Improvements in medical care over recent decades have increased the number of premature and low birth weight infants that survive hypoxic-ischemic (H-I) insults. Because there is a rising incidence in diseases associated with these events, it is critical to develop effective therapies to treat the various resulting neuropathies. Extracellular matrix constitutes the majority of brain parenchyma. Lecticans and matrix-degrading proteases including ADAMTSs (a disintegrin and metalloproteinase with thrombospondin repeats) and matrix metalloproteinases (MMPs) exert effects on cell viability and may be associated with either protective or destructive processes after H-I. Both ADAMTSs (Cross et al. 2006; Tian et al. 2007) and MMPs (del Zoppo et al. 2007; Gu et al. 2005; Rosenberg et al. 2001) have been associated with pathological states in brain, yet the relative contributions of lecticans, ADAMTSs and MMPs to inflammation and cell death remain unknown. In the present study, the first series of experiments were conducted to characterize cellular damage and neuroinflammation in the postnatal day 7 rat after exposure to H-I, and to determine if cell death and inflammation were associated with alterations in lectican expression. Data showed that reduced brevican expression occurred 4 days after H-I in lesioned hippocampus. Additionally, reduced versican expression in white matter was concomitant with pre-OL cell death at this endpoint. In contrast, both lecticans were elevated at later endpoints (14, 21 days) that were associated with increased neuroinflammation and cavitary infarction. These data suggest that lectican loss is associated with cell death at the early endpoint, whereas increased lectican deposition over time likely leads to glial scar formation and a reduced capacity for neuroplasticity. Two subsequent series of experiments were conducted to determine the relative contributions of matrix-degrading proteases to injury, and whether proteolytic activity was associated with neuroinflammatory events. The first objective was to determine whether treatment with AG3340, a selective inhibitor of gelatin-degrading MMPs, or the anti-inflammatory compound minocycline, could provide neuroprotection when administered at a delayed time point after insult, and to compare the efficacy of AG3340 with that of the well-known anti-inflammatory compound minocycline. Data showed that both compounds effectively dampened the recruitment of microglia/macrophages to the lesion site when administered 24 hrs after H-I. These effects were associated with reduced neurodegeneration, indicating that these compounds neuroprotect at a clinically relevant time point. The final series of experiments tested whether these compounds could neuroprotect in an ex vivo model of oxygen glucose deprivation (OGD) that lacks peripheral immune cell involvement, thus providing insight into the relative contributions of resident microglia and gelatinase activity to the inflammatory sequelae. Results showed that both compounds blocked the OGD-induced increase in gelatinase activity and were neuroprotective in the absence of peripheral immune cells. Taken together, these data indicate that resident microglia contribute to H-I injury through gelatinase activation. Thus, the present study demonstrates that gelatin-degrading MMPs are important targets to consider when developing therapies to combat neonatal H-I injury.

Diagnosing disease in equine neonates poses a challenge for the equine industry because of the nonspecific manifestations of many diseases and the rapid deterioration that occurs. The differential diagnostic procedure requires many laboratory tests, whose results take days to receive. Serum amyloid A (SAA) is the only major acute phase protein identified in the horse; it exists in low levels in the healthy horse and increases over 100 fold in response to inflammatory stimulus 6-8 hours post stimulus. A point of care test allows veterinarians to obtain a SAA concentration within minutes that indicates the existence of infection. Being able to test and quantify this protein at the onset of illness may reduce the time before treatment is initiated and therefore increase the chance of survival for the equine neonate, which would greatly help a large problem in the industry.

