Evaluation of melatonin and prostaglandin El combination on necrotizing enterocolitis model in neonatal rats

Background: Necrotizing enterocolitis (NEC) is one of the most common gastrointestinal emergencies in newborn infants but up to now there is no completely effective treatment for it. Objective: In order to show that a combination of melatonin and prostaglandins may be useful to save lives, we use newborn rat as a model of necrotizing enterocolitis to test the hypothesis of using the combination therapy might have more potential effect on mucosal cytoprotection and healing. Patients and methods: A total of 60 newborn pups from 5 time-mated Sprague-Dawley pregnant rats were divided equally into 5 groups as follows: NEC (subjected to NEC), NEC + Melatonin, NEC + Prostaglandin, NEC + Prostaglandin + Melatonin and control. These animals were fed with hyperosmolar formula 3 times daily and subjected to 100% CO2 inhalation for 10 min, +4 degrees C cold exposure for 5 min, and 97% O-2 for 5 min twice daily to induce NEC. This procedure was applied to the pups for 3 days. Results: The macroscopic scoring, intestinal injury scoring and apoptosis index scoring were all found to be significantly lower in NEC + Prostaglandin + Melatonin group compared with NEC group. Anti-oxidant enzyme activities were significantly higher, whereas lipid peroxidation was significantly lower in NEC + Prostaglandin + Melatonin group compared with NEC group. Conclusion: This combination therapy showed cytoprotective and healing effects on mucosa in the intestinal tissue of rat pups in necrotizing enterocolitis model. Therefore, this therapy might also show benefit in preterm infants with NEC. After confirmation of this data by other clinical and experimental studies, it may be a novel therapeutic option for the prevention of NEC in preterm infants