The effect of inhaled nitric oxide on intestinal perfusion in the neonatal piglet

• Grant number: 22/12021-1
• Support Opportunities: Scholarships abroad - Research
• Start date: February 13, 2023
• End date: February 10, 2024
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Lourenço Sbragia Neto
• Grantee: Lourenço Sbragia Neto
• Host Investigator: Oluyinka O. Olutoye
• Host Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil
• Institution abroad: Nationwide Children's Hospital, United States

Abstract

Necrotizing enterocolitis (NEC) affects 3 children per 1,000 live births. It is the most common gastrointestinal emergency in newborns. It involves an initial injury to the intestinal tract that we believe is related to poor blood flow. As the disease progresses, the intestines may die and may require surgical removal. Recent studies have suggested that the severity of NEC can be lessened through remote ischemic conditioning (RIC). RIC therapy performed on mice with NEC demonstrated that the temporary blockage of blood vessels in an area of the body makes distant tissues resistant to damage caused by the poor blood flow seen in NEC. The treatment has been shown to increase intestinal blood circulation after repeated treatment and decrease intestinal damage. Such beneficial effects of RIC were shown to be dependent on the dilation of blood vessels mediated by nitric oxide (NO), which is an important molecule in lung physiology for mediating blood vessel dilation and oxygenation in the pulmonary and intestinal circulation. Inhaled nitric oxide (iNO) is given to some neonates with certain respiratory disorders. Part of the iNO is absorbed into the bloodstream. This study aims to assess whether the amount of iNO absorbed into the circulation is sufficient to impact intestinal perfusion and oxygen content measured by abdominal near-infrared spectroscopy (NIRS). NIRS allows us to measure the levels of oxygen in the blood going to the intestines. We hypothesise that there is a direct relationship between iNO concentration and intestinal blood flow that can be measured by abdominal NIRS. The Nationwide Children's Hospital laboratory has many years of experience with the piglet model. To model newborn intestinal prematurity, the swine NEC model, although more expensive, is superior to other animal models with its similarity in intestinal anatomical structure and body size equivalent to a premature human baby. (AU)

Scientific publications

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

RAPHAEL DEL ROIO LIBERATORE JUNIOR; ISABELLA CHRISTINA MAZZARO MONTEIRO; FLAVIO DE OLIVEIRA PILEGGI; WELLEN CRISTINA CANESIN; LOURENÇO SBRAGIA. Congenital hyperinsulinism and surgical outcome in a single tertiary center in Brazil. Jornal de Pediatria, v. 100, n. 2, p. 163-168, 2024-05-13. (22/12021-1)

NOUR, A. L. A.; FABRO, A. T.; BATAH, S. S.; ORIA, M.; PEIRO, J. L.; SBRAGIA, L.. The myocardial capillary network is altered in congenital diaphragmatic hernia in the fetal rabbit model. Brazilian Journal of Medical and Biological Research, v. 56, p. 8-pg., 2023-01-01. (21/09024-6, 22/12021-1)

ANA MARIA BICUDO DINIZ; IGOR JOSÉ NOGUEIRA GUALBERTO; LUIZA ALMEIDA LIMA; MUCIO LUIZ DE ASSIS CIRINO; RODRIGO KENDI MURAKAMI; BELLA LUNA COLOMBINI ISHIKIRIAMA; RODRIGO RUANO; LUIZ FERNANDO FERRAZ DA SILVA; DANIELA TIRAPELLI; LOURENÇO SBRAGIA. miRNA-143 expression is associated with inflammation and time of exposure to amniotic fluid in experimental gastroschisis. Clinics, v. 78, 2024-01-08. (22/12021-1)