<p><b>Background. </b>Newborn infants, especially preterm infants, have an increased susceptibility to serious and overwhelming bacterial as well as fungal infections. Symptoms of septicaemia in especially the very preterm neonates are vague and unspecific. No really good biochemical parameter exists today that can confirm or exclude the existence of neonatal septicaemia. The access to such a test in neonates would be most valuable, not only to assure early institution of effective antibiotic therapy when needed, but also to avoid unnecessary use of antibiotics, thereby reducing the risk of further development of antimicrobial resistance. </p><p><b>Aim. </b>To investigate the possible use of the expression of the phagocyte receptor CD64 (FcγRI) on neutrophils for early diagnosis of bacterial infections with special reference to neonatal septicaemia. </p><p><b>Results. </b>Neutrophils from preterm and term newborn infants, older infants, children, and adults examined during the early phase of a bacterial infection showed a significantly higher expression of CD64 compared with non-infected controls (p<0.001). Neutrophils from even extremely preterm infants expressed CD64 to the same extent as did neutrophils from children and adult patients. The expression of CD64 was not affected by the respiratory distress syndrome (RDS) or by such factors as premature rupture of the membranes, gestational age, steroid treatment before delivery, method of delivery, birth weight or postnatal age.</p><p>Major surgery in adults (total hip replacement) did not affect the CD64 expression to an extent comparable to that found during bacterial infections. Indirectly CD64 was found to be at least equal to CRP for differentiation between Influenza A infection and bacterial infections in adults.</p><p><b>Conclusion.</b> CD64 was found to be a specific and reliable marker for early detection of bacterial infections in preterm and term newborn infants, as well as after surgery. For differentiation between bacterial and viral infections it is probably at least as effective as CRP.</p>

<b>Background. </b>Newborn infants, especially preterm infants, have an increased susceptibility to serious and overwhelming bacterial as well as fungal infections. Symptoms of septicaemia in especially the very preterm neonates are vague and unspecific. No really good biochemical parameter exists today that can confirm or exclude the existence of neonatal septicaemia. The access to such a test in neonates would be most valuable, not only to assure early institution of effective antibiotic therapy when needed, but also to avoid unnecessary use of antibiotics, thereby reducing the risk of further development of antimicrobial resistance. <b>Aim. </b>To investigate the possible use of the expression of the phagocyte receptor CD64 (FcγRI) on neutrophils for early diagnosis of bacterial infections with special reference to neonatal septicaemia. <b>Results. </b>Neutrophils from preterm and term newborn infants, older infants, children, and adults examined during the early phase of a bacterial infection showed a significantly higher expression of CD64 compared with non-infected controls (p&lt;0.001). Neutrophils from even extremely preterm infants expressed CD64 to the same extent as did neutrophils from children and adult patients. The expression of CD64 was not affected by the respiratory distress syndrome (RDS) or by such factors as premature rupture of the membranes, gestational age, steroid treatment before delivery, method of delivery, birth weight or postnatal age. Major surgery in adults (total hip replacement) did not affect the CD64 expression to an extent comparable to that found during bacterial infections. Indirectly CD64 was found to be at least equal to CRP for differentiation between Influenza A infection and bacterial infections in adults. <b>Conclusion.</b> CD64 was found to be a specific and reliable marker for early detection of bacterial infections in preterm and term newborn infants, as well as after surgery. For differentiation between bacterial and viral infections it is probably at least as effective as CRP.

