A novel treatment strategy for gastrointestinal development of extremely low birth weight infants : Administration of micelles derived from pulmonary surfactants in a pregnant rabbit model

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We have shown the presence of micelles derived from pulmonary surfactant in human full-term amniotic nuid. Micellization is also an important step in postnatal lipid absorption because fat is insoluble in the aqueous environment of the small intestinal lumen. Micelles exist in both amniotic fluid swallowed by the fetus and human breast milk ingested by neonates. Our study aimed to develop a new treatment strategy for gastrointestinal development of extremely low birth weight infants with a focus on the presence of micelles in the environment of fetus and neonates. We previously showed that continuous administration of micelles derived from pulmonary surfactants and vernix caseosa enhanced the development of the small intestine of the rabbit fetus.In our study, we used fluorescently labeled liposomes to show that micelles derived from pulmonary surfactant and vernix caseosa complex might directly and locally contribute to gastrointestinal development of the fetus. In addition, we developed a neonatal rat model to determine the potential beneficial effects of these micelles against necrotizing enterocolitis. Although further studies are required, our findings provide greater understanding of the physiologic interactions between the pulmonary, dermal-epidermal, and gastrointestinal development. One of the most critical issues in the early development of premature infants is the prevention and treatment of necrotizing enterocolitis. We expect that our study may contribute in improving the prognosis of premature infants.