This protocol outlines a neonatal mouse model of necrotizing enterocolitis (NEC) and subsequent isolation of lamina propria immune cells from the neonatal murine small intestine.
A subscription to JoVE is required to view this content. Sign in or start your free trial.
Method Article
This protocol outlines a neonatal mouse model of necrotizing enterocolitis (NEC) and subsequent isolation of lamina propria immune cells from the neonatal murine small intestine.
Necrotizing enterocolitis (NEC) is a severe inflammatory disease of the neonatal intestine, primarily affecting preterm infants. NEC is characterized by epithelial injury, microbial dysbiosis, and a dysregulated immune response, often resulting in intestinal necrosis and systemic inflammation. Experimental murine models that recapitulate the key aspects of human disease have been essential in advancing our understanding of the mechanisms that drive disease and inform therapeutic development. This protocol describes a well-established neonatal mouse model of necrotizing enterocolitis (NEC) utilizing formula feeding, intermittent hypoxia, oral administration of lipopolysaccharide (LPS), and enteric bacteria cultured from an infant with NEC. This combination reliably induces histological, transcriptional, and immunological features consistent with NEC in human infants and has been foundational in multiple key discoveries in the field. Additionally, this protocol describes the isolation of immune cells from the small intestinal lamina propria of neonatal mice. Lamina propria cell isolation enables detailed immune cell profiling via flow cytometry, facilitating analysis of both innate and adaptive cell populations within the intestine.
Necrotizing enterocolitis (NEC) is a severe inflammatory disease of the intestine that almost exclusively affects premature neonates. Approximately 7%-8% of very low birth weight infants (<1500 g) will be affected by NEC, and mortality rates associated with the disease can approach 50% in neonates that require surgical intervention1. The pathogenesis of NEC remains incompletely understood; however, current evidence suggests that NEC arises from the confluence of multiple factors, including an immature intestinal barrier, dysregulated immune signaling, and a dysbiotic microbiome2,3,4. The convergence of these factors can initiate and exacerbate inflammatory responses in the intestine, most notably through the activation of toll-like receptor 4 (TLR4), resulting in epithelial damage and various types of cell death, including apoptosis and necrosis5,6. The aim of this protocol is to present a reproducible and physiologically relevant mouse model of NEC that recapitulates the intestinal inflammation and pneumatosis intestinalis (gas within the bowel wall) observed in human neonates, enabling mechanistic investigation into disease pathogenesis. Additionally, this protocol describes the isolation of immune cells from the small intestinal lamina propria of neonatal mice, allowing researchers to perform immune cell profiling via flow cytometry.
Compared to larger animal models, such as neonatal rats or piglets7,8, neonatal mouse models offer several distinct advantages, including lower cost, greater access to transgenic animals, and the ability to perform experiments on larger cohorts. Murine NEC models primarily utilize a combination of formula feeding, cold stress, and hypoxia to simulate the complex pathophysiology of NEC observed in human patients7,8,9. However, many murine models of NEC are limited by their dependence on broad microbial stressors or artificial alterations of the microbiota, which may compromise their clinical relevance. In contrast, the model described in this protocol overcomes these limitations by integrating several key factors implicated in NEC pathogenesis in human infants10,11. Specifically, this model combines hypoxic stress, which has been implicated in disrupting intestinal barrier integrity3,12, with oral administration of infant formula supplemented with lipopolysaccharide (LPS), a well-characterized TLR4 ligand that induces intestinal inflammation, as well as clinically relevant dysbiotic microbiome with enteric bacteria cultured from a patient with NEC totalis, the most severe form of the disease, characterized by pan-necrosis of the bowel10,13. By integrating these clinically relevant and disease-specific stressors, our model accurately reflects the clinical and molecular features of NEC. Furthermore, to provide investigators with a framework to interrogate the immune-mediated mechanisms underlying NEC pathogenesis, this protocol outlines the isolation of lamina propria cells from the neonatal murine small intestine for flow cytometry analysis. As the principal site of intestinal mucosal immune activity, the lamina propria contains a dynamic repertoire of resident and infiltrating immune cells that play a central role in NEC-associated inflammation14. Flow cytometry provides a robust and scalable platform for characterizing these immune cell populations with high resolution, enabling detailed analysis of cellular phenotypes, quantification of immune responses, and identification of immunologic signatures implicated in NEC pathogenesis15.
