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Prophylactic efficacy of enteral miconazole administration for neonatal intestinal perforation and its potential

Motofumi Torikai1, Satoshi Ibara2, Satoshi Ieiri3

  • 1Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, 8-35-1, Sakuragaoka, Kagoshima, 890-8520, Japan. motori@m.kufm.kagoshima-u.ac.jp.

Pediatric Surgery International
|July 31, 2016
PubMed
Abstract

Insights

Enteral miconazole (MCZ) may prevent intestinal perforation (IP) in extremely low birth weight infants (ELBWI). MCZ reduces inflammatory markers like IL-8 and HMGB-1, suggesting a new prophylactic approach for neonatal IP.

Area of Science:

  • Neonatal medicine
  • Gastroenterology
  • Pharmacology

Background:

  • Intestinal perforation (IP) is a critical complication in extremely low birth weight infants (ELBWI).
  • Enteral miconazole (MCZ) administration began in 2002, coinciding with a decrease in IP incidence.
  • A need exists to understand MCZ's prophylactic role in neonatal IP.

Purpose of the Study:

  • To investigate the prophylactic effect of enteral miconazole (MCZ) in preventing neonatal intestinal perforation (IP).
  • To establish a novel prophylactic strategy for IP in extremely low birth weight infants (ELBWI).

Main Methods:

  • In vivo histopathological examination of MCZ effects on a mouse model of intestinal ischemia.
  • In vitro evaluation of MCZ's cytoprotective effects against hypoxia in Caco-2 intestinal cells.
  • Assessment of MCZ's anti-inflammatory potential using a co-culture model of Caco-2 and HL60 cells.

Main Results:

  • Miconazole (MCZ) demonstrated a tissue-protective effect against intestinal ischemia.
  • MCZ suppressed high mobility group-box 1 (HMGB1) release in Caco-2 cells under hypoxic stress.
  • MCZ attenuated leukocyte activation by suppressing interleukin-8 (IL-8) release from Caco-2 cells.

Conclusions:

  • Miconazole (MCZ) shows potential as a preventive agent for clinical management of intestinal perforation (IP) in extremely low birth weight infants (ELBWI).
  • Suppression of IL-8 and HMGB-1 by MCZ may underlie its prophylactic benefits against neonatal IP.
Keywords:
HMGB1IL-8Intestinal perforationsMiconazoleNecrotizing enterocolitisNewborn

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