Intestinal trefoil factor in treatment of neonatal necrotizing enterocolitis in the rat model

Dietary Glucose Ameliorates Impaired Intestinal Development and Immune Homeostasis Disorders Induced by Chronic Cold Stress in Pig Model

Endotherms are easily challenged by chronic cold stress. In this study, the development and injury of the small intestine in the Min pig model and Yorkshire pig model under chronic cold stress, and the molecular mechanisms by which glucose supplementation reduces small intestinal mucosal damage were investigated. The results showed that morphological structure lesions of the jejunal mucosa and ileal mucosa were visible in Yorkshire pigs under chronic cold stress. Meanwhile, the Occludin mRNA and protein expression in jejunal mucosa of Yorkshire pigs was decreased. Chronic cold stress enhanced the expression of Toll-like receptor 4 (TLR4), the myeloid differentiation main response 88 (MyD88), nucleotide-binding domain and leucine-rich repeat protein 3 (NLRP3), cleaved caspase-1, mature-IL-1β, and high-mobility group box 1 (HMGB 1) mRNA and protein expression in jejunal mucosa of Yorkshire pigs, whereas the mRNA and protein of Bax was triggered in ileal mucosa. In Min pigs, no such deleterious consequences were observed. Dietary glucose supplementation ameliorates small intestinal mucosal injury, declined TLR4 and MyD88 expression in jejunal mucosa. In conclusion, chronic cold stress induced the small intestinal mucosa damage in Yorkshire pigs, whereas glucose supplementation mitigated the deleterious effects of chronic cold stress on the small intestine.

Intestinal trefoil factor increased the Bcl-2 level in a necrotizingenterocolitis neonate rat model

BACKGROUND/AIM

The aim of this study was to investigate the therapeutic effect of intestinal trefoil factor (ITF) on necrotizing enterocolitis (NEC) by observing the pathological changes and detecting the protein level differences in Caspase-3, Bax, and Bcl-2 in an NEC neonate rat model.

MATERIALS AND METHODS

A Wistar rat model of NEC was established and 30 one-day-old neonate Wistar rats were randomly divided into three groups including a normal control (group A), NEC rats treated with 0.2 ml physiological saline through intraperitoneal (i.p.) injection (group B), and NEC rats treated with 0.2 mg ITF by i.p injection (group C).

RESULTS

Compared with group B, there were statistically significant differences in Caspase-3, Bax, and Bcl-2 levels in groups A and C(P < 0.05). Moreover, there was a significant difference in the Bcl-2 level between groups A and B (P < 0.05).

CONCLUSION

ITF alleviated injury of the intestinal tract in neonate rats with NEC and this mechanism was possibly related to a reduction in the expression of Caspase-3 and Bax and the increase in Bcl-2 expression.

Probiotics in neonatal intensive care - back to the future

Survival of extremely preterm and critically ill neonates has improved significantly over the last few decades following advances in neonatal intensive care. These include antenatal glucocorticoids, surfactant, continuous positive airway pressure support, advanced gentle modes of ventilation and inhaled nitric oxide. Probiotic supplementation is a recent significant milestone in the history of neonatal intensive care. Very few, if any, interventions match the ability of probiotics to significantly reduce the risk of death and definite necrotising enterocolitis while facilitating enteral feeds in high-risk preterm neonates. Probiotics also have a potential to benefit neonates with surgical conditions with significant gastrointestinal morbidity. Current evidence for the benefits of probiotic supplementation for neonates in an intensive care unit is reviewed. The mechanisms for the benefits of probiotics in this population are discussed, and guidelines for clinicians are provided in the context of the regulatory framework in Australia.

The role of growth factors in intestinal regeneration and repair in necrotizing enterocolitis

Necrotizing enterocolitis (NEC) is a devastating intestinal disease resulting in major neonatal morbidity and mortality. The pathology is poorly understood, and the means of preventing and treating NEC are limited. Several endogenous growth factors have been identified as having important roles in intestinal growth as well as aiding intestinal repair from injury or inflammation. In this review, we will discuss several growth factors as mediators of intestinal regeneration and repair as well as potential therapeutic agents for NEC.

Treatment with intestinal trefoil factor regulates TLR2/4 and NF-κB expression and protects against LPS-induced intestinal injury in rats

AIM: To investigate whether intestinal trefoil factor (ITF) regulates the expression of Toll-like receptor (TLR) 2/4 and nuclear factor-κB (NF-κB) and exerts a protective effect against lipopolysaccharide (LPS)-induced intestinal injury in rats.