The murine NEC model outlined in this protocol complements in vitro models by enabling the study of host-microbiome interactions, immune responses, and inflammatory signaling within the complex environment of the neonatal intestine. It reproduces key aspects of NEC pathogenesis that cannot be modeled in vitro, making it a valuable tool for elucidating disease mechanisms and assessing therapeutic strategies. Although species-specific differences remain a limitation, this model offers a robust and accessible platform to advance our understanding of NEC and accelerate the development of targeted interventions.
Access restricted. Please log in or start a trial to view this content.
All methods were performed in accordance with the ethical guidelines provided by the Institutional Animal Care and Use Committee (IACUC) at the University of North Carolina at Chapel Hill School of Medicine. Mice were bred, maintained, and housed according to procedures described in the Guide for the Care and Use of Laboratory Animals under a study proposal approved by the IACUC (protocol no. 24-114) of the University of North Carolina at Chapel Hill School of Medicine. C57BL/6J mice were used for all experiments described in this study. Pups were started in the model at postnatal day 4, weighing between 1.8-2.3 g; animals outside this weight range were excluded. The experimental cohorts had a balanced sex distribution, with males and females each comprising approximately 50% of the treated animals. The reagents and the equipment used are listed in the Table of Materials.
1. Murine NEC model
NOTE: Enteric bacterial stock is produced by obtaining the enteric contents from an infant who had the most severe form of NEC, NEC totalis13,16. The enteric contents are cultured overnight at 1 x g for 16 h at 37 °C, centrifuged at 3000 x g for 10 min at 4 °C, and resuspended in 50% glycerol. 20 µL aliquots are pipetted into cryovials and stored at -80 °C for long-term storage. The selected culture times in this protocol were chosen for workflow efficiency. These time points can be adjusted as needed to accommodate individual laboratory schedules without impacting the overall model. Additionally, this protocol was optimized for a maximum capacity of 40 mice, but can be scaled up as needed.
2. Lamina propria immune cell isolation
NOTE: This protocol is optimized for the isolation of lamina propria cells from neonatal mice at approximately one week of age. If reference samples are needed for spectral flow cytometry, weanlings (postnatal weeks 3-4) may be used. For weanling samples, double all reagent volumes specified in the protocol.
Access restricted. Please log in or start a trial to view this content.
The neonatal murine model of NEC described in this protocol replicates key features of the disease. Kaplan-Meier survival analysis (Figure 1A) revealed a significant reduction in survival in the NEC treatment group compared to the dam-fed controls (9/21 vs. 8/8; p = 0.0063). Gross inspection of the intestines from the mice subjected to the model (Figure 1B) demonstrated hallmark features of NEC, including intestinal distension, air bubbles, and visible ...
Access restricted. Please log in or start a trial to view this content.
This protocol integrates a physiologically relevant neonatal murine model of NEC with lamina propria immune cell isolation, providing a comprehensive platform to investigate mucosal immune responses during intestinal inflammation. By combining clinically relevant exposures, such as enteric microbiome from human NEC cases, hypoxic stress, and formula feeding, this model recapitulates the complex and multifactorial pathogenesis observed in human disease10,13. The a...
Access restricted. Please log in or start a trial to view this content.
The authors declare no conflict of interest related to this manuscript.
This manuscript was supported by R01DK124614, R01HD105301, DP1DK140012, the Chan Zuckerberg Initiative Grant number 2022-316749, the Yang Biomedical Scholar Award, and the University of North Carolina at Chapel Hill Department of Pediatrics.
Access restricted. Please log in or start a trial to view this content.
