanjing, 210095, P. R. China
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Abstract
The lysosomal cysteine proteinase cathepsin L is involved in proteolytic processing of internalized proteins. In transformed cells, where it is frequently overexpressed, its intracellular localization and functions can be altered. Previously, we reported that treatment of highly metastatic, murine carcinoma H-59 cells with small molecule cysteine proteinase inhibitors altered the responsiveness of the type I insulin-like growth factor (IGF-I) receptor and consequently reduced cell invasion and metastasis. To assess more specifically the role of cathepsin L in IGF-I-induced signaling and tumorigenicity, we generated H-59 subclones with reduced cathepsin L expression levels. These clonal lines showed an altered responsiveness to IGF-I in vitro, as evidenced by (i) loss of IGF-I-induced receptor phosphorylation and Shc recruitment, (ii) reduced IGF-I (but not IGF-II)-induced cellular proliferation and migration, (iii) decreased anchorage-independent growth and (iv) reduced plasma membrane levels of IGF-IR. These changes resulted in increased apoptosis in vivo and an impaired ability of the cells to form liver metastases. The results demonstrate that cathepsin L expression levels regulate cell responsiveness to IGF-I and thereby identify a novel function for cathepsin L in the control of the tumorigenic/metastatic phenotype.
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