Human milk contains ~ 25 µg/mL of soluble cluster of differentiation 14 (sCD14) protein, a pattern recognition receptor (PRR) that triggers the innate immune system to respond to bacterial lipopolysaccharide (LPS). To date, the role of CD14 in the digestive tract of breast fed infants has not been well characterized and is the subject of this thesis. To investigate the biodistribution of proteins such as CD14 in vivo, a novel method for 14C radiolabeling of proteins to high specific radioactivity was developed using in vacuo methylation. Bovine serum albumin (BSA) and casein were used as test proteins to determine the following: 1) The efficacy of the in vacuo radiolabeling procedure; 2) The extent of incorporation of the 14C-label into the organs of oro-gastric gavaged 10 day old Sprague Dawley rats. [14C]BSA, [14C]casein and [14C]CD14 were prepared with specific radioactivities of 10 400, 10 800 and 163 000 dpm/µg, respectively. After feeding 6.25 µg of 14C-labeled proteins, quantifiable levels of 14C were found in the stomach, jejunum, duodenum, ileum, large intestine, intestinal luminal flushes, blood, liver, spleen and kidneys of rats. The accumulation of radiolabel in the organs of [14C]CD14 fed rats was temporally and spatially distinct from [14C]BSA and [14C]casein. Most notably, the label persisted in the stomach 480 min post-gavage. To design a neonate animal model for biodistribution, the segmental and total gastrointestinal transit times (GItt) were measured in two litters of 10 and 15 day old Sprague Dawley rat pups using barium sulfate. Ten day old rat pups that remained with and without the dam had a total gastrointestinal transit time of 13.8 ± 0.9 hr and 9.3 ± 0.7 hr, respectively. This decrease (p<0.05) in total gastrointestinal transit time in the absence of the dam was age dependent, as it was not observed (p>0.05) in the 15 day old rat pup litter. The immunological impact of an exogenous sCD14 source was examined in human peripheral blood mononuclear cells (PBMC). Pre-treatment of CD14+ monocytes with sCD14 had a protective effect, one of reducing the production of proinflammatory cytokines (TNF-α, IL-6, IL-8, IL-1β) when challenged with LPS. 14C was absorbed by neonate rats upon ingestion of [14C]CD14 and exposure to relatively high concentrations of rCD14 led to a reduction in inflammation. This may be beneficial to initial gut colonization in breast-fed newborns. / Alexander Graham Bell NSERC CGS M scholarship. Japan Society for the Promotion of Sciences, Summer in Japan Fellowship. Funded by the Canadian Institutes of Health Research, Institute of Nutrition Metabolism and Diabetes Grant #82816 “Fate and function of breast milk and recombinant human CD14 at mammary and newborn gastrointestinal mucosal epithelia”.

The neonatal period represents a critical window of increased neurodevelopmental plasticity in the immature nervous system. Unlike other sensory modalities, which require appropriate stimulation for proper development, maturation of nociceptive circuitry in neonates typically occurs in the absence of noxious stimulation. Premature infants, however, are routinely exposed to multiple invasive medical procedures during neonatal intensive care treatment, which are largely performed in the absence of anesthetics or analgesics. To date, it is largely unknown how exposure to early noxious insult during this time of increased plasticity alters the development of the CNS and influences future nociceptive responses. As previous studies examining the impact of neonatal inflammatory insult on adult nociceptive responses have been conducted primarily in males, the potential adverse effects in females are unknown. Furthermore, the biological mechanisms underlying neonatal insult-induced deficits in nociceptive processing have yet to be elucidated. Therefore, this dissertation addressed the following questions: (1) Does neonatal inflammatory insult differentially alter male and female baseline somatosensory thresholds and response to re-inflammation in adulthood?; (2) Are neonatal inflammation-induced deficits in nociceptive responsiveness mediated by a potentiation in endogenous opioid tone?; and (3) Does pre-emptive morphine analgesia attenuate the behavioral consequences of neonatal inflammatory insult? Collectively, these studies will provide valuable information about the long-term consequences of neonatal noxious stimulation in males and females, which may lead to improved understanding and prevention of the lasting effects of repeated invasive interventions in premature infants in the NICU.

