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A Murine Model of Fetal Exposure to Maternal Inflammation to Study the Effects of Acute Chorioamnionitis on Newborn Intestinal Development
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Systemic inflammation associated with severe intestinal injury in extremely low gestational age newborns

Camilia R Martin1, Melissa Bellomy, Elizabeth N Allred

  • 1Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA. cmartin1@bidmc.harvard.edu

Fetal and Pediatric Pathology
|September 26, 2012
PubMed

Insights

Systemic inflammation markers like CRP and IL-6 are elevated in preterm infants with necrotizing enterocolitis (NEC) and intestinal perforation (IP). Understanding these inflammatory responses may aid in preventing and treating these serious infant conditions.

Area of Science:

  • Neonatal Medicine
  • Pediatric Gastroenterology
  • Immunology

Background:

  • Infants born prematurely, especially before 28 weeks gestation, are at high risk for serious gastrointestinal complications.
  • Necrotizing enterocolitis (NEC) and intestinal perforation (IP) are critical conditions in preterm neonates, often linked to inflammatory processes.
  • The precise role of systemic inflammation in the pathogenesis of NEC and IP requires further elucidation.

Purpose of the Study:

  • To investigate the profile of systemic inflammation in preterm infants diagnosed with intestinal perforation (IP) and necrotizing enterocolitis (NEC).
  • To identify specific blood protein biomarkers associated with the presence and progression of IP and NEC in very preterm infants.

Main Methods:

  • A cohort of 939 infants born before 28 weeks' gestation was studied.
  • Blood samples were collected on days 1, 7, and 14 postpartum.
  • Concentrations of 25 blood proteins, including inflammatory markers, were measured using quantitative assays.

Main Results:

  • Infants with NEC showed elevated levels of C-reactive protein (CRP), serum amyloid A (SAA), IL-6, and IL-8 on days 7 and 14.
  • Infants with IP exhibited elevated CRP and insulin growth factor binding protein-1 on day 7.
  • On day 14, infants with IP had increased levels of CRP, SAA, TNF-receptor-2, and matrix metalloproteinase-9.

Conclusions:

  • Systemic inflammation plays a significant role in the pathophysiology of both NEC and IP in very preterm infants.
  • Specific inflammatory markers differ between NEC and IP, suggesting distinct inflammatory pathways.
  • Further understanding of these systemic inflammatory responses could lead to improved diagnostic tools and therapeutic strategies for these conditions.

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