Prenatal Heparin-Binding Epidermal Growth Factor–Like Growth Factor Administration Decreases Lung Inflammation in the Experimental Model of Necrotizing Enterocolitis

Abstract

INTRODUCTION: Necrotizing enterocolitis (NEC) is the leading gastrointestinal cause of death in premature infants. Postnatal enteral and prenatal intraperitoneal Heparin-Binding EGF-like Growth Factor (HB-EGF) administration has decreased the incidence and severity of intestinal injury in a neonatal rat model of NEC. The aim was to determine the effect of prenatally administered HB-EGF on lung injury in neonatal rats exposed to the experimental model of NEC. METHODS: Pregnant rats and pups were separated into 3 groups: control (natural birth, no NEC protocol, no HB-EGF), NEC (cesarean section, NEC protocol), and HB-EGF (prenatal HB-EGF administration, cesarean section, NEC protocol). Pregnant rats were given HB-EGF (800 μg/kg/dose) via intraperitoneal injection 2 hours before timed cesarean section. After delivery, the premature rat pups were exposed to the NEC model (hypercaloric feds, hypothermia, and hypoxia). Pups were sacrificed upon clinical signs of NEC; the intestines and lungs were hematoxylin and eosin stained for grading. RESULTS: The median alveolar wall thicknesses were significantly different between control (71,646 μm2) vs NEC (75,398 μm2; p < 0.0001) and HB-EGF (71,646 μm2) vs NEC (p < 0.0001); however, the control and HB-EGF groups were similar (p = 0.307; Fig. 1A). The median alveolar areas were significantly different between control (85.23 μm2) vs NEC (66.40 μm2; p < 0.0001) and HB-EGF (64.14 μm2) vs NEC (p < 0.0001); however, again, the control and HB-EGF were similar (p = 0.215; Fig. 1B).CONCLUSION: Our results support the prenatal HB-EGF role in preventing lung injury by means of preserving alveolar wall thickness and alveolar surface area in this animal model of NEC; therefore, maternal administration of HB-EGF before delivery in prematurity could protect lungs from NEC-related injury.