Eur J Pediatr Surg 2020; 30(01): 085-089
DOI: 10.1055/s-0039-1697910
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Mitochondrial DNA: A Biomarker of Disease Severity in Necrotizing Enterocolitis

Edoardo Bindi
1   Division of General and Thoracic Surgery, Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada
2   Division of Pediatric Surgery, Department of Medical Sciences, Surgical Sciences and Neurosciences, Hospital of “Santa Maria alle Scotte,” Siena, Italy
,
Bo Li
1   Division of General and Thoracic Surgery, Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada
,
Haitao Zhou
1   Division of General and Thoracic Surgery, Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada
,
Maarten Janssen Lok
1   Division of General and Thoracic Surgery, Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada
,
Mashriq Alganabi
1   Division of General and Thoracic Surgery, Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada
,
Rossella Angotti
2   Division of Pediatric Surgery, Department of Medical Sciences, Surgical Sciences and Neurosciences, Hospital of “Santa Maria alle Scotte,” Siena, Italy
,
1   Division of General and Thoracic Surgery, Translational Medicine Program, The Hospital for Sick Children, Toronto, Ontario, Canada
› Author Affiliations
Further Information

Publication History

14 May 2019

20 August 2019

Publication Date:
10 October 2019 (online)

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Abstract

Introduction There is a need to develop sensitive markers to diagnose or monitor the severity of intestinal damage in necrotizing enterocolitis (NEC). Mitochondrial deoxyribonucleic acid (mtDNA) is increased in the intestine and blood of adults in response to intestinal ischemia and can trigger secondary organ damage. We hypothesize that mtDNA is increased during experimental NEC and that mtDNA levels are correlated to the degree of intestinal injury.

Materials and Methods NEC was induced in C57BL/6 mice (n = 18) (approval: 44032) by gavage feeding with hyperosmolar formula, hypoxia, and lipopolysaccharide administration from postnatal day (P) 5 to 9. Breastfed pups served as control (n = 15). Blood was collected by cardiac puncture and terminal ileum was harvested on P9. Reverse transcription quatitative polymerase chain reaction was used to measure mtDNA (markers COX3, CYTB, ND1) and inflammatory cytokines (interleukin 6 [IL-6] and tumor necrosis factor-α[TNF-α]) in blood and ileum. Intestinal injury was scored blindly by four investigators and classified as no/minor injury (score 0 or 1) or NEC (score ≥2).

Results mtDNA is significantly increased in gut and blood of NEC mice (p < 0.05). Furthermore, mtDNA increases in intestine and blood proportionally to the degree of intestinal injury as indicated by a positive correlation with histological scoring and inflammation (r = 0.6; p < 0.05) (expression of IL-6 and TNF-α).

Conclusion Following NEC intestinal injury, mtDNA is released from the intestine into circulation. The blood level of mtDNA is related to the degree of intestinal injury. mtDNA can be a novel marker of intestinal injury and can be useful for monitoring the progression of NEC.

Authors' Contributions

E.B., B.L., and A.P. designed experiments; E.B. performed experiments; E.B. wrote the manuscript; and A.P. provided advice and supervision; all the authors reviewed and revised the manuscript.