Engineered Colons: Medicine's Next Big Thing?


Did you know that every two weeks your intestine completely regenerates its lining itself? It's because of this incredible regenerative capacity that doctors believe intestines are the perfect organ to re-grow.

At 18 weeks pregnant, Stacy Lara was told something was terribly wrong with her son.

"He had quite a bit of bowel outside of his abdomen," says Nathan’s Mother Stacy Lara.

Nathan had a birth defect that caused his intestine to grow outside of his body.

"He really only has a few inches of intestines, whereas baby this age would normally have maybe six-to-eight feet of intestine," explains Russ Merritt, MD, PhD, the Medical Director of Intestinal Rehabilitation Program at Children's Hospital Los Angeles.

For Nathan that means a lifetime of being fed through a tube or a transplant, but Dr. Tracy Grikscheit hopes a discovery in her lab can change the prognosis for Nathan and other children like him.

"We've been able to show that we can make every part of the gastrointestinal tract,” explains Tracy Grikscheit, MD, a Principal Investigator at the Saban Research Institute at the Children's Hospital Los Angeles. “We can make esophagus, stomach, small intestine, and colon."

After children have surgery, doctors take tissue from the waste left over and then re-grow the cells in the lab, within months an organ can be made. Grikscheit says it would eliminate risk of organ rejection and a lifetime of medication.

"If we were able to make engineered intestine from your own cells, it would be part of you, grow with you. It would self-repair," says Dr. Grikscheit.

It is a medical breakthrough that could have patients healing themselves.

MEDICAL BREAKTHROUGHS
RESEARCH SUMMARY

TOPIC: Engineered Colons: Medicine's Next Big Thing?
REPORT: MB # 3646

BACKGROUND: Sometimes children are born without portions of their intestines. One cause of this is necrotizing enterocolitis (NEC). NEC is a gastrointestinal disease that affects mostly premature infants. It involves infections and inflammation that causes destruction of the bowel (intestine) or part of the bowel. NEC is the most common and serious gastrointestinal disorder among hospitalized preemies. However, it affects only one in 2,000 to 4,000 premature births. It usually occurs the first couple weeks of life. Around ten percent of babies weighing less than 3 lbs., 5 oz. (1,500 grams) have NEC. (Source: www.kidshealth.org)

CAUSES: The cause of NEC is unknown, but a theory is that the intestinal tissues of premature infants are weakened by too little oxygen or blood flow. When feedings start, the added stress of food moving through the intestine allows bacteria normally found in the intestine to invade and damage the wall of the intestinal tissues. The damage can affect a short segment of the intestine or can progress quickly to involve a larger portion. Infants are unable to continue feedings. They can also develop imbalances in the minerals in the blood. In severe cases of NEC, a hole can develop in the intestine, which allows bacteria to leak into the abdomen. Some experts believe that the makeup of infant formula, the immaturity of the mucous membranes in the intestines, and the rate of delivery of the formula can cause NEC. Babies who are fed breast milk can also develop NEC, but the risk is lower. Another theory is that babies born through difficult deliveries with lowered oxygen levels can develop NEC. When babies don't have enough oxygen, their bodies will send the available oxygen and blood to vital organs instead of the gastrointestinal tract, resulting in NEC. Babies with an increased number of red blood cells also seem to be at an increased risk for developing NEC. Too many red blood cells can thicken the blood and hinder the transport of oxygen to the intestines. (Source: www.kidshealth.org)

NEW TECHNOLOGY: Current treatment involves surgery to remove the affected portions of the intestine, or if the condition is severe, an intestinal transplant may be necessary. Both options come with significant problems. If the intestine is too short, it could be unable to perform its functions. Also, any transplant comes with sever risks. Patients who get intestinal transplants are on anti-rejection medications for the rest of their lives. The medications affect the immune system, causing infants to be more prone to other illnesses. However, researchers at Children's Hospital Los Angeles have successfully grown a tissue-engineered human colon. The concept is still in its early stages, but their goal is to offer alternative treatment for children who are born without portions of their intestine, or who require surgery to have portions of their intestine removed. Tracy Grikscheit, MD, Principal Investigator at The Saban Research Institute and Surgeon at Children's Hospital Los Angeles, used the patient's own stem cells from the intestine to regrow portions of the colon. Now, they used the procedure to regrow small amounts of the small intestine, a process that takes four weeks. Dr. Grikscheit received a $3.4 million grant to fund the steps required before the first trial can take place for engineered intestines. One of the steps will be to define characteristics of patients who would have the most success form the procedures. (Source: http://www.dailynews.com/marathon/ci_22341148/tissue-engineered-colon-will-help-treat-children)

FOR MORE INFORMATION, PLEASE CONTACT:

Ellin Kavanagh
Associate Director of Research Communication
The Saban Research Institute of
Children's Hospital Los Angeles
(323) 361-8505
ekavanagh@chla.usc.edu

If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Céline McArthur at cmcarthur@ivanhoe.com.


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