Human milk contains ~ 25 µg/mL of soluble cluster of differentiation 14 (sCD14) protein, a pattern recognition receptor (PRR) that triggers the innate immune system to respond to bacterial lipopolysaccharide (LPS). To date, the role of CD14 in the digestive tract of breast fed infants has not been well characterized and is the subject of this thesis. To investigate the biodistribution of proteins such as CD14 in vivo, a novel method for 14C radiolabeling of proteins to high specific radioactivity was developed using in vacuo methylation. Bovine serum albumin (BSA) and casein were used as test proteins to determine the following: 1) The efficacy of the in vacuo radiolabeling procedure; 2) The extent of incorporation of the 14C-label into the organs of oro-gastric gavaged 10 day old Sprague Dawley rats. [14C]BSA, [14C]casein and [14C]CD14 were prepared with specific radioactivities of 10 400, 10 800 and 163 000 dpm/µg, respectively. After feeding 6.25 µg of 14C-labeled proteins, quantifiable levels of 14C were found in the stomach, jejunum, duodenum, ileum, large intestine, intestinal luminal flushes, blood, liver, spleen and kidneys of rats. The accumulation of radiolabel in the organs of [14C]CD14 fed rats was temporally and spatially distinct from [14C]BSA and [14C]casein. Most notably, the label persisted in the stomach 480 min post-gavage. To design a neonate animal model for biodistribution, the segmental and total gastrointestinal transit times (GItt) were measured in two litters of 10 and 15 day old Sprague Dawley rat pups using barium sulfate. Ten day old rat pups that remained with and without the dam had a total gastrointestinal transit time of 13.8 ± 0.9 hr and 9.3 ± 0.7 hr, respectively. This decrease (p<0.05) in total gastrointestinal transit time in the absence of the dam was age dependent, as it was not observed (p>0.05) in the 15 day old rat pup litter. The immunological impact of an exogenous sCD14 source was examined in human peripheral blood mononuclear cells (PBMC). Pre-treatment of CD14+ monocytes with sCD14 had a protective effect, one of reducing the production of proinflammatory cytokines (TNF-α, IL-6, IL-8, IL-1β) when challenged with LPS. 14C was absorbed by neonate rats upon ingestion of [14C]CD14 and exposure to relatively high concentrations of rCD14 led to a reduction in inflammation. This may be beneficial to initial gut colonization in breast-fed newborns. / Alexander Graham Bell NSERC CGS M scholarship. Japan Society for the Promotion of Sciences, Summer in Japan Fellowship. Funded by the Canadian Institutes of Health Research, Institute of Nutrition Metabolism and Diabetes Grant #82816 “Fate and function of breast milk and recombinant human CD14 at mammary and newborn gastrointestinal mucosal epithelia”.

This research was conducted to investigate the expression of porcine intestinal nutrient transporters along the neonatal crypt-villus axis and during the postnatal development. First, we examined the transport kinetics of Na+-glucose co-tranporter 1 (SGLT1) and Na+-dependent neutral amino acid (AA) transporter B0AT1 and then the protein and mRNA abundances of SGLT1, B0AT1 and Na+-dependent neutral AA exchanger ASCT2 along the jejunal crypt-villus axis in the neonatal pig and the potential mechanisms associated with their regulations. Our results suggested that: 1) high levels of apical maximal SGLT1 and B0AT1 uptake activities were shown to exist along the entire jejunal crypt-villus axis in the neonatal pig; 2) there were no significant differences in the SGLT1, B0AT1 and ASCT2 protein abundances in spite of their different mRNA abundances among the crypt-villus axis, suggesting unique posttranscriptional regulatory mechanisms; and 3) global protein translational efficiency, as assessed by examining some of the key protein translational initiation and elongation factors, was higher in the crypt cells than in the upper villus cells, likely playing a regulatory role for maintaining apical nutrient transporter abundances in crypt cells of the neonate. Second, we further examined the protein and mRNA abundances of jejunal neutral AA transporters B0AT1 and ASCT2 and acidic AA transporter EAAC1 during the postnatal development in pigs at the ages of d 1, 4, 6, 12, 20, 28 (1-wk post-weaning), and 70 (mature gut at grower phase), respectively. Our results showed that the jejunal apical B0AT1, ASCT2 and EAAC1 protein abundances were dramatically decreased during the postnatal development and were likely regulated at both the transcriptional and post-transcriptional levels. These substantial decreases in the small intestinal apical Na+-dependent AA transporter abundances may contribute to increased intestinal microbial catabolism of AA, which may be partially responsible for the reduced whole body efficiency of nitrogen utilization during the postnatal growth in pigs. Collectively, our results suggest that apical nutrient transporters SGLT1, B0AT1 and ASCT2 are abundantly expressed along the entire jejunal crypt-villus axis in the neonatal pig, whereas abundances of jejunal apical AA transporters EAAC1, B0AT1 and ASCT2 declined substantially during the postnatal growth in pigs.

