Immunoregulatory Protein Profiles of Necrotizing Enterocolitis versus Spontaneous Intestinal Perforation in Preterm Infants

Necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP) are the most common acute surgical emergencies associated with high morbidity and mortality in preterm infants. We aimed to compare the profiles of immunoregulatory proteins and identify novel mediators in plasma of NEC and SIP infants. We also investigated the expression of target genes in resected intestinal tissues and an enterocyte cell line. Using Cytokine Antibody Array assay, we reported the first comparative profiles of immunoregulatory proteins in plasma of NEC and SIP infants, and showed that dysregulated proteins belonged to functionally diversified categories, including pro- and anti-inflammation, angiogenesis, cell growth, wound healing, anti-apoptosis, cell adhesion and extracellular matrix reorganization. Validation by ELISA confirmed significantly higher concentrations of interleukin (IL)-6, angiopoietin (Ang)-2, soluble type II interleukin-1 receptor (sIL-1RII), and soluble urokinase-type plasminogen activator receptor (suPAR) in NEC infants compared with gestational age-matched control, and a lower level of an epidermal growth factor receptor, secreted form of receptor tyrosine-protein kinase ErbB3 (sErbB3), compared with SIP infants. mRNA expressions of IL1-RII and uPAR were up-regulated in resected bowel tissues from NEC infants, indicating that immunoregulation also occurred at the cellular level. In FHs-74 Int cells, Ang-2, IL1-RII and uPAR mRNA expressions were significantly induced by the combined treatment with lipopolysaccharide (LPS) and platelet activating factor (PAF). Our study provided plasmatic signatures of immunoregulatory proteins in NEC and SIP infants, and demonstrated involvement of multiple functional pathways. The magnitude of changes in these proteins was significantly more extensive in NEC infants, reflecting the different nature of injury and/or severity of inflammation. We speculate that dysregulation of IL-6, Ang-2, IL-1RII and uPAR occurred at both systemic and cellular levels, and probably mediated via LPS and endogeneous PAF signals. Such exaggerated immunologic responses may account for the high morbidity and mortality in NEC compared with SIP patients

Resolution of Pulmonary Overinflation in an Extremely Low-Birth-Weight Infant Utilizing A ‘Lung Squeezing’ Technique — A Case Report

AbstractUneven distribution of ventilation in infants ventilated with high-frequency oscillation may be presented as regional overinflation of the lungs. Current evidence supports that inflation pattern aberrations and pseudocyst formation are pathologic lesions associated with ventilator-induced lung injuries. Physiotherapy with a ‘lung squeezing’ technique was utilized to reduce the regional overinflation in a preterm infant of extremely low birth weight. The infant responded with complete resolution of the regional overinflation and improved homogeneous distribution of ventilation. This single case report suggests that the lung squeezing technique may be useful in promoting normal lung inflation in preterm infants receiving high-frequency oscillation

Processing of speech in Chinese students with different reading abilities – an FMRI study

While imaging studies with English-speaking children showed that reading achievement of children is associated with their brain profiles during speech perception tasks, little is known about the neurocognitive processing of normal\ud Chinese students with different reading proficiencies: To study the neurocognitive processing on Chinese and the input of reading level on the process, seventeen six year old students with Chinese as their first language were recruited for the research study. These students were further assessed by a reading test to distinguish their Chinese reading ability. Those scored 2/3 deviation\ud below the cultural mean score were classified as low-proficiency readers. Those scored between 2/3 below or above the mean score were classified as intermediate-proficiency readers. Those scored 2/3 standard deviation above the mean score were regarded as high-proficiency readers. During the experiment, 12 pairs of Chinese syllables evenly distributed in three stimuli blocks were presented to the students acoustically and they had to judge whether each pair of syllables was the same in rhyme\ud or not. Throughout the whole process the students' brain activation profiles were assessed by FMRl examination using the BOW (blood oxygen level dependent) contrast method in a 1. 5 T MRI system. Result analysis was focussed on the possible neurocognitive discrepancies between students of varying reading proficiency on phonological sensitivity

Secular changes in height, weight and body mass index in Hong Kong Children

Abstract Background Large population growth surveys of children and adolescents aged 6 to 18 y were undertaken in Hong Kong in 1963 and 1993. The global epidemic of obesity is a major public health concern. To monitor the impact of this epidemic in Hong Kong children and to identify secular changes in growth, a further growth survey was undertaken in 2005/6. Methods Cross-sectional height and weight measurements of 14,842 children and adolescents aged 6 to 18 y from Hong Kong's 18 districts were obtained during the 2005/6 school year. Percentile curves were constructed using LMS method and sex-specific percentile values of weight-for-age, height-for-age, and BMI-for-age were compared with those data from 1963 and 1993. Results Secular changes in height, weight and BMI were noted between 1963 and 1993 and between 1993 and 2005/6. In the latter period, greater changes were observed at younger ages, and particularly in boys. On an annual basis, the 1993–2005/6 changes were less than those during 1963–1993. Using the International Obesity Task Force cut-offs, 16.7% of children were overweight or obese in 2005/6, which was a 5.1% increase since 1993. Conclusion These data provide policy-makers with further evidence of the secular changes in child growth and the increasing obesity epidemic among Hong Kong children.</p

mRNA expression levels of target genes in resected intestinal tissues of NEC and SIP infants.

<p>Expression levels of IL-6, Ang-2, ErbB3, IL1-RII, and uPAR in resected intestinal tissues from NEC (n = 7) and SIP (n = 6) infants were quantified by qPCR and compared with surgical control tissues (n = 6). Results showed that IL-6, IL1-RII and uPAR were significantly higher (<i>P</i><0.01) in NEC tissues, compared with surgical control tissues (<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0036977#pone-0036977-g003" target="_blank">Figure 3A, D and E</a>). Results are presented as median, interquartile range and range of expression levels relative to β-actin.</p

Clinical characteristics of NEC and SIP patients recruited for plasma analyses.

<p>Results are expressed as % or median (interquartile range).</p><p>Note: N/A = not applicable.</p

Clinical characteristics of NEC, SIP and surgical control patients recruited for mRNA analysis.

<p>Results are expressed as % or median (interquartile range).</p><p>Note: All surgical specimens were of ileal origin, except 1 SIP specimen was from the descending colon.</p