METHODS: Twenty-four 10-day-old Wistar rats were randomly and equally divided into three groups: control group (intraperitoneally injected with normal saline 1 mL/kg ), endotoxemia group (intraperitoneally injected with LPS 5 mg/kg), and LPS + ITF group (intraperitoneally injected with LPS 5 mg/kg and recombinant ITF 0.1 mL/per rat). Rats were sacrificed 3 h after injection. A segment of the distal ileum was dissected for hematoxylin-eosin staining. Pathological changes in the small intestine were observed under an optical microscope. The mRNA and protein expression of TLR2/4 and NF-κB was detected by RT-PCR and immunohistochemistry, respectively.

RESULTS: The structure of the small intestine of rats in the control group was normal. Inflammatory cell infiltration and interstitial/epithelial edema were observed in rats in the LPS group and LPS + ITF group, and the pathological changes were significantly milder in the LPS + ITF group than in the LPS group. The expression of TLR2 mRNA and protein in the LPS + ITF group was significantly higher than that in the LPS group (7.453 ± 1.90 vs 3.069 ± 0.08, 52.125 ± 4.1 vs 20.688 ± 2.4, both P < 0.01). The expression of TLR4 and NF-κB mRNAs and proteins in the LPS + ITF group was significantly lower than that in the LPS group (TLR4 mRNA: 5.373 ± 1.18 vs 16.711 ± 1.28, P< 0.01; TLR4 protein: 16.338 ± 4.98 vs 22.760 ± 3.68, P< 0.01; NF-κB mRNA: 0.533 ± 0.05 vs 2.228 ± 0.72, P< 0.01; NF-κB protein: 36.526 ± 9.18 vs 50.433 ± 3.37, P< 0.05).

CONCLUSION: Treatment with ITF protects against LPS-induced intestinal injury in rats possibly via mechanisms associated with down-regulation of TLR4 and NF-κB expression.

Can we protect the gut in critical illness? The role of growth factors and other novel approaches

The intestine plays a central role in the pathophysiology of critical illness and is frequently called the "motor" of the systemic inflammatory response. Perturbations to the intestinal barrier can lead to distant organ damage and multiple organ failure. Therefore, identifying ways to preserve intestinal integrity may be of paramount importance. Growth factors and other peptides have emerged as potential tools for modulation of intestinal inflammation and repair due to their roles in cellular proliferation, differentiation, migration, and survival. This review examines the involvement of growth factors and other peptides in intestinal epithelial repair during critical illness and their potential use as therapeutic targets.

Bifidobacterium bifidum improves intestinal integrity in a rat model of necrotizing enterocolitis

Neonatal necrotizing enterocolitis (NEC) is a major cause of morbidity and mortality in premature infants. Oral administration of probiotics has been suggested as a promising strategy for prevention of NEC. However, little is known about the mechanism(s) of probiotic-mediated protection against NEC. The aim of this study was to evaluate the effects of Bifidobacterium bifidum treatment on development of NEC, cytokine regulation, and intestinal integrity in a rat model of NEC. Premature rats were divided into three groups: dam fed (DF), hand fed with formula (NEC), or hand fed with formula supplemented with 5 x 10(6) CFU B. bifidum per day (B. bifidum). All groups were exposed to asphyxia and cold stress to develop NEC. Intestinal injury, mucin and trefoil factor 3 (Tff3) production, cytokine levels, and composition of tight junction (TJ) and adherens junction (AJ) proteins were evaluated in the terminal ileum. B. bifidum decreased the incidence of NEC from 57 to 17%. Increased levels of IL-6, mucin-3, and Tff3 in the ileum of NEC rats was normalized in B. bifidum treated rats. Reduced mucin-2 production in the NEC rats was not affected by B. bifidum. Administration of B. bifidum normalized the expression and localization of TJ and AJ proteins in the ileum compared with animals with NEC. In conclusion, administration of B. bifidum protects against NEC in the neonatal rat model. This protective effect is associated with reduction of inflammatory reaction in the ileum, regulation of main components of mucus layer, and improvement of intestinal integrity.

The development of animal models for the study of necrotizing enterocolitis

Necrotizing enterocolitis (NEC) is the leading cause of death and long-term disability from gastrointestinal disease in preterm infants, and is characterized by acute and chronic intestinal inflammation that may lead to systemic sepsis and multi-system organ failure. NEC typically develops in the preterm infant after the administration of tube feeds, although it may occasionally be seen in full-term babies. Despite extensive clinical experience in the management of patients with NEC, the underlying cellular and molecular mechanisms leading to its development remain incompletely understood. Several animal models have therefore been developed in a variety of species in order to study the pathogenesis of NEC and to develop more effective treatment strategies. This review seeks to examine the pros and cons of animal models that have been developed in the study of NEC over the past 30 years. It will highlight the various strengths and weaknesses of experimental approaches that have been used, and discuss potential directions for the development of such models for the future.