Division of General and Thoracic Surgery, Translational Medicine, The Hospital for Sick Children, Toronto, ON, Canada.
Division of Gastroenterology, Hepatology and Nutrition, Translational Medicine, The Hospital for Sick Children, Toronto, ON, Canada.
FASEB J. 2021 Jan;35(1):e21265. doi: 10.1096/fj.202001426R.
Necrotizing enterocolitis (NEC) is one of the most severe gastrointestinal diseases affecting premature infants. It has been shown that NEC is associated with disrupted intestinal barrier and dysregulated endoplasmic reticulum (ER)-stress response. It has also been shown that stem cells derived from amniotic fluid (AFSC) rescued intestinal injury in experimental NEC. Herein, we hypothesized that the beneficial effects of AFSC in the injured intestine are due to the restoration of intestinal barrier function. We evaluated intestinal barrier function using an ex vivo intestinal organoid model of NEC. We found that AFSC restored the expression and localization of tight junction proteins in intestinal organoids, and subsequently decreased epithelial permeability. AFSC rescued tight junction expression by inducing a protective ER stress response that prevents epithelial cell apoptosis in injured intestinal organoids. Finally, we validated these results in our experimental mouse model of NEC and confirmed that AFSC induced sustained ER stress and prevented intestinal apoptosis. This response led to the restoration of tight junction expression and localization, which subsequently reduced intestinal permeability in NEC pups. These findings confirm that intestinal barrier function is disrupted during NEC intestinal injury, and further demonstrate the disruption can be reversed by the administration of AFSC through the activation of the ER stress pathway. This study provides insight into the pathogenesis of NEC and highlights potential therapeutic targets for the treatment of NEC.
坏死性小肠结肠炎(NEC)是影响早产儿的最严重的胃肠道疾病之一。研究表明,NEC 与肠道屏障破坏和内质网(ER)应激反应失调有关。研究还表明,羊水来源的干细胞(AFSC)可挽救实验性 NEC 中的肠道损伤。在此,我们假设 AFSC 在受损肠道中的有益作用是由于恢复了肠道屏障功能。我们使用 NEC 的离体肠类器官模型来评估肠道屏障功能。我们发现 AFSC 通过诱导保护性 ER 应激反应来恢复肠类器官中紧密连接蛋白的表达和定位,从而降低上皮细胞通透性。AFSC 通过诱导保护性 ER 应激反应来挽救紧密连接蛋白的表达,从而防止受损肠类器官中的上皮细胞凋亡。最后,我们在 NEC 的实验性小鼠模型中验证了这些结果,并证实 AFSC 诱导持续的 ER 应激并防止肠道细胞凋亡。这种反应导致紧密连接蛋白的表达和定位恢复,从而降低 NEC 幼仔的肠道通透性。这些发现证实了肠道屏障功能在 NEC 肠道损伤期间受到破坏,并进一步表明通过激活 ER 应激途径给予 AFSC 可以逆转这种破坏。这项研究为 NEC 的发病机制提供了新的见解,并强调了通过激活 ER 应激途径治疗 NEC 的潜在治疗靶点。
Stem Cells Transl Med. 2025-2-11