Invited review: the preterm pig as a model in pediatric gastroenterology.
Invited review: the preterm pig as a model in pediatric gastroenterology.
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DOI：
10.2527/jas.2013-6359
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发表时间：
2013-10
影响因子：
3.3
通讯作者：
Buddington RK
中科院分区：
文献类型：
--
作者：
Sangild PT;Thymann T;Schmidt M;Stoll B;Burrin DG;Buddington RK
在出生时，新生哺乳动物经历了从无菌的子宫环境和持续的营养供应过渡到微生物丰富的环境，通过胃肠道(GIT)间歇性地口服复合牛奶营养素。这些功能挑战部分解释了新生儿发病率和死亡率相对较高的原因。早产会中断产前器官的成熟，包括胃肠道器官成熟，并增加疾病风险。例如坏死性小肠结肠炎(NEC)，它与胃肠发育不成熟、肠道喂养和细菌定植密切相关。患有NEC的婴儿可能需要切除肠道的坏死部分，导致短肠综合征(SBS)，其特征是消化能力降低、液体丢失和对肠外营养的依赖。这篇综述将早产猪作为儿科胃肠病学的翻译模型，为NEC和SBS等重要儿科疾病提供了新的见解。我们描述了早产猪的分娩、护理和处理方案，并展示了未成熟的GIT如何对分娩方法和不同的营养和治疗干预做出反应。早产猪也可能为表现出高死亡率的弱足月仔猪的出生后适应提供一个敏感的模型。早产猪模型的属性包括在身体大小、器官发育和许多临床特征方面与早产儿非常相似，从而提供了相对于GIT未成熟啮齿动物模型的翻译优势。另一方面，对母猪外科设施、仔猪重症监护病房和经过临床培训的人员的需求可能会限制早产猪的广泛使用。对早产猪器官适应的研究有助于确定新生儿存活的生理基础，并有助于确定新生儿关键时期的最佳饮食和饲养条件。
At birth, the newborn mammal undergoes a transition from a sterile uterine environment with a constant nutrient supply, to a microbe-rich environment with intermittent oral intake of complex milk nutrients via the gastrointestinal tract (GIT). These functional challenges partly explain the relatively high morbidity and mortality of neonates. Preterm birth interrupts prenatal organ maturation, including that of the GIT, and increases disease risk. Exemplary is necrotizing enterocolitis (NEC), which is associated closely with GIT immaturity, enteral feeding, and bacterial colonization. Infants with NEC may require resection of the necrotic parts of the intestine, leading to short bowel syndrome (SBS), characterized by reduced digestive capacity, fluid loss, and dependency on parenteral nutrition. This review presents the preterm pig as a translational model in pediatric gastroenterology that has provided new insights into important pediatric diseases such as NEC and SBS. We describe protocols for delivery, care, and handling of preterm pigs, and show how the immature GIT responds to delivery method and different nutritional and therapeutic interventions. The preterm pig may also provide a sensitive model for postnatal adaptation of weak term piglets showing high mortality. Attributes of the preterm pig model include close similarities with preterm infants in body size, organ development, and many clinical features, thereby providing a translational advantage relative to rodent models of GIT immaturity. On the other hand, the need for a sow surgical facility, a piglet intensive care unit, and clinically trained personnel may limit widespread use of preterm pigs. Studies on organ adaptation in preterm pigs help to identify the physiological basis of neonatal survival for hypersensitive newborns and aid in defining the optimal diet and rearing conditions during the critical neonatal period.
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DOI：
10.1097/mpg.0b013e318286891e
发表时间：
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影响因子：
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