PT  - JOURNAL ARTICLE
AU  - Sacks, Marla Ashley
AU  - Mendez, Yomara Stephanie
AU  - Khan, Faraz A
AU  - Propst, Robert
AU  - Zuppan, Craig W
AU  - Wilson, Christopher G
AU  - Radulescu, Andrei
TI  - Prenatal administration of heparin-binding epidermal growth factor-like growth factor in an experimental model of necrotizing enterocolitis decreased both incidence and severity of the disease
AID  - 10.1136/wjps-2021-000345
DP  - 2022 Jan 01
TA  - World Journal of Pediatric Surgery
PG  - e000345
VI  - 5
IP  - 1
4099  - http://wjps.bmj.com/content/5/1/e000345.short
4100  - http://wjps.bmj.com/content/5/1/e000345.full
SO  - World Jnl Ped Surgery2022 Jan 01; 5
AB  - Background Necrotizing enterocolitis (NEC) is the leading gastrointestinal cause of death in premature infants and causes long-term disabilities. Previously, enteral heparin-binding epidermal growth factor-like growth factor (HB-EGF) administered after birth demonstrated decreased incidence and severity of NEC in a neonatal animal model of NEC. We investigated the potential prophylactic strategy of preventing NEC using prenatally administered HB-EGF.Methods An HB-EGF (800 µg/kg/dose) dose was injected into pregnant rats via tail vein or intraperitoneal route 2 hours prior to delivery. After cesarean section (C-section) at 21 days’ gestation, the rat pups were subjected to the NEC protocol by inducing stressors: hypoxia, hypothermia, hypertonic feeds, and orogastric gavage of lipopolysaccharide (2 mg/kg). Postnatally, pups were monitored for 96 hours and assessed for the development of clinical and postmortem histological NEC.Results The experimental NEC incidence in untreated, stressed rat pups was 66%. Compared with untreated pups, the maternal administration of HB-EGF correlated with a significant NEC incidence and severity decrease in rat pups. The strongest decrease was seen when HB-EGF was administered via the intraperitoneal route 2 hours prior to C-section (66% vs 31%, *p<0.05). Prenatal HB-EGF administration significantly increased pups’ survival after NEC protocol exposure, with the greatest benefit observed in the group that received HB-EGF intraperitoneally 2 hours before delivery.Conclusions Prenatal administration of HB-EGF decreases the incidence and severity of NEC, preserves gut barrier function and increases survival. This may represent a novel prophylactic clinical strategy for NEC offered to mothers at risk of delivering a premature infant.Data are available upon reasonable request.