Human milk contains ~ 25 µg/mL of soluble cluster of differentiation 14 (sCD14) protein, a pattern recognition receptor (PRR) that triggers the innate immune system to respond to bacterial lipopolysaccharide (LPS). To date, the role of CD14 in the digestive tract of breast fed infants has not been well characterized and is the subject of this thesis. To investigate the biodistribution of proteins such as CD14 in vivo, a novel method for 14C radiolabeling of proteins to high specific radioactivity was developed using in vacuo methylation. Bovine serum albumin (BSA) and casein were used as test proteins to determine the following: 1) The efficacy of the in vacuo radiolabeling procedure; 2) The extent of incorporation of the 14C-label into the organs of oro-gastric gavaged 10 day old Sprague Dawley rats. [14C]BSA, [14C]casein and [14C]CD14 were prepared with specific radioactivities of 10 400, 10 800 and 163 000 dpm/µg, respectively. After feeding 6.25 µg of 14C-labeled proteins, quantifiable levels of 14C were found in the stomach, jejunum, duodenum, ileum, large intestine, intestinal luminal flushes, blood, liver, spleen and kidneys of rats. The accumulation of radiolabel in the organs of [14C]CD14 fed rats was temporally and spatially distinct from [14C]BSA and [14C]casein. Most notably, the label persisted in the stomach 480 min post-gavage. To design a neonate animal model for biodistribution, the segmental and total gastrointestinal transit times (GItt) were measured in two litters of 10 and 15 day old Sprague Dawley rat pups using barium sulfate. Ten day old rat pups that remained with and without the dam had a total gastrointestinal transit time of 13.8 ± 0.9 hr and 9.3 ± 0.7 hr, respectively. This decrease (p<0.05) in total gastrointestinal transit time in the absence of the dam was age dependent, as it was not observed (p>0.05) in the 15 day old rat pup litter. The immunological impact of an exogenous sCD14 source was examined in human peripheral blood mononuclear cells (PBMC). Pre-treatment of CD14+ monocytes with sCD14 had a protective effect, one of reducing the production of proinflammatory cytokines (TNF-α, IL-6, IL-8, IL-1β) when challenged with LPS. 14C was absorbed by neonate rats upon ingestion of [14C]CD14 and exposure to relatively high concentrations of rCD14 led to a reduction in inflammation. This may be beneficial to initial gut colonization in breast-fed newborns. / Alexander Graham Bell NSERC CGS M scholarship. Japan Society for the Promotion of Sciences, Summer in Japan Fellowship. Funded by the Canadian Institutes of Health Research, Institute of Nutrition Metabolism and Diabetes Grant #82816 “Fate and function of breast milk and recombinant human CD14 at mammary and newborn gastrointestinal mucosal epithelia”.