| Name | Company | Catalog Number | Comments |
|---|---|---|---|
| 1 mL Syringe-Tuberculin Slip Tip | Becton Dickinson | 309659 | Syringe for formula feeding |
| 1.5 mL semi-micro Disposable Cuvettes | BRAND GMBH + CO KG | 759085D | |
| 1.7 ml Microtubes Clear | Axygen - Corning Inc. | MCT-175-C | Nonpryogenic & Rnase-/Dnase-free |
| 5% Oxygen, Balance Nitrogen Certified Reference Material, Size 200 High Pressure Steel Cylinger, CGA 580 | Airgas | X02NI95C2003186 | |
| Anti-Mo CD16/CD32 Purified Clone: 93 | eBioscience Inc. | 14-0161-85 | |
| Anti-Mouse CD16/CD32 Purified Clone: 93 | eBioscience Inc. | 14-0161-86 | |
| APC anti-mouse Ly-6C Clone: HK1.4 Isotype: Rat IgGc | BioLegend | 128015 | |
| autoMACS Rinsing Solution | Miltenyi Biotec | 130-091-222 | |
| BB515 Rat Anti-CD11b Clone: M1/70 | BD Biosciences | 564455 | |
| BB700 Rat Anti-Mouse CD4 Clone: RM4-5 | BD Biosciences | 566408 | |
| BD Microtainer SST | Becton Dickinson | 365867 | Serum Tube |
| BIOTIX Rainin LTS Compatible Racked Filter Tips, p1200 | Fisher Scientific | 12-111-365 | |
| BIOTIX Rainin LTS Compatible Racked Filter Tips, p20 | Fisher Scientific | 12-111-366 | |
| BIOTIX Rainin LTS Compatible Racked Filter Tips, p200 | Fisher Scientific | 12-111-362 | |
| Brilliant Stain Buffer | BD Biosciences | 563795 | |
| BUV615 Rat Anti-Mouse Ly-6G Clone: 1A8 | BD Biosciences | 751263 | |
| BV650 Rat Anti-Mouse I-A/I-E Clone: M5/114.15.2 | BD Biosciences | 563415 | |
| C57BL/6J Neonatal Mice | The Jackson Laboratory | 000664 | |
| CD45-VioGreen mouse | Miltenyi Biotec | 130-102-412 | |
| CD64 Antibody, anti-mouse, PE-Vio 770, REAfinity Clone REA286 | Miltenyi Biotec | 130-119-659 | |
| CFX Opus Real-Time PC Systems | Bio-Rad | 12011319 | |
| Collagenase Type 4 | Worthington Biochemical Corporation | LS004188 | |
| DL-dithiothreitol | Sigma | D9779-5g | |
| eBioscience FOXP3/Transcription Factor Staining Buffer Set | Life Technologies Corp. | 00-5523-00 | |
| EDTA (0.5M), pH 8.0 | Quality Biological Inc | 351-027-721 | |
| Esbilac Puppy Milk Replacer | Pet-Ag, Inc. | 99502-1 | Puppy Milk |
| Fisherbrand Disposable Cuvettes | Fisher Scientific | 14-955-127 | |
| Fisherbrand Sterile Polystyrene Disposable Serological Pipets with Magnifier Stripe (paper/plastic wrap), 10mL | Fisher Scientific | 13-678-11E | |
| Fisherbrand Sterile Polystyrene Disposable Serological Pipets with Magnifier Stripe (paper/plastic wrap), 25mL | Fisher Scientific | 13-678-11 | |
| Fisherbrand Sterile Polystyrene Disposable Serological Pipets with Magnifier Stripe (paper/plastic wrap), 50mL | Fisher Scientific | 13-678-11F | |
| Fisherbrand Sterile Polystyrene Disposable Serological Pipets with Magnifier Stripe (paper/plastic wrap), 5mL | Fisher Scientific | 13-678-11D | |
| Genie Temp-Shaker 300 | USA Scientific, Inc. | SI-G1600 | |
| gentleMACS Dissociator (protocol; m_intestine-01) | Miltenyi Biotec | 130-093-235 | |
| gentleMACS C Tubes | Miltenyi Biotec | 130096334 | |
| Ghost Dye Red 780 Viability Dye | Tonbo Biosciences | 13-0865-T100 | |
| Glycerol ReagentPlus | Sigma-Aldrich | G7757-500ML | |
| GraphPad Prims Software, Version 10.0 | GraphPad | N/A | |
| Greiner Bio-One Round Bottom Polypropylene Culture Tube with Two-Position Vent Stopper | Fisher Scientific | 07-000-212 | |
| Handi+ Oxygen analyzer | Maxtec | N/A | |
| Hanks' Balanced Salt Solution | Gibco | 141650-095 | |
| HEPES Buffer | Mediatech, Inc. | 25-060-CI | |
| Hypoxia Chamber | Billups-Rothenburg, Inc. | N/A | |
| ImageJ | Schneider et al., 2012 | N/A | |
