• Rebecca M Rentea, Jennifer L Liedel, Scott R Welak, Laura D Cassidy, Alan N Mayer, Kirkwood A Pritchard, Keith T Oldham, and David M Gourlay.
• Medical College of Wisconsin, Milwaukee, WI 53226, USA.
• J. Pediatr. Surg. 2012 Jun 1; 47 (6): 1135-42.

BackgroundPreviously, we have shown that supplementation of intestinal alkaline phosphatase (IAP) decreased severity of necrotizing enterocolitis (NEC)-associated intestinal injury. We hypothesized that IAP administration is protective of intestinal epithelial barrier function in a dose-dependent manner.MethodsControl rat pups were vaginally delivered and breast-fed. Premature rats were divided into 4 groups: formula fed with lipopolysaccharide and hypoxia (NEC) or additional daily bovine IAP 40, 4, or 0.4 U/kg (NEC + IAP 40 U, IAP 4 U, or IAP 0.4 U).ResultsNecrotizing enterocolitis is associated with decreased IAP protein expression and activity. Supplemental IAP increases IAP activity in intestinal homogenates and decreased NEC injury score in a dose-dependent manner. Intestinal injury as measured by fluorescein isothiocyanate-dextran flux from ileal loops showed increased permeability vs control, but supplemental IAP reversed this. Tight junction proteins claudin-1, claudin-3, occludin, and zonula occludin 1 were elevated in the NEC and IAP-treated groups with differences in expression patterns. No differences in messenger RNA levels were observed on postinjury day 3. Intestinal alkaline phosphatase administration decreases intestinal NEC injury in a dose-dependent manner.ConclusionEarly enteral supplemental IAP may reduce NEC-related injury and may be useful for preserving the intestinal epithelial barrier function.Copyright © 2012 Elsevier Inc. All rights reserved.

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