Giang Beverly, Radulescu Andrei, Mladenov Georgi Dianov, Wilson Christopher G
Pediatrics, Loma Linda University, Loma Linda, California, USA.
Department of Neonatology, Loma Linda University Children's Hospital, Loma Linda, California, USA.
World J Pediatr Surg. 2025 Sep 4;8(4):e001034. doi: 10.1136/wjps-2025-001034. eCollection 2025.
Necrotizing enterocolitis (NEC) is a gastrointestinal emergency in premature neonates. NEC is mediated by toll-like receptor-4 (TLR-4) and associated with lung injury. Previously, we showed that prenatal heparin-binding epidermal growth factor (HB-EGF) administration decreases the incidence of intestinal injury in a rat model of NEC. We tested the hypothesis that prenatally administered HB-EGF would decrease TLR-4 activation and lung injury in a murine model.
Pregnant mice were given HB-EGF (800 μg/kg/dose) via intraperitoneal injection prior to cesarean section. Pups were exposed to a NEC model and sacrificed on signs of NEC. We collected tissue, performed histological grading of NEC, evaluated alveolar morphometry, and counted TLR-4-expressing cells by immunohistochemistry, unbiased stereology, and quantified TLR-4 protein via ELISA.
Mean alveolar area was significantly different between HB-EGF and control groups compared with NEC only (HB-EGF>NEC; <0.0001; control>NEC; =0.0008). Alveolar wall area was significantly decreased in HB-EGF and control groups versus NEC group (<0.0001). TLR-4-expressing cells were greater in the NEC group versus HB-EGF and control groups (=0.002). TLR-4 protein was increased in pups exposed to the NEC protocol compared with control (=0.005 for NEC only; =0.0004 for HB-EGF treated). There was no difference in TLR-4 protein between HB-EGF and NEC groups.
Our results suggest that prenatal HB-EGF administration preserves lung morphometry and decreases TLR-4 in a murine model of NEC. Possibly, the administration of HB-EGF prenatally to pregnant mothers at risk of delivering a premature infant susceptible to NEC may prevent lung injury.
坏死性小肠结肠炎(NEC)是早产儿的一种胃肠道急症。NEC由Toll样受体4(TLR-4)介导,并与肺损伤相关。此前,我们发现产前给予肝素结合表皮生长因子(HB-EGF)可降低NEC大鼠模型中肠损伤的发生率。我们检验了以下假设:产前给予HB-EGF可降低小鼠模型中TLR-4的激活及肺损伤。
剖宫产术前,通过腹腔注射给予怀孕小鼠HB-EGF(800μg/kg/剂量)。将幼崽暴露于NEC模型中,并在出现NEC体征时处死。我们收集组织,对NEC进行组织学分级,评估肺泡形态学,并通过免疫组织化学、无偏立体学计数表达TLR-4的细胞,并通过酶联免疫吸附测定法定量TLR-4蛋白。
与仅NEC组相比,HB-EGF组和对照组的平均肺泡面积有显著差异(HB-EGF组>NEC组;P<0.0001;对照组>NEC组;P=0.0008)。与NEC组相比,HB-EGF组和对照组的肺泡壁面积显著减小(P<0.0001)。与HB-EGF组和对照组相比,NEC组中表达TLR-4的细胞更多(P=0.002)。与对照组相比,暴露于NEC方案的幼崽中TLR-4蛋白增加(仅NEC组P=0.005;HB-EGF治疗组P=0.0004)。HB-EGF组和NEC组之间的TLR-4蛋白无差异。
我们的结果表明,产前给予HB-EGF可维持小鼠NEC模型中的肺形态学并降低TLR-4。可能,对有早产易患NEC婴儿风险的孕妇产前给予HB-EGF可预防肺损伤。