Abstract
Introduction: A neonatal rat model of necrotizing enterocolitis (NEC) is useful to investigate
this devastating and obscure disease. The aim of this study was to assess a neonatal
rat model of NEC to evaluate whether the histological appearance of the damaged intestine
could be predicted by the clinical behaviour of the animals and the macroscopic appearance
of the gut. Materials and Methods: Neonatal rats were delivered at term and assigned either to a control group consisting
of breastfeeding and no stress factors, or to a NEC group in which NEC was induced
by gavage feeding + hypoxia + oral lipopolysaccharide (4 mg/kg/day once daily for
the first 2 days of life). Clinical status was assessed on day 4 using a clinical
sickness score (general appearance, response to touch, natural activity, body colour;
0 – 3 for each variable). Neonatal rats were sacrificed at 4 different time points:
day 1, day 2, day 3, and day 4. At sacrifice, a macroscopic assessment of the gut
was performed using a new scoring system based on: colour (0 – 2), consistency (0 – 2)
and degree of dilatation (0 – 2). The resected gut was stained with haematoxylin/eosin,
and evaluated microscopically by 2 independent blinded scorers, including a consultant
histopathologist. The histology results were used to validate the macroscopic gut
assessment. Results were compared by ANOVA and linear regression analysis. Ethics
Committee and Home Office approvals were obtained. Results: In the control group NEC was not present either macroscopically or histologically.
The clinical sickness score was higher in the NEC group (median = 4.5; range = 2 – 6)
compared to controls (median = 0; range = 0 – 1; p < 0.0001). In the NEC group the
macroscopic appearance (from day 2) and histological score (from day 1) increased
significantly (p < 0.0001) and were strongly correlated (r2 = 0.74, p < 0.0001). Conclusions: The clinical behaviour and macroscopic appearance of the intestine are valid tools
to assess gut damage in our neonatal rat model of NEC. This allows future studies
that are not exclusively based on histology.
Key words
NEC - rat - lipopolysaccharide - histology
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Professor M.D., FRCS (Eng), FRCS (Ed), FAAP, Professor of Paediatric Surgery Agostino Pierro
Department of Surgery
Institute of Child Health
30 Guilford Street
London, WC1N 1EH
UK
eMail: pierro.sec@ich.ucl.ac.uk