Dimethyloxalylglycine preserves the intestinal microvasculature and protects against intestinal injury in a neonatal mouse NEC model: role of VEGF signaling

BACKGROUND: NEC is a devastating neonatal disease characterized by intestinal necrosis. Hypoxia inducible factor-1α (HIF-1α) plays a critical role in cellular oxygen homeostasis. Here, we hypothesized that prolyl hydroxylase (PHD) inhibition, which stabilizes HIF-1α, protects against NEC by promoting intestinal endothelial cell proliferation and improving intestinal microvascular integrity via VEGF signaling. METHODS: To assess the role of PHD inhibition in a neonatal mouse NEC model, we administered DMOG or vehicle to pups prior to or during the NEC protocol, and determined mortality and incidence of severe intestinal injury. We assessed intestinal VEGF by Western blot and quantified endothelial cell and epithelial cell proliferation following immunofluorescence. RESULTS: DMOG decreased mortality and incidence of severe NEC, increased intestinal VEGF expression, and increased intestinal villus endothelial and epithelial cell proliferation in experimental NEC. Inhibiting VEGFR2 signaling eliminated DMOG’s protective effect on intestinal injury severity, survival, and endothelial cell proliferation while sparing DMOG’s protective effect on intestinal epithelial cell proliferation. CONCLUSION: DMOG upregulates intestinal VEGF, promotes endothelial cell proliferation and protects against intestinal injury and mortality in experimental NEC in a VEGFR2-dependent manner. DMOG’s protective effect on the neonatal intestinal mucosa may be mediated via VEGFR-2 dependent improvement of the intestinal microvasculature.