| Integra Miltex MeisterHand Iris Scissors, 10.2cm | Fisher Scientific | 12-460-655 | |
| Integra Miltex MeisterHand Iris Scissors, 9cm | Fisher Scientific | 12-460-598 | |
| Integra Miltex™ Swiss Jeweler-Style Forceps | Fisher Scientific | 12-460-110 | |
| Isolette Infant Incubator | Air-Shields Vickers | C100-200-2 Series 02 | Incubator for mice |
| Kimtech Science Kimwipes Delicate Task Wipes | Kimberly-Clark | 34120 | |
| LPS | Sigma-Aldrich | L3129-10mg | |
| Luria Broth Broth, Miller Molecular Genetics Powder | Fisher Scientific | BP1426-500 | |
| MACS BSA Stock Solution | Miltenyi Biotec | 130-091-376 | |
| MACSmix Tube Rotator | Miltenyi Biotec | 130-090-753 | |
| Microcentrifuge Tubes | Thermo Scientific | 3451 | 1.5 ml, clear, graduated, sterile |
| NanoDrop OneC Microvolume UV-Vis Spectrophotometer | ThermoFisher Scientific | ND-ONEC-W | |
| Ohaus scout portable balance | Fisher Scientific | 30253024 | |
| Paraformaldehyde | Thermo Scientific | J61899.AK | |
| PE Rat Anti-Mouse TIM-4 Clone: RMT4-54 | BD Biosciences | 564147 | |
| PE-CF594Rat Anti-Mouse CD24 Clone:M1/69 | BD Biosciences | 562477 | |
| Peripherally Inserted Central Catheter, 1.9 French, Single-Lumen | Utah Medical Products, Inc. | P-2S | A single-lumen silicone peripherallly inserted central catheter. |
| Phosphate buffered saline (PBS) | Gibco | 10010023 | |
| Quick-RNA MicroPrep kit | Zymo Research | R1051 | |
| Rainin pipette - 1000 uL | Rainin | 17014382 | |
| Rainin pipette - 200 uL | Rainin | 17014390 | |
| Rainin pippette - 20 uL | Rainin | 17014392 | |
| RB780 Hamster Anti-Mouse CD11c Clone: HL3 | BD Biosciences | 755338 | |
| RPMI Medium 1640 (1x) | Gibco | 11875-093 | |
| Similac Advance | Abbott Nutrition | 53363 | Baby Formula |
| Sorvall ST8R Centrifuge | Fisher Scientific | 75007200 | |
| SsoAdvanced Universal SYBR Green Supermix | Bio-Rad | 1725271 | |
| Straight, fine, sharp point sciessors | Miltex Instruments | MH5-300 | |
| T100 Thermocycler | Bio-Rad | 621BR71229 | |
| Thermo Scientific Nunc 50mL Conical Sterile Polypropylene Centrifuge Tubes, blue racks | Fisher Scientific | 12-565-271 | |
| Thermo Scientific S1 Pipet Fillers | Fisher Scientific | 14387166 | |
| Tissue Culture Flask | Fischer Scientific | FB012937 | 75 cm2 , Vented cap, TC treated, Sterile |
| True-Stain Monocyte Blocker | BioLegend | 426102 | |
| Two Stage Brass 0-50 psi General Purpose Cylinder Regulator | Airgas | Y12215B580-AG | |
| Vortex-Genie 2 | USA Scientific, Inc. | NC9864336 | |
| World Precision Instrument Iris Forceps, 10cm, Curved, Serrated, German | Fisher Scientific | 50-822-332 | |
| World Precision Instrument Iris Forceps, 10cm, Straight, Serrated | Fisher Scientific | 50-822-329 | |
| ZymoScript RT PreMix Kit | Zymo Research | R3012 | |
| Primers | |||
| Sequence | |||
| Cxcl2 (Mouse) forward primer for quantitative PCR | Integrated DNA Technologies | CCAGACAGAAGTCATAGCCACT | |
| Cxcl2 (Mouse) reverse primer for quantitative PCR | Integrated DNA Technologies | GGCACATCAGGTACGATCCA | |
| Il1b (Mouse) forward primer for quantitative PCR | Integrated DNA Technologies | AGTGTGGATCCCAAGCAATACCCA | |
| Il1b (Mouse) reverse primer for quantitative PCR | Integrated DNA Technologies | TGTCCTGACCACTGTTGTTTCCCA | |
| LCN2 (Mouse) forward primer for quantitative PCR | Integrated DNA Technologies | GACTTCCGGAGCGATCAGTT | |
| LCN2 (Mouse) reverse primer for quantitative PCR | Integrated DNA Technologies | CTGTACCTGAGGATACCTGTGC |
Access restricted. Please log in or start a trial to view this content.