Pentoxifylline reduces the incidence and severity of necrotizing enterocolitis in a neonatal rat model.
Necrotizing enterocolitis (NEC) is a potentially fatal illness in premature neonates. Tumor necrosis factor alpha (TNF-alpha) has been shown to play a central role in the inflammatory cascade leading to the development of NEC. Published evidence points to a significant role of pentoxifylline in inhibition of TNF-alpha and in reducing mucosal injury and improving healing in ischemia-reperfusion experiments. Our aim was to investigate the effect of pentoxifylline on the incidence of NEC in a neonatal rat model. Newborn Sprague-Dawley rat pups originating from eight separate litters were delivered by cesarean section at 21.5 d and were formula fed from birth by orogastric gavage. The rat pups were randomized to receive either intraperitoneal pentoxifylline (15 mg/kg/dose) or placebo, given every 8 h beginning at 24 h of age, in a blinded fashion. Experimental NEC was induced by exposure to hypoxia for 60 s followed by cold stress at 4 degrees C for 10 min. The animals were euthanized at development of NEC or at 96 h and intestinal tissue was processed and examined for histologic changes of NEC. The incidence of NEC was significantly lower in the pentoxifylline group [pentoxifylline 5/38 versus placebo 15/36; p = 0.008, odds ratio (OR) = 0.21 95% confidence interval (CI) 0.07-0.67]. Among the pups developing NEC, significantly fewer rat pups treated with pentoxifylline had severe (>or=3) intestinal injury scores [pentoxifylline 1/5 versus placebo 10/15; p = 0.031, OR 0.06, 95% CI 0.01-0.79]. We conclude that intraperitoneal administration of pentoxifylline significantly reduced the incidence and severity of NEC in our experimental animal model.
Travadi
Javeed
J
Women's and Children's Health Service, Women's and Infants' Research Foundation and The University of Western Australia, Perth, Australia.
Patole
Sanjay
S
Charles
Adrian
A
Dvorak
Bohuslav
B
Doherty
Dorota
D
Simmer
Karen
K
D000818:Animals; D000831:Animals, Newborn; D004195:Disease Models, Animal; D020345:Enterocolitis, Necrotizing / Q000473:pathology / Q000517:prevention & control*; D016166:Free Radical Scavengers / Q000627:therapeutic use*; D015994:Incidence; D007422:Intestines / Q000473:pathology; D010431:Pentoxifylline / Q000627:therapeutic use*; D047928:Premature Birth / Q000473:pathology*; D051381:Rats; D017207:Rats, Sprague-Dawley
D016166:Free Radical Scavengers; D010431:Pentoxifylline