Offersen Simone Margaard, Henriksen Nicole Lind, Brunse Anders
Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark.
Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg, Denmark.
Exp Mol Pathol. 2024 Dec;140:104936. doi: 10.1016/j.yexmp.2024.104936. Epub 2024 Oct 3.
Necrotizing enterocolitis (NEC) is a serious condition in premature infants, in which a portion of the intestine undergoes inflammation and necrosis. The preterm pig develops NEC spontaneously, making it a suitable model for exploring novel NEC treatments. We aimed to revise the intestinal scoring system to more accurately describe the diversity of NEC lesions in the preterm piglet model. We included 333 preterm piglets from four experiments, each delivered via cesarean section. The piglets were fed either a gently processed (GP) or harshly processed (HP) milk formula for 96 h before euthanasia. At necropsy, the gastrointestinal tract was assessed with 1) an established 6-grade score and 2) a descriptive approach focusing on the distribution and severity of hyperemia, hemorrhage, pneumatosis intestinalis (intramural gas), and necrosis. Subsequently, the descriptive registrations were converted into a weighted and cumulative point (WCP) score. Compared to the 6-grade score, the WCP score enabled a greater segregation of severity levels, especially among organs with more prominent NEC lesions. IL-1β in small intestinal lesions and both IL-8 and IL-1β in colon lesions correlated positively with the WCP scale. A histopathological grade system (0-8) was established and revealed mucosal pathology in lesion biopsies, which were not recognized macroscopically. Finally, the WCP score showed a higher NEC-promoting effect of the HP formula compared to the GP formula. The descriptive registrations and extended score range of this revised intestinal scoring system enhance the accuracy of describing NEC lesions in preterm pigs. This approach may increase the efficiency of preclinical NEC experiments.
坏死性小肠结肠炎（NEC）是一种发生在早产儿身上的严重病症，其中一部分肠道会发生炎症和坏死。早产猪会自发患上NEC，这使其成为探索新型NEC治疗方法的合适模型。我们旨在修订肠道评分系统，以更准确地描述早产仔猪模型中NEC病变的多样性。我们纳入了来自四项实验的333只早产仔猪，每只均通过剖宫产分娩。在安乐死之前，给仔猪喂食轻度加工（GP）或重度加工（HP）的牛奶配方奶96小时。尸检时，用以下两种方法评估胃肠道：1）既定的6级评分；2）一种描述性方法，重点关注充血、出血、肠壁积气（肠壁内气体）和坏死的分布及严重程度。随后，将描述性记录转换为加权累积积分（WCP）评分。与6级评分相比，WCP评分能够更明显地区分严重程度级别，尤其是在NEC病变更突出的器官中。小肠病变中的白细胞介素-1β（IL-1β）以及结肠病变中的白细胞介素-8（IL-8）和IL-1β均与WCP量表呈正相关。建立了一种组织病理学分级系统（0 - 8级），并在病变活检中发现了肉眼未识别的黏膜病理学变化。最后，与GP配方奶相比，WCP评分显示HP配方奶对NEC的促进作用更强。这种修订后的肠道评分系统的描述性记录和扩展的评分范围提高了描述早产猪NEC病变的准确性。这种方法可能会提高临床前NEC实验的效率。
