Cortisone Strengthens the Intestinal Mucosal Barrier in a Rodent Necrotizing Enterocolitis Model

Abstract

Necrotizing enterocolitis (NEC) is the most common acquired gastrointestinal emergency in the neonates¹. The disease is an enigmatic one with no identifiable risk factor except for prematurity. The pathogenesis of the disease appears to be multifactorial with bacterial proliferation, intestinal ischemia, and enteral alimentation all appearing to have a role, either individually or in concert, in any specific patient². It has been suggested that the breakdown of the gastrointestinal mucosal barrier, which is already immature secondary to the prematurity, may very well be the common pathway through which the different factors manifest themselves, allowing for the systemic penetration of toxins, bacteria, and antigens and the development of NEC³. There is no specific treatment for this disease, but based on this hypothesis on its etiology precocious maturation of the intestinal barrier might ameliorate or prevent this life-threatening disease. The aim of this study, therefore, was to re-establish a model of NEC in the rat and to see if the lesion could be prevented with the prenatal administration of corticosteroids, a known maturational agent. We then went on to study the intestinal mucosal barrier in this model that may explain the beneficial effects of the corticosteroids.