Este trabalho avaliou [1] os fatores associados à ocorrência de restrição ao ganho de peso observada na alta hospsitalar e [2] a associação entre as práticas de alimentação e o ganho de peso durante a internação, em recém-nascidos prematuros de muito baixo peso de nascimento (501 a 1.499g) na maternidade do Hsopital Geral de Bonsucesso (Rio de Janeiro). Os dados foram coletados de forma retrospectiva para os nascimetnos do período compreendido entre junho de 2002 a junho de 2004. Do total de 247 recém-nascidos incluídos no estudo, 203 tiveram alta hospitalar. As características ao nascimento, asmorbidades e as práticas de alimentação foram levantadas dos prontuários de acordo com um questionário de pesquisa. O menor peso de nascimento, ser pequeno para idade gestacional-percentil 3, o maior escore CRIB e a ocorrência de sepse foram associados à ocorrência de restrição ao ganho de peso extra-uterino na alta. Das cento e cinquenta e oito crianças com peso adequado ao nascimento, sessenta e nova (43,7%) encontravam-se com peso abaixo do 3 percentil na alta. Nesses casos de restrição ao ganho de peso foram preditores: a ocorrência de sepse, de doença metabólica óssea e o maior número de transfusões sanguíneas, embora a capacidade de explicação do modelo tenha sido pequena (14%). Estas situações merecem destaque na prática neonatal, pois podem ser marcadores de um pior desempenho no que diz respeito ao ganho de peso durante a internação. Uma vez que as morbidades explicaram pouco a c]ocorrência de restrição ao ganho de peso extra-uterino, em especial os casos intrahospitalares. Foi analisada a associação entre evolução do peso nos primeiro dois meses de vida e as práticas de alimentação. Utilizando a análise de regressão longitudinal de efeitos mistos foi observado que o número de dias para o início de dieta enteral, de dias para atingir a dieta plena, de dias para início de dieta parenteral e de dias de uso de dieta parenteral, influenciaram a evolução precoce do peso (até 17 dia). O número de dias para início da dieta parenteral não influenciou a evolução do peso após o 17 dia de vida. Os resultados do presente estudo sugerem 1) que o menor peso de nascimento, ser pequeno para idade gestacional, ter maior escore CRIB e a ocorrência de sepse associam-se a ocorrência de restrição ao ganho de peso extra-uterino; 2) dentre os recém-nascidos com peso apropriado ao nascimento, a ocorrência de sepse, de doença metabólica óssea e o maior número de transfusões sanguíneas associaram-se a um pior desempenho ponderal; 3) que as práticas de alimentação decididas precocemente associam-se ao ganho de pseo intra-hospitalar e a revisão destas pode melhorar o desempenho ponderal de recém-nascidos prematuros de muito baixo peso de nascimento. / This paper evaluated [1] factors associated to weight gain restriction at discharge and [2] the association between feeding practices and weight gain during hospitalization in very low birth weight infants (501 to 1.499) at Hospital Geral de Bonsucesso (Rio de Janeiro). Data were collected from hospital charts including all births between June 2002 and June 2004. Two hundred forty-seven alive-births were included and 203 of them were discharged from hospital. Birth characteristics, illness and feeding practices were registered. A lower birth weight, small for gestational age (third percentile), a higher CRIB score and sepsis were factor associated to weight gain restriction at discharge. Among those appropriate at birth (158), sixty-nine (43.7%) children were below the third percentile at discharge. Those cases of weight gain restriction were associated to sepsis, metabolic bone disease and higher number of blood transfusions, although the model poorly explained them (14%). These illness (or exposures) may be markers of a worse weight performance during hospitalization. As morbidities poorly explain weight gain restriction at discharge, particularly the inhospital cases. We analyzed the association between feeding practices and inhospital weight gain. By using mixed effects longitudinal regression we observed that the number of days to start enteral feedings, to achieve full enteral feeding, to start parenteral nutrition and days on th parenteral nutrition were associated to the initial weight variation (until the 17day). The number of days to begin parenteral nutrition did not influence weight variation after the 17day of life. This study results suggest 1) that a lower birth weight, small for gestational age, a higher CRIB score and sepsis are associated to weight gain restriction at discharge; 2) among those appropriate at birth, the occurrence of sepsis, metabolic bone disease and higher number of blood transfusion area associated to a worse inhospital weight performance; 3) that feeding practices, decided at the first days of life influence weight gain along the hospitalization and by reviewing those practices we might improve inhospital weight performance of preterm very low birth weight infants.