title: Deficiency in milk fat globule-epidermal growth factor-factor 8 exacerbates organ injury and mortality in neonatal sepsis.
abstract: BACKGROUND
  Neonatal sepsis is a systemic inflammation occurring in neonates because of a proven infection within the first 28days of birth. It is the third leading cause of morbidity and mortality in the newborns. The mechanism(s) underlying the systemic inflammation in neonatal sepsis has not been completely understood. We hypothesize that the deficiency of milk fat globule-epidermal growth factor-factor 8 (MFG-E8), a protein commonly found in human milk, could be responsible for the increased inflammatory response leading to morbidity and mortality in neonatal sepsis.
  
  
  METHODS
  Male and female newborn mice aged 5-7days were injected intraperitoneally with 0.9mg/g body weight cecal slurry (CS). At 10h after CS injection, they were euthanized, and blood, lungs and gut tissues were obtained for further analyses. Control newborn mice underwent similar procedures with the exception of the CS injection. In duplicate newborn mice after CS injection, they were returned to their respective cages with their mothers and were closely monitored for 7days and survival rate recorded.
  
  
  RESULTS
  At 10h after CS injection, serum LDH in the MFG-E8 knockout (KO) newborn mice was significantly increased by 58% and serum IL-6, IL-1β and TNF-α in the MFG-E8KO newborn mice were also significantly increased by 56%, 65%, and 105%, respectively, from wild type (WT) newborn mice. There were no significant difference between WT control and MFG-E8 control newborn mice. The lung architecture was severely damaged and a significant 162% increase in injury score was observed in the CS MFG-E8KO newborn mice. The MPO, TUNEL staining, and cytokine levels in the lungs and the intestine in CS MFG-E8KO newborn mice were significantly increased from CS WT newborn mice. Similarly, intestinal integrity was also compromised in the CS MFG-E8KO newborn mice. In a survival study, while the mortality rate within 7days was only 29% in the CS WT newborn mice, 80% of the CS MFG-E8KO newborn mice died during the same time period with the majority of mortality occurring within 48h.
  
  
  CONCLUSIONS
  The deficiency in MFG-E8 caused increases in inflammation, tissue injury, neutrophil infiltration and apoptosis, which led to morbidity and mortality in murine neonatal sepsis. These studies suggest that MFG-E8 has a protective role in fighting against neonatal sepsis.
authors.affiliation: Department of Surgery, Hofstra Northwell School of Medicine, Manhasset, NY.
authors.forename: Laura W
authors.initials: LW
authors.lastname: Hansen
authors.affiliation: Department of Surgery, Hofstra Northwell School of Medicine, Manhasset, NY.
authors.forename: Adam
authors.initials: A
authors.lastname: Khader
authors.affiliation: Department of Surgery, Hofstra Northwell School of Medicine, Manhasset, NY; Center for Immunology and Inflammation, The Feinstein Institute for Medical Research, Manhasset, NY.
authors.forename: Weng-Lang
authors.initials: WL
authors.lastname: Yang
authors.affiliation: Department of Surgery, Hofstra Northwell School of Medicine, Manhasset, NY; Center for Immunology and Inflammation, The Feinstein Institute for Medical Research, Manhasset, NY.
authors.forename: Asha
authors.initials: A
authors.lastname: Jacob
authors.affiliation: Center for Immunology and Inflammation, The Feinstein Institute for Medical Research, Manhasset, NY.
authors.forename: Tracy
authors.initials: T
authors.lastname: Chen
authors.affiliation: Department of Surgery, Hofstra Northwell School of Medicine, Manhasset, NY.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Nicastro
authors.affiliation: Department of Surgery, Hofstra Northwell School of Medicine, Manhasset, NY.
authors.forename: Gene F
authors.initials: GF
authors.lastname: Coppa
authors.affiliation: Department of Surgery, Hofstra Northwell School of Medicine, Manhasset, NY; Center for Immunology and Inflammation, The Feinstein Institute for Medical Research, Manhasset, NY.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Prince
authors.affiliation: Department of Surgery, Hofstra Northwell School of Medicine, Manhasset, NY; Center for Immunology and Inflammation, The Feinstein Institute for Medical Research, Manhasset, NY. Electronic address: pwang@northwell.edu.
authors.forename: Ping
authors.initials: P
authors.lastname: Wang
mesh_terms: D000818:Animals; D000831:Animals, Newborn; D000954:Antigens, Surface / Q000627:therapeutic use*; D004195:Disease Models, Animal; D005260:Female; D006017:Glycolipids / Q000627:therapeutic use*; D006023:Glycoproteins / Q000627:therapeutic use*; D007249:Inflammation; D007275:Injections, Intravenous; D066292:Lipid Droplets; D008297:Male; D051379:Mice; D008894:Milk Proteins / Q000627:therapeutic use*; D000071074:Neonatal Sepsis / Q000378:metabolism / Q000517:prevention & control*
chemical_list: D000954:Antigens, Surface; D006017:Glycolipids; D006023:Glycoproteins; C098942:MFGE8 protein, human; D008894:Milk Proteins; C110367:milk fat globule
keywords: Cytokines; Lung injury; MFG-E8; MIP-2; Neonatal sepsis