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      The ErbB4 ligand neuregulin-4 protects against experimental necrotizing enterocolitis.

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          Abstract

          Necrotizing enterocolitis (NEC) affects up to 10% of premature infants, has a mortality of 30%, and can leave surviving patients with significant morbidity. Neuregulin-4 (NRG4) is an ErbB4-specific ligand that promotes epithelial cell survival. Thus, this pathway could be protective in diseases such as NEC, in which epithelial cell death is a major pathologic feature. We sought to determine whether NRG4-ErbB4 signaling is protective in experimental NEC. NRG4 was used i) in the newborn rat formula feeding/hypoxia model; ii) in a recently developed model in which 14- to 16-day-old mice are injected with dithizone to induce Paneth cell loss, followed by Klebsiella pneumoniae infection to induce intestinal injury; and iii) in bacterially infected IEC-6 cells in vitro. NRG4 reduced NEC incidence and severity in the formula feed/hypoxia rat model. It also reduced Paneth cell ablation-induced NEC and prevented dithizone-induced Paneth cell loss in mice. In vitro, cultured ErbB4(-/-) ileal epithelial enteroids had reduced Paneth cell markers and were highly sensitive to inflammatory cytokines. Furthermore, NRG4 blocked, through a Src-dependent pathway, Cronobacter muytjensii-induced IEC-6 cell apoptosis. The potential clinical relevance of these findings was demonstrated by the observation that NRG4 and its receptor ErbB4 are present in human breast milk and developing human intestine, respectively. Thus, NRG4-ErbB4 signaling may be a novel pathway for therapeutic intervention or prevention in NEC.

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          Author and article information

          Journal
          Am. J. Pathol.
          The American journal of pathology
          1525-2191
          0002-9440
          Oct 2014
          : 184
          : 10
          Affiliations
          [1 ] Division of Neonatology, Department of Pediatrics, University of Iowa, Iowa City, Iowa.
          [2 ] Division of Pediatric Surgery, Department of Surgery, University of Southern California Keck School of Medicine, Los Angeles, California.
          [3 ] Department of Pediatrics, University of Southern California Keck School of Medicine and The Saban Research Institute at Children's Hospital Los Angeles, Los Angeles, California.
          [4 ] Departments of Surgery and Pediatrics, Ann and Robert H. Lurie Children's Hospital, Northwestern University, Chicago, Illinois.
          [5 ] Department of Pathology, University of Southern California Keck School of Medicine, Los Angeles, California.
          [6 ] Department of Pediatrics, University of Southern California Keck School of Medicine and The Saban Research Institute at Children's Hospital Los Angeles, Los Angeles, California; Department of Biochemistry and Molecular Biology, University of Southern California Keck School of Medicine, Los Angeles, California. Electronic address: mfrey@chla.usc.edu.
          Article
          S0002-9440(14)00370-8
          10.1016/j.ajpath.2014.06.015
          25216938
          Copyright © 2014 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

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